
==== Front
Br J Cancer
Br J Cancer
British Journal of Cancer
0007-0920
1532-1827
Nature Publishing Group UK London

38926526
2748
10.1038/s41416-024-02748-x
Review Article
The Physical Activity and Cancer Control (PACC) framework: update on the evidence, guidelines, and future research priorities
http://orcid.org/0000-0002-1698-6666
Yang Lin 12
http://orcid.org/0000-0002-9677-3918
Courneya Kerry S. 3
http://orcid.org/0000-0002-4783-1966
Friedenreich Christine M. Christine.friedenreich@ahs.ca

12
1 https://ror.org/02nt5es71 grid.413574.0 0000 0001 0693 8815 Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB Canada
2 https://ror.org/03yjb2x39 grid.22072.35 0000 0004 1936 7697 Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
3 https://ror.org/0160cpw27 grid.17089.37 Faculty of Kinesiology, Sport and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB Canada
27 6 2024
27 6 2024
5 10 2024
131 6 957969
15 3 2024
22 5 2024
3 6 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by/4.0/ Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Background

We proposed the Physical Activity and Cancer Control (PACC) framework in 2007 to help organise, focus, and stimulate research on physical activity in eight cancer control categories: prevention, detection, treatment preparation/coping, treatment coping/effectiveness, recovery/rehabilitation, disease prevention/health promotion, palliation, and survival.

Methods

This perspective paper provides a high-level overview of the scientific advances in physical activity research across cancer control categories, summarises current guidelines, updates the PACC framework, identifies remaining and emerging knowledge gaps, and provides future research directions.

Results

Many scientific advances have been made that are reflected in updated physical activity guidelines for six of the cancer control categories apart from detection and palliation. Nevertheless, the minimal and optimal type, dose, and timing of physical activity across cancer control categories remain unknown, especially for the understudied population subgroups defined by cancer type, age, race/ethnicity, and resource level of regions/countries.

Conclusion

To achieve the full benefit of physical activity in cancer control, future research should use innovative study designs that include diverse at-risk populations and understudied cancer sites. Additionally, effective behaviour change strategies are needed to increase physical activity levels across populations that use implementation science to accelerate the translation from evidence generation into practical, real-world interventions.

Subject terms

Cancer epidemiology
Cancer prevention
issue-copyright-statement© Springer Nature Limited 2024
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pmcIntroduction

The cancer care continuum is a multi-phase, sometimes cyclic process that may include multiple treatment modalities, cancer progression, recurrence and new primary cancers and that necessitates a range of cancer control categories depending on various factors including the patient and setting [1]. While the major focus in cancer treatment and care has been on clinical interventions, only in the past few decades has the role of lifestyle factors, including dietary intake and physical activity, been considered in cancer control. The first research studies that examined how physical activity could be involved in cancer etiology were published in early 1980s with limited research until the 1990s. Given that this field was relatively new and unstructured, we were motivated to publish an organizational framework for research on physical activity across the cancer experience (PEACE) to help provide structure to this emerging research area [2]. In 2007, we updated that framework with the Physical Activity and Cancer Control (PACC) framework [3] to organize, focus, and stimulate further research on physical activity and cancer control (Fig. 1). Eight cancer control categories (eight populations at risk) on the cancer care continuum were specified in the PACC framework in six cancer-related time periods including two pre-diagnosis (prevention, detection) and four post-diagnosis (pre-treatment, treatment, survivorship and end of life). This framework has been seminal in structuring and focusing research on physical activity in cancer control to specific time points.Fig. 1 Physical Activity and Cancer Control (PACC) framework (reproduced from [3]a).

aThis article was published in Seminars Oncology Nursing journal, Copyright Elsevier (2007).

The purpose of this review paper was to assess the current state of scientific evidence on physical activity across the entire cancer continuum from prevention to survival to identify: 1) existing knowledge gaps; 2) opportunities for future research and 3) needs for further physical activity/exercise guideline development. We conducted a narrative review to assess the updated current evidence of the role of physical activity in cancer control in accordance with the PACC framework (Supplementary Materials). We searched for published systematic reviews in physical activity/exercise and cancer control in the past five years in MEDLINE by March 19, 2023, and updated the search on April 27, 2024. When systematic reviews were not available for a component of the PACC framework, we included the most current literature based on our literature search to identify and assess the emerging evidence and to identify future research directions.

Throughout this review paper, we use the term “physical activity” which includes all forms of movement done in occupational, recreational, household and transportation settings. For post-diagnosis components of the PACC framework (e.g., before, during and after treatment) where research studies frequently investigated exercise interventions, the focus of the evidence review is mainly on “exercise” which is a subset of physical activity that is planned, structured, and done repeatedly to improve or maintain physical fitness. Herein we describe the current state of evidence on physical activity by cancer control category followed by a summary of the current physical activity guidelines. We then identify the gaps in knowledge and identify priority areas for future research.

Evidence review

Physical activity and cancer prevention

The body of evidence on the etiologic role of physical activity in cancer prevention has markedly increased since 2007, when colon, breast, endometrial, prostate and lung were the main cancer sites that had been investigated [3]. The evidence on risk reduction for cancer of the gallbladder, liver, kidney, small intestine, myeloid leukemia, myeloma, and non-Hodgkin lymphoma is now accumulating [4]. Highest vs. lowest leisure-time physical activity was associated with a relative cancer risk reduction ranging between 8 to 25%, with the level of evidence deemed strong for bladder, breast, colon, endometrium, esophagus, gastric and renal, moderate for lung, and limited for hematologic, head and neck, ovary, pancreas, prostate, brain, thyroid and rectal cancer [5]. Recent review articles have also begun to synthesize evidence for understudied cancer types and different dimensions of physical activity, reporting inconsistent associations between physical activity and risk of testicular cancer [6], lower risk in colon (26%) but higher risk (115%) in lung cancer associated with occupational physical activity [7, 8], lower risk in endometrial, colon and breast cancers associated with transport-related physical activity (1–9%) [9] and lifetime physical activity (18–25%) [10], lower risk in colon and breast cancers associated with physical activity at young age (19–33%) [10]; and have examined potential risk stratifications by menopausal status [11] and by family history for breast [12] and colorectal cancer [13], and potential biological mechanisms involved for breast cancer [14, 15].

It is worth noting that nearly all research evidence on physical activity for cancer prevention is from observational epidemiologic studies given the cost, feasibility and time requirements that would be required for randomized controlled trials. To the best of our knowledge, no randomized controlled exercise trials reported cancer incidence as the primary endpoint. Consequently, the focus has been on exercise intervention trials that have examined hypothesized biological pathways [16, 17] that could explain how physical activity reduces the risk of developing cancer. Observational studies have suggested the relationship between physical activity and specific cancer risk differs by the magnitude of the relative risk reduction as well as the shape of the dose-response [18]. Leisure-time physical activity within the recommended level (7.5–15 MET hours/week) was associated with 6–29% risk reduction among several cancers, including colon, breast, endometrial, kidney, myeloma, liver and non-Hodgkin lymphoma (in women). Beyond the recommended level, physical activity continued to further reduce risk in some but not all cancers, likely suggesting fundamental differences in the underlying biological mechanisms for different cancer types [18]. However, the number of trials testing the minimal and optimal dose (type, frequency, intensity, and duration) of exercise for cancer prevention remains small [19–23]. Additionally, these trials have focused primarily on aerobic exercise with only a limited emphasis on resistance (i.e., muscle strengthening activity) as well.

Muscle-strengthening activities are not well captured by self-reported questionnaire or accelerometer-based devices that are commonly used in large cohort studies. A small body of evidence from observational studies found muscle-strengthening activity was associated with inconsistent findings for the risk of colon and bladder cancer [24–27], reduced risks for kidney cancer [24–26], and limited evidence regarding the risks for cancers of the lung, pancreas, prostate and rectal [26]. Muscle-strengthening activities involving major muscle groups could influence metabolic function [28], inflammation [29], and sex hormones [30–32], which are biological mechanisms associated with developing cancer [33]. Currently, it is unknown whether muscle-strengthening activity alone, or combined with aerobic activity, contributes to cancer risk reduction.

Sedentary behavior, independent of physical activity, has been associated with an increased risk of colon, endometrial and lung cancer [34]. Sedentary behavior is hypothesized to operate through the metabolic function pathway to influence cancer risk [33]. Given the methodologic limitations in measuring the bouts and duration of sedentary behavior at the population level and the lack of available intervention tools to interrupt or reduce sedentary behavior, generating observational or interventional data to examine and elucidate the potential relationship between sedentary behavior and cancer risk remains limited.

