Analysis of the association of physical activity with survival in colon cancer in two GALGB trials

Colon cancer patients have inferior overall survival when compared with a matched general population (MGP). It is unknown whether physical activity is associated with a reduction in this survival disparity. CALGB 89803 and 80702 were postoperative treatment trials in stage III colon cancer, with 2876 patients who self-reported physical activity. Physical activity in the trial was converted to metabolic equivalents (MET-hours/week). The MGP data were derived from the National Center for Health Statistics, and matched on age, sex, and year. In CALGB 89803, among patients who were alive at 3 years, those with <3.0 and ≥ 18.0 MET-hours/week had subsequent 3-year overall survival rates that were -17.1% (95% CI -22.4 to -11.8) and -3.5% (-7.07 to 0.3) lower than MGP, respectively. In CALGB 80702, among patients who were alive at 3 years, those with <3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were -10.8% (95% CI -15.4 to -6.9) and -4.4%( -7.6 to -1.6) lower that MGP, respectively. In pooled analyses, among patients who were alive and did not have tumor recurrence by year 3, those with <3.0 and ≥ 18.0 MET-hours/week had subsequent 3-year overall survival rates that were -3.1 (95% CI -6.2 to -0.3) and 2.9% (1.5 to 4.2) higher than MGP, respectively. The authors conclude that physical activity is associated with an attenuation of the survival disparity between patients with stage III colon cancer participating in clinical trials and MGP. Colon cancer survivors who are physically active may achieve survival that approximates survival of the MGP.