title: Physical Activity and Survival After Prostate Cancer.
abstract: Despite the high global prevalence of prostate cancer (PCa), few epidemiologic studies have assessed physical activity in relation to PCa survival.
  
  
  
  To evaluate different types, intensities, and timing of physical activity relative to PCa survival.
  
  
  
  A prospective study was conducted in Alberta, Canada, in a cohort of 830 stage II-IV incident PCa cases diagnosed between 1997 and 2000 with follow-up to 2014 (up to 17 yr). Prediagnosis lifetime activity was self-reported at diagnosis. Postdiagnosis activity was self-reported up to three times during follow-up.
  
  
  
  Cox proportional hazards models related physical activity to all-cause and PCa-specific deaths and to first recurrence/progression of PCa.
  
  
  
  A total of 458 deaths, 170 PCa-specific deaths, and, after first follow-up, 239 first recurrences/progressions occurred. Postdiagnosis total activity (>119 vs ≤42 metabolic equivalent [MET]-hours/week per year) was associated with a significantly lower all-cause mortality risk (hazard ratio [HR]: 0.58; 95% confidence interval [CI], 0.42-0.79; p value for trend <0.01). Postdiagnosis recreational activity (>26 vs ≤4 MET-hours/week per year) was associated with a significantly lower PCa-specific mortality risk (HR: 0.56; 95% CI, 0.35-0.90; p value for trend = 0.01). Sustained recreational activity before and after diagnosis (>18-20 vs <7-8 MET-hours/week per year) was associated with a lower risk of all-cause mortality (HR: 0.66; 95% CI, 0.49-0.88). Limitations included generalisability to healthier cases and an observational study design.
  
  
  
  These findings support emerging recommendations to increase physical activity after the diagnosis of PCa and would inform a future exercise intervention trial examining PCa outcomes.
  
  
  
  In a 17-yr prostate cancer (PCa) survival study, men who survived at least 2 yr who were more physically active postdiagnosis or performed more recreational physical activity before and after diagnosis survived longer. Recreational physical activity after diagnosis was associated with a lower risk of PCa death.
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: christine.friedenreich@albertahealthservices.ca.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Friedenreich
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Qinggang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Heather K
authors.initials: HK
authors.lastname: Neilson
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Mathematics and Statistics, Faculty of Science, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Kopciuk
authors.affiliation: Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Population, Public and Aboriginal Health, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: S Elizabeth
authors.initials: SE
authors.lastname: McGregor
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D002423:Cause of Death; D018450:Disease Progression; D015444:Exercise / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D055686:Metabolic Equivalent; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D011998:Recreation / Q000502:physiology; D057566:Self Report; D015996:Survival Rate
keywords: Physical activity; Prospective cohort; Prostate cancer; Sedentary behaviour; Survival analysis