Physical activity and cancer detection

Limited research has examined the role of physical activity on cancer detection. Physical activity has at least two ways to influence cancer detection: 1) indirectly by influencing cancer screening behavior (i.e., higher uptake of cancer screening which could result in an early stage at diagnosis), and 2) directly by influencing the sensitivity and/or specificity of cancer screening tests [3]. Several studies indicated that physical activity, among other lifestyle behaviors, was associated with higher uptake of colorectal screening [35, 36]. Observational studies that examined cancer stage at diagnosis found physical activity was associated with higher odds of late-stage lung cancer diagnosis [37] and no association with stage at breast cancer diagnosis [38]. With respect to cancer screening tests, observational and intervention studies have found no association between physical activity and mammographic density [39–42]. Meanwhile, physical activity, especially acute exercise may increase serum prostate-specific antigen (PSA) concentration [43, 44] leading to false PSA levels, but habitual physical activity may be associated with lower PSA concentration [45]. More recently, a case study reported that the supervision of exercise may be a cancer detection test for metastatic disease by uncovering symptoms that suggest recurrence or metastatic spread such as pain, neurological issues, or functional issues [46]. These “exercise-detected” symptoms may allow for earlier detection of recurrence or metastatic spread.

Physical activity and treatment preparation/coping

Using physical activity as preparation to increase readiness prior to cancer treatment, or cancer prehabilitation, has gained significant clinical interest [47]. The concept of “prehabilitationc” was first scientifically documented in 1946, in a non-clinical setting, as a total body exercise training program that the British Army developed to increase the physical health of young recruits, i.e., to qualify for conscription [48]. In the oncology setting, physical activity for cancer prehabilitation has the potential to: 1) improve physical health to endure or become eligible for cancer treatment, 2) improve psychological health to cope with the diagnosis and impending cancer treatment, 3) prevent treatment-induced toxicities and improve treatment completion and recovery, and 4) influence the tumor biology and microenvironment directly to improve treatment efficacy or delay the need for treatment. Over 30 review articles have been published on the topic of physical activity for cancer prehabilitation. Existing systematic reviews were mostly focused on: selective cancer sites (majority in lung cancer surgery) [49–60], cancer site-specific treatment side-effects [61–63], or selective exercise intervention modalities (HIIT or combined aerobic and resistance training) [64–67]. Importantly, many prehabilitation studies included cancer patients undergoing neoadjuvant therapy [49, 51–53, 67–72] or undergoing other systematic therapies (chemotherapy and radiation therapy) [73, 74], which overlaps with the cancer control category of physical activity and treatment effectiveness/coping. While the combination of patients before and during treatment does not allow for investigation into physical activity and cancer control category-specific outcomes, both cancer control categories are situated in the clinical setting, i.e., likely using similar or overlapping intervention delivery strategies/pathways.

Given the relatively small volume of primary research in treatment preparation/coping, it is not surprising that findings from previous systematic reviews were inconclusive. Our recent scoping review reports that the number of primary studies on physical activity for cancer prehabilitation consists of 32 interventions and 12 observational studies using heterogeneous intervention designs and physical activity assessments [75]. All previous studies on physical activity and cancer prehabilitation enrolled patients waiting for planned cancer treatment, therefore it is unknown whether physical activity may influence treatment decision especially in settings where multiple treatment options exist. Prehabilitation exercise appears to improve health-related fitness but the evidence to improve clinical outcomes is lacking [75]. Notably, nearly all studies conducted in the oncology setting to investigate the role of physical activity for prehabilitation have focused on surgical treatment, presenting a major knowledge gap and opportunities to increase evidence generation and translation to realize the full potential benefits of physical activity to prepare cancer patients facing non-surgical treatment modalities.

Physical activity and treatment effectiveness/coping

Many randomized controlled trials have been conducted in this cancer control category testing exercise dose in accordance with the generic physical activity guidelines. For example, for cancer patients undergoing curative treatment, there is evidence from over 70 systematic reviews of exercise interventions. Notably, the endpoints of these interventions were largely patient-oriented instead of oncologic outcomes, i.e., improved fatigue, cardiorespiratory fitness, muscle strength, physical function, body composition, quality of life, depression and anxiety, sleep, and cognitive function. Physical activity may influence treatment effectiveness/coping through: 1) a direct effect on tumor growth and metastasis, 2) improved treatment completion rate, 3) improved treatment efficacy, 4) managing treatment-induced toxicities, and 5) improved physical, psychosocial outcomes and quality of life. However, most of these hypothesized effects have not been fully investigated.

In this cancer control category, exercise interventions remain exploring feasibility measures in different treatment settings [76, 77], understanding the potential to prevent cardiotoxicity [78–80], and accumulating data on physical, psychosocial outcomes and quality of life [81, 82]. Limited data are available on the impact of exercise intervention on “treatment effectiveness”, such as chemotherapy completion or dose intensity, cancer treatment response, or cancer progression, recurrence and survival [83]. Furthermore, there is significant heterogeneity across exercise intervention studies in their study designs, interventions, and study populations making it difficult to recommend the minimal and optimal type and dose of physical activity during cancer treatment. Nevertheless, interest is growing to investigate exercise as a cancer treatment; considerations related to observational and experimental study designs for specific clinical oncology settings have been detailed elsewhere [84, 85].

Another important consideration in, but not limited to, this cancer control category is the potential harm of exercise. A recent systematic review and meta-analysis included 129 published and unpublished controlled trials comparing exercise interventions versus usual care in adults with cancer scheduled to undergo systemic treatment to synthesize evidence on adverse events, health-care utilization, and treatment tolerability and response [86]. This meta-analysis reported higher risks of serious adverse events, thromboses, and fracture, lower risk of fever, and higher relative dose intensity of systemic treatment in intervention versus control. Their findings indicated uncertainty regarding the harms of exercise in cancer patients undergoing systemic treatment, and concluded that insufficient data existed on the harms to make evidence-based risk-benefit assessments of the application of structured exercise in this population.

Physical activity and cancer survivorship (recovery/rehabilitation and disease prevention/health promotion)

Many systematic reviews have been published on the topic of physical activity and cancer survivorship which includes the two cancer control categories of “recovery/rehabilitation” and “disease prevention/health promotion”. Separating research conducted in these two cancer control categories is difficult because of the lack of clear definitions for patient characteristics and outcome assessment. “Recover” defined by the US National Cancer Institute is “to become well and healthy again” [87], and “rehabilitation” is defined as “a process to restore mental and/or physical abilities lost due to injury or disease, in order to function in a normal or near-normal way” [88]. Hence, the recovery/rehabilitation category is the acute phase (within six months) after treatment completion [3] with the goal for cancer patients to regain function and reach normalcy. Therefore, the goals of physical activity after cancer treatment completion for recovery/rehabilitation are to: 1) reduce acute treatment toxicities, 2) improve physical function, 3) improve psychosocial outcomes, to 4) improve quality of life and regain normalcy. With respect to “health promotion”, defined by WHO as “the process of enabling people to increase control over, and to improve, their health”, and “disease prevention”, the focus is on specific efforts aimed at reducing the development and severity of chronic disease and other morbidities [89, 90]. Therefore, the goals of physical activity after cancer treatment completion for disease prevention/health promotion are to: 1) manage long-term and late effects of cancer and cancer treatment, 2) improve psychosocial outcomes and quality of life, 3) reduce the risks of chronic diseases, and 4) reduce the risk of cancer recurrence, and a second primary cancer. Accordingly, we updated the PACC framework to include specific outcomes and intervention settings for each cancer control category (Fig. 2).Fig. 2 Updated physical activity and cancer control framework.

Over 1000 exercise trials have been conducted to examine the effect of exercise on outcomes during the post-treatment survivorship period. Nevertheless, common cancers such as breast [91, 92], prostate [93–95], colorectal [96, 97], and lung cancers [98, 99] are heavily investigated, some studies on childhood cancers [100, 101], while there is a paucity of data on less common cancers [102] including survivors of adolescent and young adult cancer [103]. Admittedly, the potential feasibility of this type of trial is low in less common cancers, especially when randomized controlled trials tend to be designed and powered to generate evidence on a single primary outcome [104, 105]. Even for cancer types/sites that are more frequently investigated, few data are available on the effect of physical activity on chronic disease risks among cancer survivors. A few reviews summarized the positive effect of exercise on the cardiovascular system [106], C-reactive protein as an inflammatory biomarker [107], blood lipid profile [108], fasting insulin levels [109], and metabolic function [110] among breast cancer survivors as biologic pathways involved in physical activity and breast cancer outcomes. These biologic pathways also operate on the development of chronic disease among cancer survivors. Cancer treatment can exacerbate the existing comorbidities and increase the risk of new comorbidities in cancer survivors [111, 112], many of which can be potentially prevented and managed by physical activity. Currently, the natural history of comorbidities in relation to physical activity is largely unknown in cancer survivors, representing a clear gap of future studies to inform the timing, type, frequency, intensity, and duration of physical activity that should be considered in exercise interventions aiming at disease prevention.

Although most identified systematic reviews remain focused on synthesizing the effect of exercise on acute, long-term, and late effect of cancer, several reviews have begun to explore how to design physical activity behavior change interventions among cancer survivors [113–123] including digital approach [124]. These intervention designs include both clinical [125, 126] and community [127–131] settings, but have mostly used individual-based approaches. Typical strategies of health promotion and disease prevention are population-based interventions that aim to address social determinants and health inequity simultaneously [90]. However, how to design population-based interventions with evidence-based risk stratification strategies that target cancer-specific outcomes remains unknown.

