Cardiorespiratory Fitness, Physical Activity, Walking Speed, Lack of Participation in Leisure Activities, and Lung Cancer Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Lung Cancer

Lee J. Cancer Nurs 2020.


BACKGROUND: Lung cancer (LC) is the most common cause of death in cancer patients. The influence of cardiorespiratory fitness (CF) and physical activity (PA) on LC mortality has not previously been investigated.

OBJECTIVE: The aim of this study was to investigate through a meta-analysis the associations among CF, PA, walking speed, or leisure activity, and LC mortality and all-cause mortality.

METHODS: MEDLINE and EMBASE were used to select relevant studies from January 2000 to August 2019. A total of 6 037 058 study subjects from 11 prospective cohort studies were included in this meta-analysis. Pooled relative risks were calculated using fixed and random-effects models to estimate the associations between CF and PA, and LC mortality. In addition, a subgroup analysis was conducted to investigate associations between walking speed and leisure activity, and LC morality.

RESULTS: Greater than 9.45 metabolic equivalents of CF was associated with reduced LC mortality, compared with low-level CF. Participating in more than 150 minutes per week of PA reduced LC mortality. Slower and same walking speed were associated with increased all-cause mortality compared with age-matched individuals. Finally, moderately inactive and inactive levels of leisure activity increased all-cause mortality.

CONCLUSIONS: Moderate to high CF and PA were each associated with reduced risks of LC mortality. In addition, slower and same walking speed, and moderately inactive and inactive levels of leisure activity were each associated with increased risks of all-cause mortality.

IMPLICATIONS FOR PRACTICE: Greater than 9.45 metabolic equivalents of CF, more than 150 minutes per week of PA, fast walking speed, and keeping active should be recommended to increase LC patient survivorship.