Grading the evidence for physical activity and any outcome in cancer survivors: An Umbrella review of 740 meta-analytic associations.
Level 1 - systematic review of randomized trials
Umbrella review of systematic reviews and meta-analyses
PubMed 39730034 · doi:10.1016/j.critrevonc.2024.104602
What was done
Medline and Scopus were searched in January 2024 for systematic reviews and meta-analyses evaluating any type of physical activity across all cancer survivor populations and outcomes. Statistically significant meta-analyses were graded into four categories (strong, highly suggestive, suggestive, weak) using pre-established criteria.
What was found
The authors reviewed 102 publications covering 740 meta-analytic associations: breast (n = 427), prostate (n = 104), colorectal (n = 79), hematological (n = 58), and lung (n = 54) cancer. While 401 associations (54%) were nominally statistically significant, only 16 were graded as strong, 10 as highly suggestive, and 93 as suggestive. Strong or highly suggestive evidence supported post-diagnosis physical activity for reduced all-cause mortality (breast, colorectal), lower recurrence (breast), reduced fatigue (breast, prostate), reduced depression (breast), improved mental health, strength, aerobic capacity, and weight loss (breast), improved cardiovascular fitness and quality of life (prostate), and reduced hospital length of stay with preoperative breathing exercises and physical activity (lung).
Why it matters
This umbrella review synthesizes a vast exercise oncology literature to pinpoint which specific clinical and functional benefits have high-certainty meta-analytic support, enabling more targeted cancer-specific exercise prescriptions.
Limits
The abstract does not report numerical effect sizes, relative risks, or confidence intervals. The evidence base is heavily skewed toward breast cancer (over 57% of all associations), with comparatively little robust evidence for other cancers like hematological malignancies. As an umbrella review, conclusions depend on the methodological rigor and potential biases of the underlying meta-analyses.
Cited by
- supports Epidemiological studies show that cancer patients who report more exercise have a lower risk of disease recurrence and a lower risk of dying from cancer.