Physical activity and palliation

Palliative care aims to improve quality of life and help reduce pain in people who have a serious or life-threatening disease [132]. The body of literature on physical activity in the cancer palliation setting is increasing yet remains limited. The largest most recently published systematic review identified 22 exercise interventions explicitly in the cancer palliative care setting that improved quality of life, health-related fitness and fatigue [133–135]. Other reviews reported similar benefits of exercise interventions among patients with advanced cancer [136–145] or with cancer metastasis [146–149] on physical and psychological health and quality of life outcomes. The 2007 PACC framework proposed that in the palliative care setting, physical activity may help cancer survivors manage symptoms, improve mobility, slow functional decline, and maintain quality of life at the end of life [3]. Importantly, the survival of certain advanced cancers has improved to the point where a diagnosis of advanced cancer is no longer an acute “end of life” phase [150]. In addition, early palliative care may even prolong cancer survival [151]. While exercise appears feasible in this setting, more evidence is needed to understand the potential benefits and harms of physical activity in patients diagnosed with advanced cancer, especially those with bone metastases [152]. More importantly, given the potential of palliative care to prolong cancer survival, further research in physical activity and cancer palliation should consider clinical outcomes such as disease progression and metastasis [84]. Given the severe symptoms associated with advanced cancer and its treatment, such as fatigue, pain and muscle wasting, exercise trials in this population are more challenging and should consider the physical and psychological capability of cancer survivors to avoid exacerbating any symptoms and mental distress.

Physical activity and survival

There is limited to moderate evidence for physical activity to reduce cancer-specific and all-cause mortality for breast, colorectal and prostate cancer [5]. Notably, the mortality risk reduction associated with physical activity is estimated to range between 30% for cancer-specific mortality and 32% reduced risk of all-cause mortality [153]. A few ongoing randomized controlled trials are examining the effect of exercise intervention on survival outcomes among colorectal [154] and prostate [155] cancer survivors. Given the challenges in cost, recruitment and time requirements in such trials, the minimal and optimal type and dose of exercise to improve cancer survival remains unknown. One large scale, on-going observational study in breast cancer is assessing physical activity, sedentary behavior and health-related fitness using both direct measurements as well as self-report to examine the association with survival outcomes with greater precision [156, 157]. In addition, the effect of exercise on inflammatory, insulin, and metabolic pathways involved in physical activity and cancer survival is hypothesized [110], however, current evidence is limited to select high risk populations, or to monitor the biologic response to exercise among cancer survivors. This topic area is being assessed in some of the on-going trials and observational studies [154–156, 158].

Physical activity guidelines

As the evidence base on physical activity in cancer control has accumulated, national and international agencies have developed and updated their physical activity guidelines. With more targeted research, it has also been possible to begin developing more specific guidelines for the cancer control categories with some developed for all but cancer detection and palliation. We have included examples of current guidelines that provided recommendations on quantified physical activity/exercise and cancer in each of the cancer control categories (Table 1).Table 1 Examples of international guidelines/recommendations/position statements on physical activity and exercise across the cancer control categories.

Cancer control category	Guidelines/recommendations/position statement	
Prevention	ACS, HHS, WCRF: 150–300 min of moderate-intensity aerobic activity, 75–150 min of vigorous aerobic activity, or an equivalent combination of each intensity each week.	
Detection	None	
Treatment preparation/coping	ASCO: may recommend preoperative exercise for patients undergoing surgery for lung cancer.	
Treatment coping/effectiveness	ACS, ACSM, ASCO: 150–300 min/week of moderate-intensity activity or 75–150 min/week vigorous-intensity activity or a combination of the two intensities, and muscle-strengthening two or more days per week to improve quality of life during treatment.	
Recovery/rehabilitation	ACSM: 150 min/week aerobic exercise and twice weekly strength training to manage the acute, long-term and late effect of cancer.	
Disease prevention/health promotion	ACSM: 150 min/week aerobic exercise and twice weekly strength training to manage the acute, long-term and late effect of cancer.	
Palliation	None	
Survival	ACS, ACSM: 150–300 min/week of moderate-intensity activity or 75–150 min/week vigorous-intensity activity or a combination of the two intensities, and muscle-strengthening two or more days per week to improve survival for during long-term disease-free living or stable disease.	
ACS American Society of Cancer, ASCO American Society of Clinical Oncology, ACSM The American College of Sports Medicine, HHS U.S. Department of Health and Human Services, WCRF World Cancer Research Fund International.

Cancer prevention

For physical activity and cancer prevention, the World Cancer Research Fund (WCRF) [159] in 2018 recommended that adults be active daily and do at last 150 min of moderate physical activity or at least 75 min of vigorous physical a week which aligned with the 2008 Physical Activity Guidelines for Americans [160] and the 2010 World Health Organization’s (WHO) guidelines on physical activity [161]. The 2018 Physical Activity Guidelines for Americans updated their recommendation to 150 to 300 min of moderate-intensity aerobic activity, 75–150 min of vigorous aerobic activity, or an equivalent combination of each intensity each week for cancer prevention, which were adopted by the 2020 American Cancer Society (ACS) guidelines for reducing the risk of developing cancer [162] and the 2020 World Health Organization’s (WHO) recommendation [163]. These updated guidelines have recognized that more physical activity (i.e., up to 300 min/week) confers additional benefits whilst emphasizing that benefits are also attained at 150–300 min of weekly activity. Generic physical activity guidelines, e.g., those of the WHO [163], or USA [164], recommend twice-weekly muscle-strengthening activity in addition to aerobic activity for health promotion and the prevention of other chronic disease such as cardiovascular disease and Type 2 diabetes [163]. Muscle-strengthening activity, however, is currently not included in cancer prevention guidelines because of the lack of evidence. Another physical activity related recommendation in generic physical activity guidelines [163] is to limit sedentary behavior, which is not currently included in guidelines specific to cancer prevention.

Cancer treatment

The American College of Sports Medicine (ACSM) published updated exercise guidelines for cancer survivors during and after treatment in 2019 [102]. In 2022, the American Society of Clinical Oncology (ASCO) developed guidelines stating that oncology providers should recommend regular aerobic and resistance (muscle-strengthening) exercise for patients during active treatment with curative intent and preoperative exercise for patients undergoing surgery for lung cancer [165]. Similar guidelines have been developed for activity during and after treatment in several other countries worldwide (e.g. Australia, UK) [166, 167].

The 2019 ACSM updated exercise guidelines for cancer survivors stated that exercise training was generally safe and well tolerated during and after cancer treatment, and recommended 150 min/week aerobic exercise and twice weekly strength training to manage the acute, long-term and late effects of cancer [102]. More specific guidelines were provided for particular symptoms and side effects including fatigue, anxiety, depression, and sleep quality [102].

The 2022 American Cancer Society (ACS) nutrition and physical activity guidelines [168] for cancer survivors agreed with the WHO 2020 guidelines for populations with chronic disease. Both organizations currently recommend 150–300 min/week of moderate-intensity activity or 75–150 min/week vigorous-intensity activity or a combination of the two intensities, and muscle-strengthening two or more days per week. These recommendations are aimed at improving quality of life during cancer treatment and long-term survivorship for survivors who are disease-free or have stable disease [168].

Cancer survivorship

The ACSM 2019 guidelines were developed based on evidence generated from randomized controlled trials that examined the effect of exercise on a list of cancer-related health outcomes with a high degree of clinical relevance [102]. It is important to note that these outcomes of acute, long-term and late effects of cancer have variable trajectories [169].

Consequently, the randomized controlled trials in the evidence syntheses included cancer survivors at both recovery/rehabilitation and disease prevention/health promotion categories.

For cancer survivors who are disease-free or living with stable disease, the 2022 ACS guidelines recommend physical activity to reduce cancer-specific and all-cause mortality for specific cancer types (breast, upper aerodigestive and digestive system, genitourinary, gynecologic, lung, hematological, and childhood cancer survivors) [168]. Besides evidence on survival, the ACS guidelines attempted to synthesize evidence on physical activity and the risk of cancer recurrence and a second cancer [168]. Currently, there is preliminary evidence synthesized from two randomized controlled trials on physical activity to reduce the risk of breast cancer recurrence [170], but in general there is no data on other cancer sites/types or the risk of a second primary cancer.

Future research

This review of the current state of evidence on the role of physical activity in cancer control has revealed that evidence has accumulated unevenly across the cancer continuum with most evidence on cancer prevention, during cancer treatment, and rehabilitation; moderate research on cancer survival; and only limited evidence in cancer detection and palliation. Furthermore, across all cancer control categories in the PACC framework, it remains unknown which populations may benefit the most from physical activity to improve cancer-related outcomes and the minimal and optimal type, frequency, intensity, and duration of physical activity to achieve such benefits (Table 2). Substantial biological and behavioral heterogeneities exist within populations in terms of how they respond to physical activity. Some initial research has been conducted demonstrating the potential effect of physical activity on colorectal cancer risk reduction irrespective of cancer genetic predisposition [171]. Much more observational and intervention epidemiologic research is required to understand the biologic mechanisms whereby physical activity may reduce cancer risk and to identify biologic markers that could be used to identify, monitor, and evaluate individuals who could benefit from physical activity. Thus far, most of the existing evidence and guidelines have been derived from and pertain to high-income countries. While the level of physical activity remains higher in low- and middle-income countries than in high income countries [172], there is a global trend of declining physical activity that was exacerbated by the COVID-19 pandemic [173]. Future research is needed in low- and middle-income countries to refine the evidence of cancer prevention and control in relation to physical activity and to reverse this declining trend. In addition, programs and policies that are targeted, relevant, and feasible in these low- and middle-income countries are needed that will encourage physical activity and reverse the declining levels of activity that accompany industrialization.Table 2 Cancer outcomes and future directions in physical activity and cancer control.

