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Review
. 2017;13(5):370-401.
doi: 10.1007/s11888-017-0386-1. Epub 2017 Sep 14.

Lifestyle after Colorectal Cancer Diagnosis in Relation to Survival and Recurrence: A Review of the Literature

Moniek van Zutphen  1 , Ellen Kampman  1 , Edward L Giovannucci  2 , Fränzel J B van Duijnhoven  1
Affiliations
Review

Lifestyle after Colorectal Cancer Diagnosis in Relation to Survival and Recurrence: A Review of the Literature

Moniek van Zutphen et al. Curr Colorectal Cancer Rep. 2017.

Abstract

Purpose of review: This review summarizes the evidence regarding diet, physical activity, smoking, and body composition after colorectal cancer (CRC) diagnosis in relation to all-cause and CRC-specific mortality and disease recurrence and gives suggestions for future research directions.

Recent findings: Overall, this review suggests that some, albeit not all, of the well-known modifiable risk factors for cancer incidence might also be associated with CRC survival. CRC prognosis appears to be worse with increased physical inactivity, smoking, or being underweight after CRC diagnosis. Emerging evidence suggests that diets associated with a positive energy balance, e.g., high consumption of sugar-sweetened beverages, may negatively impact survival in CRC survivors. In contrast, there is currently little evidence to support the recommendation to limit red and processed meat or alcohol intake after CRC diagnosis. Whether being overweight and obese after CRC diagnosis improves or worsens CRC prognosis remains controversial and may depend on the measure used to assess body fatness.

Summary: Further research on post-diagnosis lifestyle patterns is needed to understand the multifactorial influence on CRC prognosis. Disease recurrence and the development of comorbidities should be included as key outcomes in future studies and lifestyle should preferably be repeatedly measured.

Keywords: Alcohol; Body composition; Body mass index; Colorectal cancer; Diet; Lifestyle; Physical activity; Sedentary behavior; Smoking; Survival.

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Conflict of interest statement

Conflict of Interest

Moniek van Zutphen has received research support through a grant from the Dutch Cancer Society. Ellen Kampman declares that she has no conflict of interest. Edward L. Giovannucci declares that he has no conflict of interest. Fränzel J.B. van Duijnhoven declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
Schematic diagram of identification of three study categories based on the characteristics of the included study population. Based on the study population, studies were categorized into (1) population-based studies including all incident colorectal cancer cases, (2) studies in the adjuvant setting limited to survivors treated with adjuvant therapy, and (3) studies in the metastatic setting limited to metastatic patients. In each study category, we identified studies with lifestyle information available at or after colorectal cancer diagnosis. Studies with lifestyle information limited to the period before colorectal cancer diagnosis, either collected prospectively before diagnosis or retrospectively after diagnosis, were not taken into account
Fig. 2
Fig. 2
Overview of the number of included relevant articles on diet, physical activity, smoking and body mass index (BMI) or body composition at or after colorectal cancer diagnosis in relation to all-cause mortality, cancer-specific mortality, or disease recurrence by type of included study population. In total, 57 articles were included: 54 articles reported on one exposure, two articles reported on both physical activity and BMI, and one article reported on all four exposures
See this image and copyright information in PMC

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