title: Associations of sedentary time and patterns of sedentary time accumulation with health-related quality of life in colorectal cancer survivors.
abstract: Sedentary behavior (sitting/lying at low energy expenditure while awake) is emerging as an important risk factor that may compromise the health-related quality of life (HRQoL) of colorectal cancer (CRC) survivors. We examined associations of sedentary time with HRQoL in CRC survivors, 2-10 years post-diagnosis. In a cross-sectional study, stage I-III CRC survivors (n = 145) diagnosed (2002-2010) at Maastricht University Medical Center+, the Netherlands, wore the thigh-mounted MOX activity monitor 24 h/day for seven consecutive days. HRQoL outcomes were assessed by validated questionnaires (EORTC QLQ-C30, WHODAS II, Checklist Individual Strength, and Hospital Anxiety and Depression Scale). Confounder-adjusted linear regression models were used to estimate associations with HRQoL outcomes of MOX-derived total and prolonged sedentary time (in prolonged sedentary bouts ≥ 30 min), and usual sedentary bout duration, corrected for waking wear time. On average, participants spent 10.2 h/day sedentary (SD, 1.6), and 4.5 h/day in prolonged sedentary time (2.3). Mean usual sedentary bout duration was 27.3 min (SD, 16.8). Greater total and prolonged sedentary time, and longer usual sedentary bout duration were associated with significantly (P < 0.05) lower physical functioning, and higher disability and fatigue scores. Greater prolonged sedentary time and longer usual sedentary bout duration also showed significant associations with lower global quality of life and role functioning. Associations with distress and social functioning were non-significant. Sedentary time was cross-sectionally associated with poorer HRQoL outcomes in CRC survivors. Prospective studies are needed to investigate whether sedentary time reduction is a potential target for lifestyle interventions aiming to improve the HRQoL of CRC survivors.
authors.affiliation: Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Eline H
authors.initials: EH
authors.lastname: van Roekel
authors.affiliation: The University of Queensland, School of Population Health, Herston Road, Herston, Qld 4006, Australia.
authors.forename: Elisabeth A H
authors.initials: EA
authors.lastname: Winkler
authors.affiliation: Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Martijn J L
authors.initials: MJ
authors.lastname: Bours
authors.affiliation: Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic 3004, Australia; Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic 3010, Australia; Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, P.O. Box 6492, Melbourne, Vic 3004, Australia.
authors.forename: Brigid M
authors.initials: BM
authors.lastname: Lynch
authors.affiliation: Department of Human Movement Science, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Paul J B
authors.initials: PJ
authors.lastname: Willems
authors.affiliation: Department of Human Movement Science, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Meijer
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Ijmert
authors.initials: I
authors.lastname: Kant
authors.affiliation: Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Geerard L
authors.initials: GL
authors.lastname: Beets
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sanduleanu
authors.affiliation: The University of Queensland, School of Population Health, Herston Road, Herston, Qld 4006, Australia; Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, P.O. Box 6492, Melbourne, Vic 3004, Australia; School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
authors.forename: Genevieve N
authors.initials: GN
authors.lastname: Healy
authors.affiliation: Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Matty P
authors.initials: MP
authors.lastname: Weijenberg
keywords: BMI, body mass index; CI, confidence interval; CIS, Checklist Individual Strength; CRC, colorectal cancer; Colorectal Neoplasms; EORTC QLQ-C30, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30; EnCoRe study, Energy for life after ColoRectal cancer study; HADS, Hospital Anxiety and Depression Scale; HRQoL, health-related quality of life; ICF, International Classification of Functioning, Disability and Health; MET, metabolic equivalent; MVPA, moderate-to-vigorous physical activity; Quality of Life; SD, standard deviation; Sedentary Lifestyle; Survivors; WHO, World Health Organization; WHODAS II, 12-item World Health Organization Disability Assessment Schedule II; β, unstandardized regression coefficient