	Outcomes with evidence	Future directions	
Prevention	Cancer risk, cancer stage, cancer subtype.	Role of muscle strengthening activity in cancer risk reduction

Biological mechanisms involved in physical activity and cancer risk

Evidence on physical activity and risk reduction for rare cancers

	
Detection		Effect of physical activity on cancer screening behavior

Effect of physical activity on sensitivity and/or specificity of cancer screening tests

	
Treatment preparation/coping	Health-related fitness in some cancers, postoperative length of hospital stays and complication in lung cancer.	Effect of physical activity on postsurgical complications

Effect of physical activity on length of hospital stay

Evidence on physical activity during treatment preparation/coping in non-surgical settings

Effect of physical activity on treatment-induced toxicities prevention

Effect of physical activity on tumor biology and microenvironment

Effect of physical activity on treatment completion and efficacy

Effect of physical activity on treatment delay and/or avoidance

	
Treatment coping/effectiveness	Health-related fitness, cancer symptom management, cancer and treatment related side effects.	Effect of physical activity on treatment-induced toxicities management

Effect of physical activity on tumor biology and microenvironment

Effect of physical activity on treatment completion and efficacy

	
Recovery/rehabilitation	Health-related fitness, cancer symptom management, cancer and treatment related side effects.	Evidence on physical activity during recovery/rehabilitation in less common cancers	
Disease prevention/health promotion	Health-related fitness, cancer symptom management, cancer and treatment related late effects.	Effect of physical activity on cancer recurrence and a second primary cancer

Effect of physical activity on the risk of other chronic diseases

Evidence on physical activity during disease prevention/health promotion in less common cancers

	
Palliation	Health-related fitness, cancer symptom management, cancer and treatment related late effects.	Effect of physical activity on the risk of disease progression and cancer metastases	
Survival	All-cause and cancer specific survival in breast, prostate and colorectal cancers.	Effect of physical activity on other disease-specific survival

Biological mechanisms involved in physical activity and survival outcomes

Evidence on physical activity and survival in other cancers

	
All cancer control categories	Evidence generation

• What are the optimal types, frequencies, intensities, and durations of physical activity for improved outcomes in cancer prevention and control?

• What is the role of sedentary behavior in cancer prevention and control?

• How can we improve the precision of intervention content (risk-stratification to identify population subgroups with the greatest gain from physical activity intervention)?

• How can we improve the precision of intervention delivery (implementation model personalized to individuals interacting with the complex social system)?

• How do we design and test interventions in populations to increase their physical activity when we have limited evidence accumulated because these populations have individual, physical, environmental, and financial barriers to increasing physical activity?

	
	Evidence translation

• How should we use a whole-systems approach to develop population behavior change interventions?

• How do we identify and engage key stakeholders by setting (clinical and/or community)?

• Is there a logic model for intervention delivery to inform process measures that we could incorporate in trial implementation, monitoring, and evaluation?

	
Health-related fitness: cardiorespiratory fitness, muscular strength and endurance, body composition, flexibility.

Cancer symptoms, side effects and late effects of cancer: including but not limited to anxiety, bone health, cardiotoxicity, chemotherapy-induced peripheral neuropathy, cognitive function, depression symptoms, falls, fatigue, health-related quality of life, lymphedema, nausea, pain, physical function, sexual function, sleep, treatment tolerance.

Observational research

Observational studies are the cornerstone to generate evidence that can inform exercise dose in interventional studies [174, 175]. It is important to understand the minimal and optimal dose of exercise that can benefit targeted outcomes for individuals diagnosed with cancer, who face multi-faceted demands and time constraints. Many exercise interventions for cancer survivors follow the generic physical activity guidelines. There is a paucity of data generated from observational studies that is specific to cancer survivors. The effect of physical activity on the range of cancer, health-related, and healthcare utilization outcomes, is particularly unexplored in the three most clinically relevant cancer control categories: treatment preparation/coping, treatment coping/effectiveness, and palliation. Thus, generating this evidence is critical to inform the optimal design of clinical exercise programs.

Intervention research

Clinical exercise trials that use experimental designs can serve a range of purposes to test the effect of physical activity on a specific outcome, to investigate the underlying biological mechanisms, to determine the optimal dose of exercise intervention, or to compare different exercise modalities to address causality in physical activity and cancer control. Given the accumulating evidence supporting the benefits of exercise on patient-centered outcomes and the current knowledge gaps, more intervention studies after diagnosis are needed in under-studied patient populations that are adequately powered to examine clinically important outcomes (such as treatment efficacy, recurrence, and survival) and to explore the heterogeneity in patient behavioral and biological responses to exercise. This research is needed before more definitive and targeted guidelines can be developed for health care providers to prescribe exercise to cancer patients and survivors.

Sustaining physical activity is challenging, which makes the investigation into long-term physical activity interventions and cancer outcomes extremely challenging. Effective intervention design should consider two domains of precision: 1) the intervention content (i.e., type and dose of physical activity specific to cancer-related outcomes) and the intervention delivery (i.e., individuals interacting with the complex social system). Hence, behavior change research is required to understand the behavioral mechanisms involved in exercise intervention delivery for cancer survivors. Behavior change techniques targeting individual and structural barriers to increase physical activity, ideally, should be fully integrated into clinical exercise trials in the oncology setting to enhance the intervention fidelity.

Future intervention studies should also consider adequate adverse event reporting for risk-benefit assessments, particularly among patients with high symptom burdens. Currently, adverse event tracking tools exist in the oncology setting, such as the European Organisation for Research and Treatment of Cancer (EORTC) Item Library for patient-reported outcomes and the Common Terminology Criteria for Adverse Events (CTCAE) for clinician reporting [176]; however their application in exercise trials is yet to be standardized.

Meanwhile, modern societies continue to become increasingly sedentary [177]. One important factor contributing to this sedentary trend was the sole focus on increasing structured, moderate-to-vigorous intensity physical activity in previous interventions [178]. Such interventions were indeed useful for socially advantaged populations but likely widened the equity gap between high resource populations and those facing barriers related to social and environmental constraints created by limited time, affordability, access to facilities, and low neighborhood walkability [179]. Novel approaches such as home-based interventions addressing the social and environment determinants of physical activity are needed to narrow the equity gap between high and low resource populations. From a behavior change perspective, interventions to increase physical activity could target sedentary behavior to interrupt prolonged sitting to increase physical activity. Developing tools and methods to assess domain-specific physical activity (including both aerobic and muscle-strengthening activities) and sedentary behavior at the population level, as well as intervention tools to interrupt and reduce sedentary behavior, are necessary to begin generating efficacy evidence on the cancer prevention potential of targeting sedentary behavior.

Biologic mechanisms research

Whilst some observational [180] and experimental research [19–23] has examined the underlying biologic mechanisms that are operative between physical activity and cancer control outcomes, there remains a dearth of evidence regarding these putative mechanisms. A key recommendation for future research is to embed assessments of biologic mechanisms into future observational and exercise intervention trials.

Translational research

Primary prevention is arguably the most challenging timepoint in the cancer care continuum for translating from evidence to implementation because of the inherent difficulties in evaluating effective interventions aimed at reducing cancer incidence in the population [181]. Cancer prevention requires a sufficient evidence base, political will to fund programs to address the prevention potential, and a social strategy or plan by which we apply our knowledge to initiate or improve programs [182]. Current efficacy evidence on the role of physical activity in cancer etiology, although not yet fully elucidated, is sufficient to inform policy changes and to develop strategies for population health interventions to increase physical activity for primary cancer prevention. Nevertheless, evidence is lacking on how to best design interventions to increase physical activity at the population level [183]. Whilst programs for physical activity exist, chronic conditions and low resources pose physical, financial and environmental barriers to participation [184]. These barriers are remarkably common among individuals at disadvantaged socioeconomic positions who are also at higher risks of cancer and, therefore, the highest needs for behavior change. Hence, future research should consider evaluating physical activity as the endpoint in effectiveness trials that take into consideration equity parameters to fully understand the context of behavior change.

Several guidelines exist on physical activity during cancer treatment and cancer survivorship. While there remains a dearth of evidence for specific components across the cancer continuum, sufficient evidence has been accumulated for several time points across this cancer continuum. More research is needed to understand the heterogeneity in patient behavioral and biological responses to exercise in order to have individualized exercise or activity prescriptions that are tailored to the patient/survivor that take into consideration their physical abilities, tolerance to exercise, their cancer stage, status and treatment, their comorbidities, and their likelihood of responding to an exercise regimen. Whilst this objective would be the ideal endpoint, it is unlikely that such level of specificity in the evidence will be achieved in the short term. However, efforts to begin disseminating physical activity guidelines remains paramount given the clear benefits that have already been documented for physical activity after a cancer diagnosis.

