Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 27;38(1):239.
doi: 10.1007/s00384-023-04536-0.

Association of pre-diagnostic physical exercise and peri-diagnostic body composition with mortality in non-metastatic colorectal cancer

David Renman  1 , Bethany van Guelpen  2   3 , Fredrick Anderson  2 , Jan Axelsson  4 , Katrine Riklund  5 , Karin Strigård  6 , Richard Palmqvist  7 , Ulf Gunnarsson  6 , Björn Gylling  7
Affiliations

Association of pre-diagnostic physical exercise and peri-diagnostic body composition with mortality in non-metastatic colorectal cancer

David Renman et al. Int J Colorectal Dis. .

Abstract

Purpose: Sarcopenia and myosteatosis, quantified via computed tomography (CT), are associated with poor colorectal cancer outcomes. These body composition estimates can be influenced by physical exercise. We explored the correlation between pre-diagnostic physical exercise, body composition close to diagnosis, and the combined prognosis impact of these factors.

Methods: We studied 519 stage I-III colorectal cancer (CRC) cases diagnosed 2000-2016 with pre-diagnostic self-reported recreational physical exercise data collected in the prospective, population-based Northern Sweden Health and Disease Study, and CT-estimated skeletal muscle index (SMI) or skeletal muscle density (SMD). Risk estimates were calculated by multivariable logistic regression and Cox proportional hazards models.

Results: No association was seen between low pre-diagnostic physical exercise and sarcopenia/myosteatosis in the multivariable model adjusted for age, sex, educational level, tumor stage, and tumor location. In multivariable Cox regression models, the combination of low pre-diagnostic physical exercise and either sarcopenia or myosteatosis at the time of diagnosis was associated with cancer-specific mortality compared to the reference group of high physical exercise combined with no sarcopenia/myosteatosis (adjusted HR 1.94 95% CI 1.00-3.76 for sarcopenia and adjusted HR 2.39 95% CI 1.16-4.94 for myosteatosis).

Conclusions: The combined presence of low pre-diagnostic physical exercise and sarcopenia or myosteatosis was associated with increased CRC-specific mortality. Despite the positive effect on prognosis, physical exercise did not alter body composition estimates at diagnosis, which could indicate attenuation from other factors.

Keywords: Colorectal cancer; Exercise; Myosteatosis; Physical activity; Sarcopenia.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study population and exclusions. CRC, colorectal cancer; CT, computed tomography; MRI, Magnetic resonance imaging; SMI, skeletal muscle index; SMD, skeletal muscle density
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Qiu S, Jiang C, Zhou L. Physical activity and mortality in patients with colorectal cancer: a meta-analysis of prospective cohort studies. Eur J Cancer Prev. 2020;29(1):15–26. doi: 10.1097/CEJ.0000000000000511. - DOI - PubMed
    1. Goodpaster BH et al (2008) Effects of physical activity on strength and skeletal muscle fat infiltration in older adults: a randomized controlled trial. J Appl Physiol 105(5):1498–1503 - PMC - PubMed
    1. Steffl M, et al. Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis. Clin Interv Aging. 2017;12:835–845. doi: 10.2147/CIA.S132940. - DOI - PMC - PubMed
    1. Beaudart C, et al. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS ONE. 2017;12(1):e0169548. doi: 10.1371/journal.pone.0169548. - DOI - PMC - PubMed
    1. Trejo-Avila M, et al. Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis. 2021;36(6):1077–1096. doi: 10.1007/s00384-021-03839-4. - DOI - PubMed