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Physical activity in people diagnosed with cancer: a rapid review of recommendations and critical appraisal of international guidelines

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Abstract

Purpose

There are numerous guidelines that recommend physical activity (PA) in people diagnosed with cancer, but the quality of these guidelines is unknown. The aim of this study was to identify existing PA guidelines for cancer survivors, describe the recommendations, and assess their methodology quality.

Methods

A rapid review of the literature was conducted in PubMed and EMBASE, supplemented by a search of the grey literature. The methodological quality of the guidelines was assessed using the AGREE II checklist. A descriptive synthesis of the recommendations from guidelines judged to be of good quality has been performed.

Results

A total of nine guidelines published between 2006 and 2019 were included. Of nine guidelines, five achieved a high enough AGREE II score and were judged to be of good quality for use in clinical practice. We found that the recommendations from the five guidelines converged on the prescription of supervised PA (aerobic and resistance exercise) of at least 75 min per week of high intensity or 150 min per week of moderate intensity, spread over two to five sessions per week, equating to a PA dose between 8.70 and 17.5 MET.h/week. The recommendations were applicable to address the most common side effects of cancer and its treatment, namely fatigue, lymphedema, anxiety, depressive symptoms, health-related quality of life (QoL), survival, and physical function. However, no guideline recommends PA to improve other cancer-related outcomes, such as cognitive impairment, falls, sexual function, and peripheral neuropathy frequently experienced by cancer survivors. No guideline also referred to work outcomes (i.e., work ability, return to work, etc.).

Conclusion

Most PA guidelines for cancer survivors are of good quality. However, specific PA guidelines are needed for a given cancer site (e.g., location, stage), at a particular phase of the cancer trajectory, and for specific outcomes including return to work (RTW) in order to tailor PA to each cancer survivor.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This manuscript was prepared as part of the SIRIC ILIAD program funded by the French National Cancer Institute (INCa), the French Ministry of Health, and the Institute of Health and Medical Research (Inserm), INCa-DGOS-INSERM-ITMO Cancer_18011.

Têtê Norbert Wilson received a scholarship from the Togolese government and the non-profit organization Grain de Sel Togo, Inc., for his Ph.D. research. 

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Authors and Affiliations

  1. Univ Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000, Angers, France

    Têtê Norbert Wilson, Yves Roquelaure & Bertrand Porro

  2. Grain de Sel Togo, Inc., Athens, USA

    Têtê Norbert Wilson

  3. Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000, Angers, France

    Yves Roquelaure

  4. Washington University in St. Louis, School of Medicine, St. Louis, USA

    Bradley Evanoff

  5. INRS (Institut National de Recherche et de Sécurité), Direction des Etudes et de la Recherche, 1 rue du Morvan, CS60027, 54519, Vandœuvre-lès-Nancy, France

    Agnès Aublet-Cuvelier

  6. Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest (ICO), 49055, Angers, France

    Bertrand Porro

Authors
  1. Têtê Norbert Wilson
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  4. Agnès Aublet-Cuvelier
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Contributions

TNW: designed and planned the study, developed the search strategy, screened guidelines for eligibility, extracted and analyzed the data, interpreted the results, and drafted the manuscript. YR, BE, AAC: designed and planned the study, coordinated all stages of the study, critically revised the methodological and scientific aspects of the manuscript. BP: designed and planned the study, contributed to the quality assessment of guidelines, critically revised the methodological and scientific aspects of the manuscript. All authors read and approved the final manuscript.”

Corresponding author

Correspondence to Têtê Norbert Wilson.

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Ethical approval and consent to participate

Ethical approval and patient consent are not required for this study as it is based on secondary data and does not directly involve human participants. The study was conducted in accordance with the ethical standards of the National Consultative Ethics Committee, the 1964 Declaration of Helsinki, and its subsequent amendments or comparable ethical standards.

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The authors have no conflicts of interest to disclose in relation to the content of this article.

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Wilson, T.N., Roquelaure, Y., Evanoff, B. et al. Physical activity in people diagnosed with cancer: a rapid review of recommendations and critical appraisal of international guidelines. Support Care Cancer 31, 679 (2023). https://doi.org/10.1007/s00520-023-08123-5

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