In such settings, health professionals play a pivotal role in recommending physical activity to cancer patients and survivors [185]. Nevertheless, safety concerns, time constraints, and the lack of screening tools and referral resources remain barriers for exercise counseling and referral in cancer care [186]. Educational and infrastructure support with brief risk assessment and stratification tools of exercise readiness are needed to accelerate the implementation of existing guidelines. Future studies in these settings should incorporate implementation science methods to optimize the effectiveness and sustainability of the exercise program within complex treatment pathways and health system. Beyond a focus on patient-centered data, implementation process measures with healthcare providers should also be carefully considered using a mixed-methods evaluation approach to understand fully the implementation of exercise programs in the real-world condition. In addition, while exercise programs with professionals specialized in exercise in cancer care exist, this type of resource is often limited. Home-based exercise interventions and other digital exercise options with low resource demands should be developed to meet the needs of the majority of the cancer survivor population [187].

Natural experiment

While knowledge gaps remain in each of the cancer control categories, there is a strong and growing interest to develop and implement exercise programs in clinical practise [185, 188, 189]. The development of this type of intervention delivery infrastructure can also lead to the creation of natural experiments to generate further evidence on changes in cancer outcomes in response to exposure variations [190]. The traditional approach of translation of evidence into practice takes a linear path that typically starts from proof of concept and feasibility/pilot research, through efficacy and effectiveness studies, to dissemination and implementation trials to generate “evidence-based medicine” [191, 192]. Natural experiments, on the other hand, create the opportunity to evaluate an exercise program rigorously using existing environments, settings, infrastructure to generate “practice-based evidence” that includes all aspects of the research continuum from feasibility to implementation [191]. Such infrastructure will continue to refine the intervention content and offer efficient strategies to gather data on survivors of different types of cancer (e.g., rare cancers) and at various time points in the continuum (e.g., at treatment preparation, treatment effectiveness) that are logistically challenging to study.

Conclusion

Substantial scientific progress has been achieved in physical activity and cancer control since the publication of the updated PACC framework in 2007. The growing quantity and quality of research has informed the development and refinement of guidelines on physical activity and cancer control for prevention and survival, as well as before, during and after cancer treatment. Nonetheless, significant knowledge gaps remain, particularly in discerning the minimal and optimal dose of physical activity required for each cancer control category and in devising population-based interventions with evidence-based risk stratification strategies tailored to cancer-specific outcomes. This level of evidence is crucial to harness the potential benefit of physical activity fully in reducing the cancer burden. We provided future research directions that incorporate comprehensive monitoring of adverse events, innovative study design, and the application of implementation science to accelerate the translation from evidence generation into practical, real-world interventions.

Supplementary information

Supplemental Material clean version

Supplementary information

The online version contains supplementary material available at 10.1038/s41416-024-02748-x.

Author contributions

LY, KSC, and CMF contributed to the conceptualization. LY reviewed the literature and drafted the manuscript. LY, KSC and CMF reviewed, revised and approved the final manuscript.

Competing interests

The authors declare no competing interests.

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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References

