Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer

E. H. van Roekel*, J. Duchateau, M. J. L. Bours, L. van Delden, J. J. L. Breedveld-Peters, J. L. Koole, M. Kenkhuis, P. A. van den Brandt, R. L. Jansen, I. Kant, V. Lima Passos, K. Meijer, S. O. Breukink, M. L. G. Janssen-Heijnen, E. Keulen, M. P. Weijenberg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose Evidence from cross-sectional studies suggests that higher levels of light-intensity physical activity (LPA) are associated with better health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. However, these associations have not been investigated in longitudinal studies that provide the opportunity to analyse how within-individual changes in LPA affect HRQoL. We investigated longitudinal associations of LPA with HRQoL outcomes in CRC survivors, from 6 weeks to 2 years post-treatment. Methods Data were used of a prospective cohort study among 325 stage I-III CRC survivors (67% men, mean age: 67 years), recruited between 2012 and 2016. Validated questionnaires were used to assess hours/week of LPA (SQUASH) and HRQoL outcomes (EORTC QLQ-C30, Checklist Individual Strength) at 6 weeks, and 6, 12 and 24 months post-treatment. We applied linear mixed regression to analyse longitudinal confounder-adjusted associations of LPA with HRQoL. Results We observed statistically significant longitudinal associations between more LPA and better global quality of life and physical, role and social functioning, and less fatigue over time. Intra-individual analysis showed that within-person increases in LPA (per 8 h/week) were related to improved HRQoL, including better global quality of life (beta = 1.67, 95% CI 0.71; 2.63; total range scale: 0-100) and less fatigue (beta = - 1.22, 95% CI - 2.37; - 0.07; scale: 20-140). Stratified analyses indicated stronger associations among participants below the median of moderate-to-vigorous physical activity (MVPA) at diagnosis. Conclusion Higher levels of LPA were longitudinally associated with better HRQoL and less fatigue in CRC survivors up to two years post-treatment. Further prospective studies using accelerometer data are necessary to inform development of interventions targeting LPA.

Original languageEnglish
Pages (from-to)2987-2998
Number of pages12
JournalQuality of Life Research
Issue number11
Early online date2 Jul 2020
Publication statusPublished - Nov 2020


  • Colorectal cancer survivor
  • Light-intensity physical activity
  • Longitudinal
  • Health-related quality of life
  • Functioning
  • Fatigue
  • HEAD

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