1. Taplin SH Anhang Price R Edwards HM Foster MK Breslau ES Chollette V Introduction: Understanding and influencing multilevel factors across the cancer care continuum J Natl Cancer Inst Monogr 2012 2012 2 10 10.1093/jncimonographs/lgs008 22623590
Taplin SH, Anhang Price R, Edwards HM, Foster MK, Breslau ES, Chollette V, et al. Introduction: Understanding and influencing multilevel factors across the cancer care continuum. J Natl Cancer Inst Monogr. 2012;2012:2–10.22623590 10.1093/jncimonographs/lgs008
2. Courneya KS Friedenreich CM Framework PEACE: an organizational model for examining physical exercise across the cancer experience Ann Behav Med 2001 23 263 72 10.1207/S15324796ABM2304_5 11761343
Courneya KS, Friedenreich CM. Framework PEACE: an organizational model for examining physical exercise across the cancer experience. Ann Behav Med. 2001;23:263–72.11761343 10.1207/S15324796ABM2304_5
3. Courneya KS Friedenreich CM Physical activity and cancer control Semin Oncol Nurs 2007 23 242 52 10.1016/j.soncn.2007.08.002 18022052
Courneya KS, Friedenreich CM. Physical activity and cancer control. Semin Oncol Nurs. 2007;23:242–52.18022052 10.1016/j.soncn.2007.08.002
4. Moore SC Lee IM Weiderpass E Campbell PT Sampson JN Kitahara CM Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults JAMA Intern Med 2016 176 816 25 10.1001/jamainternmed.2016.1548 27183032
Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016;176:816–25.27183032 10.1001/jamainternmed.2016.1548
5. McTiernan A, Friedenreich CM, Katzmarzyk PT, Powell KE, Macko R, Buchner D, et al. Physical Activity in Cancer Prevention and Survival: A Systematic Review. Med Sci Sports Exerc. 2019;51:1252–61.
6. Huang S Signal V Sarfati D Shaw C Stanley J McGlynn K Physical activity and risk of testicular cancer: a systematic review BMC Cancer 2018 18 189 10.1186/s12885-018-4093-3 29444652
Huang S, Signal V, Sarfati D, Shaw C, Stanley J, McGlynn K, et al. Physical activity and risk of testicular cancer: a systematic review. BMC Cancer. 2018;18:189.29444652 10.1186/s12885-018-4093-3
7. Mahmood S MacInnis RJ English DR Karahalios A Lynch BM Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis Int J Epidemiol 2017 46 1797 813 10.1093/ije/dyx137 29025130
Mahmood S, MacInnis RJ, English DR, Karahalios A, Lynch BM. Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis. Int J Epidemiol. 2017;46:1797–813.29025130 10.1093/ije/dyx137
8. Rana B Hu L Harper A Cao C Peters C Brenner D Occupational Physical Activity and Lung Cancer Risk: A Systematic Review and Meta-Analysis Sports Med 2020 50 1637 51 10.1007/s40279-020-01312-w 32651861
Rana B, Hu L, Harper A, Cao C, Peters C, Brenner D, et al. Occupational Physical Activity and Lung Cancer Risk: A Systematic Review and Meta-Analysis. Sports Med. 2020;50:1637–51.32651861 10.1007/s40279-020-01312-w
9. Thu W Woodward A Cavadino A Tin Tin S Associations between transport modes and site-specific cancers: a systematic review and meta-analysis Environ Health 2024 23 39 10.1186/s12940-024-01081-3 38609941
Thu W, Woodward A, Cavadino A, Tin Tin S. Associations between transport modes and site-specific cancers: a systematic review and meta-analysis. Environ Health. 2024;23:39.38609941 10.1186/s12940-024-01081-3
10. Hidayat K Zhou H-J Shi B-M Influence of physical activity at a young age and lifetime physical activity on the risks of 3 obesity-related cancers: systematic review and meta-analysis of observational studies Nutr Rev 2020 78 1 18 10.1093/nutrit/nuz024 31393566
Hidayat K, Zhou H-J, Shi B-M. Influence of physical activity at a young age and lifetime physical activity on the risks of 3 obesity-related cancers: systematic review and meta-analysis of observational studies. Nutr Rev. 2020;78:1–18.31393566 10.1093/nutrit/nuz024
11. Neilson HK Farris MS Stone CR Vaska MM Brenner DR Friedenreich CM Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis Menopause 2017 24 322 44 10.1097/GME.0000000000000745 27779567
Neilson HK, Farris MS, Stone CR, Vaska MM, Brenner DR, Friedenreich CM. Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis. Menopause. 2017;24:322–44.27779567 10.1097/GME.0000000000000745
12. Cohen SY Stoll CR Anandarajah A Doering M Colditz GA Modifiable risk factors in women at high risk of breast cancer: a systematic review Breast Cancer Res 2023 25 45 10.1186/s13058-023-01636-1 37095519
Cohen SY, Stoll CR, Anandarajah A, Doering M, Colditz GA. Modifiable risk factors in women at high risk of breast cancer: a systematic review. Breast Cancer Res. 2023;25:45.37095519 10.1186/s13058-023-01636-1
13. Shaw E Farris MS Stone CR Derksen JWG Johnson R Hilsden RJ Effects of physical activity on colorectal cancer risk among family history and body mass index subgroups: a systematic review and meta-analysis BMC Cancer 2018 18 71 10.1186/s12885-017-3970-5 29325535
Shaw E, Farris MS, Stone CR, Derksen JWG, Johnson R, Hilsden RJ, et al. Effects of physical activity on colorectal cancer risk among family history and body mass index subgroups: a systematic review and meta-analysis. BMC Cancer. 2018;18:71.29325535 10.1186/s12885-017-3970-5
14. Boyne DJ O’Sullivan DE Olij BF King WD Friedenreich CM Brenner DR Physical Activity, Global DNA Methylation, and Breast Cancer Risk: A Systematic Literature Review and Meta-analysis. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Soc Prev Oncol 2018 27 1320 31
Boyne DJ, O’Sullivan DE, Olij BF, King WD, Friedenreich CM, Brenner DR. Physical Activity, Global DNA Methylation, and Breast Cancer Risk: A Systematic Literature Review and Meta-analysis. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American. Soc Prev Oncol. 2018;27:1320–31.
15. Hong BS Lee KP A systematic review of the biological mechanisms linking physical activity and breast cancer Phys Act Nutr 2020 24 25 31 10.20463/pan.2020.0018 33108715
Hong BS, Lee KP. A systematic review of the biological mechanisms linking physical activity and breast cancer. Phys Act Nutr. 2020;24:25–31.33108715 10.20463/pan.2020.0018
16. Hojman P Gehl J Christensen JF Pedersen BK Molecular Mechanisms Linking Exercise to Cancer Prevention and Treatment Cell Metab 2018 27 10 21 10.1016/j.cmet.2017.09.015 29056514
Hojman P, Gehl J, Christensen JF, Pedersen BK. Molecular Mechanisms Linking Exercise to Cancer Prevention and Treatment. Cell Metab. 2018;27:10–21.29056514 10.1016/j.cmet.2017.09.015
17. Jurdana M Physical activity and cancer risk. Actual knowledge and possible biological mechanisms Radio Oncol 2021 55 7 17 10.2478/raon-2020-0063
Jurdana M. Physical activity and cancer risk. Actual knowledge and possible biological mechanisms. Radio Oncol. 2021;55:7–17.10.2478/raon-2020-0063
18. Matthews CE Moore SC Arem H Cook MB Trabert B Håkansson N Amount and Intensity of Leisure-Time Physical Activity and Lower Cancer Risk J Clin Oncol 2020 38 686 97 10.1200/JCO.19.02407 31877085
Matthews CE, Moore SC, Arem H, Cook MB, Trabert B, Håkansson N, et al. Amount and Intensity of Leisure-Time Physical Activity and Lower Cancer Risk. J Clin Oncol. 2020;38:686–97.31877085 10.1200/JCO.19.02407
19. Friedenreich CM Woolcott CG McTiernan A Ballard-Barbash R Brant RF Stanczyk FZ Alberta physical activity and breast cancer prevention trial: sex hormone changes in a year-long exercise intervention among postmenopausal women J Clin Oncol 2010 28 1458 66 10.1200/JCO.2009.24.9557 20159820
Friedenreich CM, Woolcott CG, McTiernan A, Ballard-Barbash R, Brant RF, Stanczyk FZ, et al. Alberta physical activity and breast cancer prevention trial: sex hormone changes in a year-long exercise intervention among postmenopausal women. J Clin Oncol. 2010;28:1458–66.20159820 10.1200/JCO.2009.24.9557
20. Friedenreich CM Neilson HK O’Reilly R Duha A Yasui Y Morielli AR Effects of a High vs Moderate Volume of Aerobic Exercise on Adiposity Outcomes in Postmenopausal Women: A Randomized Clinical Trial JAMA Oncol 2015 1 766 76 10.1001/jamaoncol.2015.2239 26181634
Friedenreich CM, Neilson HK, O’Reilly R, Duha A, Yasui Y, Morielli AR, et al. Effects of a High vs Moderate Volume of Aerobic Exercise on Adiposity Outcomes in Postmenopausal Women: A Randomized Clinical Trial. JAMA Oncol. 2015;1:766–76.26181634 10.1001/jamaoncol.2015.2239
21. Monninkhof EM Velthuis MJ Peeters PH Twisk JW Schuit AJ Effect of exercise on postmenopausal sex hormone levels and role of body fat: a randomized controlled trial J Clin Oncol 2009 27 4492 9 10.1200/JCO.2008.19.7459 19687339
Monninkhof EM, Velthuis MJ, Peeters PH, Twisk JW, Schuit AJ. Effect of exercise on postmenopausal sex hormone levels and role of body fat: a randomized controlled trial. J Clin Oncol. 2009;27:4492–9.19687339 10.1200/JCO.2008.19.7459
22. Irwin ML Yasui Y Ulrich CM Bowen D Rudolph RE Schwartz RS Effect of Exercise on Total and Intra-abdominal Body Fat in Postmenopausal Women: A Randomized Controlled Trial JAMA 2003 289 323 30 10.1001/jama.289.3.323 12525233
Irwin ML, Yasui Y, Ulrich CM, Bowen D, Rudolph RE, Schwartz RS, et al. Effect of Exercise on Total and Intra-abdominal Body Fat in Postmenopausal Women: A Randomized Controlled Trial. JAMA. 2003;289:323–30.12525233 10.1001/jama.289.3.323
23. McTiernan A Tworoger SS Ulrich CM Yasui Y Irwin ML Rajan KB Effect of Exercise on Serum Estrogens in Postmenopausal Women: A 12-Month Randomized Clinical Trial Cancer Res 2004 64 2923 8 10.1158/0008-5472.CAN-03-3393 15087413
McTiernan A, Tworoger SS, Ulrich CM, Yasui Y, Irwin ML, Rajan KB, et al. Effect of Exercise on Serum Estrogens in Postmenopausal Women: A 12-Month Randomized Clinical Trial. Cancer Res. 2004;64:2923–8.15087413 10.1158/0008-5472.CAN-03-3393
24. Mazzilli KM Matthews CE Salerno EA Moore SC Weight Training and Risk of 10 Common Types of Cancer Med Sci Sports Exerc 2019 51 1845 51 10.1249/MSS.0000000000001987 30920488
Mazzilli KM, Matthews CE, Salerno EA, Moore SC. Weight Training and Risk of 10 Common Types of Cancer. Med Sci Sports Exerc. 2019;51:1845–51.30920488 10.1249/MSS.0000000000001987
25. Rezende LFM Lee DH Keum N Wu K Eluf-Neto J Tabung FK Resistance training and total and site-specific cancer risk: a prospective cohort study of 33,787 US men Br J Cancer 2020 123 666 72 10.1038/s41416-020-0921-8 32493991
Rezende LFM, Lee DH, Keum N, Wu K, Eluf-Neto J, Tabung FK, et al. Resistance training and total and site-specific cancer risk: a prospective cohort study of 33,787 US men. Br J Cancer. 2020;123:666–72.32493991 10.1038/s41416-020-0921-8
26. Nascimento W Ferrari G Martins CB Rey-Lopez JP Izquierdo M Lee DH Muscle-strengthening activities and cancer incidence and mortality: a systematic review and meta-analysis of observational studies Int J Behav Nutr Phys Act 2021 18 69 10.1186/s12966-021-01142-7 34051796
Nascimento W, Ferrari G, Martins CB, Rey-Lopez JP, Izquierdo M, Lee DH, et al. Muscle-strengthening activities and cancer incidence and mortality: a systematic review and meta-analysis of observational studies. Int J Behav Nutr Phys Act. 2021;18:69.34051796 10.1186/s12966-021-01142-7
27. Boyle T Bull F Fritschi L Heyworth J Resistance training and the risk of colon and rectal cancers Cancer Causes Control 2012 23 1091 7 10.1007/s10552-012-9978-x 22562221
Boyle T, Bull F, Fritschi L, Heyworth J. Resistance training and the risk of colon and rectal cancers. Cancer Causes Control. 2012;23:1091–7.22562221 10.1007/s10552-012-9978-x
28. Pesta DH Goncalves RLS Madiraju AK Strasser B Sparks LM Resistance training to improve type 2 diabetes: working toward a prescription for the future Nutr Metab 2017 14 24 10.1186/s12986-017-0173-7
Pesta DH, Goncalves RLS, Madiraju AK, Strasser B, Sparks LM. Resistance training to improve type 2 diabetes: working toward a prescription for the future. Nutr Metab. 2017;14:24.10.1186/s12986-017-0173-7
29. Calle MC Fernandez ML Effects of resistance training on the inflammatory response Nutr Res Pract 2010 4 259 69 10.4162/nrp.2010.4.4.259 20827340
Calle MC, Fernandez ML. Effects of resistance training on the inflammatory response. Nutr Res Pract. 2010;4:259–69.20827340 10.4162/nrp.2010.4.4.259
30. Kraemer WJ Häkkinen K Newton RU Nindl BC Volek JS McCormick M Effects of heavy-resistance training on hormonal response patterns in younger vs. older men J Appl Physiol 1999 87 982 92 10.1152/jappl.1999.87.3.982 10484567
Kraemer WJ, Häkkinen K, Newton RU, Nindl BC, Volek JS, McCormick M, et al. Effects of heavy-resistance training on hormonal response patterns in younger vs. older men. J Appl Physiol. 1999;87:982–92.10484567 10.1152/jappl.1999.87.3.982
31. Roberts CK Croymans DM Aziz N Butch AW Lee CC Resistance training increases SHBG in overweight/obese, young men Metabolism 2013 62 725 33 10.1016/j.metabol.2012.12.004 23318050
Roberts CK, Croymans DM, Aziz N, Butch AW, Lee CC. Resistance training increases SHBG in overweight/obese, young men. Metabolism. 2013;62:725–33.23318050 10.1016/j.metabol.2012.12.004
32. Westcott WL Resistance training is medicine: effects of strength training on health Curr Sports Med Rep 2012 11 209 16 10.1249/JSR.0b013e31825dabb8 22777332
Westcott WL. Resistance training is medicine: effects of strength training on health. Curr Sports Med Rep. 2012;11:209–16.22777332 10.1249/JSR.0b013e31825dabb8
33. Friedenreich CM Ryder-Burbidge C McNeil J Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms Mol Oncol 2021 15 790 800 10.1002/1878-0261.12772 32741068
Friedenreich CM, Ryder-Burbidge C, McNeil J. Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Mol Oncol. 2021;15:790–800.32741068 10.1002/1878-0261.12772
34. Schmid D, Leitzmann MF. Television viewing and time spent sedentary in relation to cancer risk: a meta-analysis. J Natl Cancer Inst. 2014;106:dju098.
35. Weber MF Banks E Ward R Sitas F Population characteristics related to colorectal cancer testing in New South Wales, Australia: results from the 45 and Up Study cohort J Med Screen 2008 15 137 42 10.1258/jms.2008.008050 18927096
Weber MF, Banks E, Ward R, Sitas F. Population characteristics related to colorectal cancer testing in New South Wales, Australia: results from the 45 and Up Study cohort. J Med Screen. 2008;15:137–42.18927096 10.1258/jms.2008.008050
36. Unanue-Arza S Solís-Ibinagagoitia M Díaz-Seoane M Mosquera-Metcalfe I Idigoras I Bilbao I Inequalities and risk factors related to non-participation in colorectal cancer screening programmes: a systematic review Eur J Public Health 2021 31 346 55 10.1093/eurpub/ckaa203 33313657
Unanue-Arza S, Solís-Ibinagagoitia M, Díaz-Seoane M, Mosquera-Metcalfe I, Idigoras I, Bilbao I, et al. Inequalities and risk factors related to non-participation in colorectal cancer screening programmes: a systematic review. Eur J Public Health. 2021;31:346–55.33313657 10.1093/eurpub/ckaa203
37. Aktary ML Ghebrial M Wang Q Shack L Robson PJ Kopciuk KA Health-Related and Behavioral Factors Associated With Lung Cancer Stage at Diagnosis: Observations From Alberta’s Tomorrow Project Cancer Control 2022 29 10732748221091678 10.1177/10732748221091678 35392690
Aktary ML, Ghebrial M, Wang Q, Shack L, Robson PJ, Kopciuk KA. Health-Related and Behavioral Factors Associated With Lung Cancer Stage at Diagnosis: Observations From Alberta’s Tomorrow Project. Cancer Control. 2022;29:10732748221091678.35392690 10.1177/10732748221091678
38. Wang Q Aktary ML Spinelli JJ Shack L Robson PJ Kopciuk KA Pre-diagnosis lifestyle, health history and psychosocial factors associated with stage at breast cancer diagnosis – Potential targets to shift stage earlier Cancer Epidemiol 2022 78 102152 10.1016/j.canep.2022.102152 35390584
Wang Q, Aktary ML, Spinelli JJ, Shack L, Robson PJ, Kopciuk KA. Pre-diagnosis lifestyle, health history and psychosocial factors associated with stage at breast cancer diagnosis – Potential targets to shift stage earlier. Cancer Epidemiol. 2022;78:102152.35390584 10.1016/j.canep.2022.102152
39. Azam S Kemp Jacobsen K Aro AR von Euler-Chelpin M Tjønneland A Vejborg I Regular physical activity and mammographic density: a cohort study Cancer Causes Control 2018 29 1015 25 10.1007/s10552-018-1075-3 30194548
Azam S, Kemp Jacobsen K, Aro AR, von Euler-Chelpin M, Tjønneland A, Vejborg I, et al. Regular physical activity and mammographic density: a cohort study. Cancer Causes Control. 2018;29:1015–25.30194548 10.1007/s10552-018-1075-3
40. Siozon CC Ma H Hilsen M Bernstein L Ursin G The association between recreational physical activity and mammographic density Int J Cancer 2006 119 1695 701 10.1002/ijc.22020 16688715
Siozon CC, Ma H, Hilsen M, Bernstein L, Ursin G. The association between recreational physical activity and mammographic density. Int J Cancer. 2006;119:1695–701.16688715 10.1002/ijc.22020
41. Soh WH Rajaram N Mariapun S Eriksson M Fadzli F Ho WK Physical activity and mammographic density in an Asian multi-ethnic cohort Cancer Causes Control 2018 29 883 94 10.1007/s10552-018-1064-6 30062608
Soh WH, Rajaram N, Mariapun S, Eriksson M, Fadzli F, Ho WK, et al. Physical activity and mammographic density in an Asian multi-ethnic cohort. Cancer Causes Control. 2018;29:883–94.30062608 10.1007/s10552-018-1064-6
42. Woolcott CG Courneya KS Boyd NF Yaffe MJ Terry T McTiernan A Mammographic Density Change with 1 Year of Aerobic Exercise among Postmenopausal Women: A Randomized Controlled Trial Cancer Epidemiol Biomark Prev 2010 19 1112 21 10.1158/1055-9965.EPI-09-0801
Woolcott CG, Courneya KS, Boyd NF, Yaffe MJ, Terry T, McTiernan A, et al. Mammographic Density Change with 1 Year of Aerobic Exercise among Postmenopausal Women: A Randomized Controlled Trial. Cancer Epidemiol Biomark Prev. 2010;19:1112–21.10.1158/1055-9965.EPI-09-0801
43. Oremek GM Seiffert UB Physical activity releases prostate-specific antigen (PSA) from the prostate gland into blood and increases serum PSA concentrations Clin Chem 1996 42 691 5 10.1093/clinchem/42.5.691 8653893
Oremek GM, Seiffert UB. Physical activity releases prostate-specific antigen (PSA) from the prostate gland into blood and increases serum PSA concentrations. Clin Chem. 1996;42:691–5.8653893 10.1093/clinchem/42.5.691
44. Kindermann W Lehmann V Herrmann M Loch T [Influencing of the PSA concentration in serum by physical exercise (especially bicycle riding)] Urol A 2011 50 188 96 10.1007/s00120-010-2489-z
Kindermann W, Lehmann V, Herrmann M, Loch T. [Influencing of the PSA concentration in serum by physical exercise (especially bicycle riding)]. Urol A. 2011;50:188–96.10.1007/s00120-010-2489-z
45. Loprinzi PD Kohli M Effect of physical activity and sedentary behavior on serum prostate-specific antigen concentrations: results from the National Health and Nutrition Examination Survey (NHANES), 2003–2006 Mayo Clin Proc 2013 88 11 21 10.1016/j.mayocp.2012.10.012 23274016
Loprinzi PD, Kohli M. Effect of physical activity and sedentary behavior on serum prostate-specific antigen concentrations: results from the National Health and Nutrition Examination Survey (NHANES), 2003–2006. Mayo Clin Proc. 2013;88:11–21.23274016 10.1016/j.mayocp.2012.10.012
46. Pelaez M, Stuiver MM, Broekman M, Schmitz KH, Zopf EM, Clauss D, et al. Early Detection of Brain Metastases in a Supervised Exercise Program for Patients with Advanced Breast Cancer: A Case Report. Med Sci Sports Exerc. 2023;55:1745–9.
47. Principles and guidance for prehabilitation within the management and support of people with cancer. Available at : https://www.macmillan.org.uk/assets/prehabilitation-guidance-for-people-with-cancer.pdf, Accessed March 09, 2020
48. “Prehabilitation, rehabilitation, and revocation in the Army” SUPPLEMENT 2170. Brit Med J. 1946;1:S187-S204
49. Himbert C Klossner N Coletta AM Barnes CA Wiskemann J LaStayo PC Exercise and lung cancer surgery: A systematic review of randomized-controlled trials Crit Rev Oncol Hematol 2020 156 103086 10.1016/j.critrevonc.2020.103086 33038630
Himbert C, Klossner N, Coletta AM, Barnes CA, Wiskemann J, LaStayo PC, et al. Exercise and lung cancer surgery: A systematic review of randomized-controlled trials. Crit Rev Oncol Hematol. 2020;156:103086.33038630 10.1016/j.critrevonc.2020.103086
50. Piraux E Reychler G de Noordhout LM Forget P Deswysen Y Caty G What are the impact and the optimal design of a physical prehabilitation program in patients with esophagogastric cancer awaiting surgery? A systematic review BMC Sports Sci Med Rehabil 2021 13 33 10.1186/s13102-021-00260-w 33766107
Piraux E, Reychler G, de Noordhout LM, Forget P, Deswysen Y, Caty G. What are the impact and the optimal design of a physical prehabilitation program in patients with esophagogastric cancer awaiting surgery? A systematic review. BMC Sports Sci Med Rehabil. 2021;13:33.33766107 10.1186/s13102-021-00260-w
51. Falz R Bischoff C Thieme R Lässing J Mehdorn M Stelzner S Effects and duration of exercise-based prehabilitation in surgical therapy of colon and rectal cancer: a systematic review and meta-analysis J Cancer Res Clin Oncol 2022 148 2187 213 10.1007/s00432-022-04088-w 35695931
Falz R, Bischoff C, Thieme R, Lässing J, Mehdorn M, Stelzner S, et al. Effects and duration of exercise-based prehabilitation in surgical therapy of colon and rectal cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol. 2022;148:2187–213.35695931 10.1007/s00432-022-04088-w
52. Cuijpers ACM Linskens FG Bongers BC Stassen LPS Lubbers T van Meeteren NLU Quality and clinical generalizability of feasibility outcomes in exercise prehabilitation before colorectal cancer surgery - A systematic review Eur J Surgical Oncol 2022 48 1483 97 10.1016/j.ejso.2022.04.012
Cuijpers ACM, Linskens FG, Bongers BC, Stassen LPS, Lubbers T, van Meeteren NLU. Quality and clinical generalizability of feasibility outcomes in exercise prehabilitation before colorectal cancer surgery - A systematic review. Eur J Surgical Oncol. 2022;48:1483–97.10.1016/j.ejso.2022.04.012
53. Vermillion SA James A Dorrell RD Brubaker P Mihalko SL Hill AR Preoperative exercise therapy for gastrointestinal cancer patients: a systematic review Syst Rev 2018 7 103 10.1186/s13643-018-0771-0 30041694
Vermillion SA, James A, Dorrell RD, Brubaker P, Mihalko SL, Hill AR, et al. Preoperative exercise therapy for gastrointestinal cancer patients: a systematic review. Syst Rev. 2018;7:103.30041694 10.1186/s13643-018-0771-0
54. Li X Li S Yan S Wang Y Wang X Sihoe ADL Impact of preoperative exercise therapy on surgical outcomes in lung cancer patients with or without COPD: a systematic review and meta-analysis Cancer Manag Res 2019 11 1765 77 10.2147/CMAR.S186432 30858729
Li X, Li S, Yan S, Wang Y, Wang X, Sihoe ADL, et al. Impact of preoperative exercise therapy on surgical outcomes in lung cancer patients with or without COPD: a systematic review and meta-analysis. Cancer Manag Res. 2019;11:1765–77.30858729 10.2147/CMAR.S186432
55. Rosero ID, Ramírez-Vélez R, Lucia A, Martínez-Velilla N, Santos-Lozano A, Valenzuela PL, et al. Systematic Review and Meta-Analysis of Randomized, Controlled Trials on Preoperative Physical Exercise Interventions in Patients with Non-Small-Cell Lung Cancer. Cancers. 2019;11:944
56. Briggs LG Reitblat C Bain PA Parke S Lam NY Wright J Prehabilitation Exercise Before Urologic Cancer Surgery: A Systematic and Interdisciplinary Review Eur Urol 2022 81 157 67 10.1016/j.eururo.2021.05.015 34074558
Briggs LG, Reitblat C, Bain PA, Parke S, Lam NY, Wright J, et al. Prehabilitation Exercise Before Urologic Cancer Surgery: A Systematic and Interdisciplinary Review. Eur Urol. 2022;81:157–67.34074558 10.1016/j.eururo.2021.05.015
57. Wade-Mcbane K King A Urch C Jeyasingh-Jacob J Milne A Boutillier CL Prehabilitation in the lung cancer pathway: a scoping review BMC Cancer 2023 23 747 10.1186/s12885-023-11254-x 37568130
Wade-Mcbane K, King A, Urch C, Jeyasingh-Jacob J, Milne A, Boutillier CL. Prehabilitation in the lung cancer pathway: a scoping review. BMC Cancer. 2023;23:747.37568130 10.1186/s12885-023-11254-x
58. Raz DJ Kim JY Erhunwmunesee L Hite S Varatkar G Sun V The value of perioperative physical activity in older patients undergoing surgery for lung cancer Expert Rev Respiratory Med 2023 17 691 700 10.1080/17476348.2023.2255133
Raz DJ, Kim JY, Erhunwmunesee L, Hite S, Varatkar G, Sun V. The value of perioperative physical activity in older patients undergoing surgery for lung cancer. Expert Rev Respiratory Med. 2023;17:691–700.10.1080/17476348.2023.2255133
59. Kichena S Kamani A Fricke B Potential of prehabilitation in hepatocellular carcinoma: a narrative review of available evidence Ann Palliat Med 2024 13 101 11 10.21037/apm-23-175 37993401
Kichena S, Kamani A, Fricke B. Potential of prehabilitation in hepatocellular carcinoma: a narrative review of available evidence. Ann Palliat Med. 2024;13:101–11.37993401 10.21037/apm-23-175
60. Dovey Z Horowitz A Waingankar N The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review BJUI Compass 2023 4 385 416 10.1002/bco2.237 37334023
Dovey Z, Horowitz A, Waingankar N. The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review. BJUI Compass. 2023;4:385–416.37334023 10.1002/bco2.237
61. Yang A, Sokolof J, Gulati A. The effect of preoperative exercise on upper extremity recovery following breast cancer surgery: a systematic review. Int J Rehabilit Res. 2018;41:189–96.
62. Geng E Yin S Yang Y Ke C Fang K Liu J The effect of perioperative pelvic floor muscle exercise on urinary incontinence after radical prostatectomy: a meta-analysis Int Braz J Urol 2023 49 441 51 10.1590/s1677-5538.ibju.2023.0053 37267610
Geng E, Yin S, Yang Y, Ke C, Fang K, Liu J, et al. The effect of perioperative pelvic floor muscle exercise on urinary incontinence after radical prostatectomy: a meta-analysis. Int Braz J Urol. 2023;49:441–51.37267610 10.1590/s1677-5538.ibju.2023.0053
63. Zhou L Chen Y Yuan X Zeng L Zhu J Zheng J Preoperative pelvic floor muscle exercise for continence after radical prostatectomy: a systematic review and meta-analysis Front Public Health 2023 11 1186067 10.3389/fpubh.2023.1186067 37588123
Zhou L, Chen Y, Yuan X, Zeng L, Zhu J, Zheng J. Preoperative pelvic floor muscle exercise for continence after radical prostatectomy: a systematic review and meta-analysis. Front Public Health. 2023;11:1186067.37588123 10.3389/fpubh.2023.1186067
64. Smyth E O’Connor L Mockler D Reynolds JV Hussey J Guinan E Preoperative high intensity interval training for oncological resections: A systematic review and meta-analysis Surgical Oncol 2021 38 101620 10.1016/j.suronc.2021.101620
Smyth E, O’Connor L, Mockler D, Reynolds JV, Hussey J, Guinan E. Preoperative high intensity interval training for oncological resections: A systematic review and meta-analysis. Surgical Oncol. 2021;38:101620.10.1016/j.suronc.2021.101620
65. Franssen RFW Janssen-Heijnen MLG Barberan-Garcia A Vogelaar FJ Van Meeteren NLU Bongers BC Moderate-intensity exercise training or high-intensity interval training to improve aerobic fitness during exercise prehabilitation in patients planned for elective abdominal cancer surgery? Eur J Surgical Oncol 2022 48 3 13 10.1016/j.ejso.2021.08.026
Franssen RFW, Janssen-Heijnen MLG, Barberan-Garcia A, Vogelaar FJ, Van Meeteren NLU, Bongers BC. Moderate-intensity exercise training or high-intensity interval training to improve aerobic fitness during exercise prehabilitation in patients planned for elective abdominal cancer surgery? Eur J Surgical Oncol. 2022;48:3–13.10.1016/j.ejso.2021.08.026
66. Piraux E Caty G Reychler G Effects of preoperative combined aerobic and resistance exercise training in cancer patients undergoing tumour resection surgery: A systematic review of randomised trials Surgical Oncol 2018 27 584 94 10.1016/j.suronc.2018.07.007
Piraux E, Caty G, Reychler G. Effects of preoperative combined aerobic and resistance exercise training in cancer patients undergoing tumour resection surgery: A systematic review of randomised trials. Surgical Oncol. 2018;27:584–94.10.1016/j.suronc.2018.07.007
67. Palma S Hasenoehrl T Jordakieva G Ramazanova D Crevenna R High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis Supportive Care Cancer 2021 29 1781 94 10.1007/s00520-020-05834-x
Palma S, Hasenoehrl T, Jordakieva G, Ramazanova D, Crevenna R. High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis. Supportive Care Cancer. 2021;29:1781–94.10.1007/s00520-020-05834-x
68. Jin S Li S Zhang Q Pang D Preoperative physical exercise strategies for patients undergoing major abdominal cancer surgery: a scoping review Support Care Cancer 2021 29 7057 71 10.1007/s00520-021-06287-6 34037844
Jin S, Li S, Zhang Q, Pang D. Preoperative physical exercise strategies for patients undergoing major abdominal cancer surgery: a scoping review. Support Care Cancer. 2021;29:7057–71.34037844 10.1007/s00520-021-06287-6
69. Lee K Zhou J Norris MK Chow C Dieli-Conwright CM Prehabilitative Exercise for the Enhancement of Physical, Psychosocial, and Biological Outcomes Among Patients Diagnosed with Cancer Curr Oncol Rep 2020 22 71 10.1007/s11912-020-00932-9 32537699
Lee K, Zhou J, Norris MK, Chow C, Dieli-Conwright CM. Prehabilitative Exercise for the Enhancement of Physical, Psychosocial, and Biological Outcomes Among Patients Diagnosed with Cancer. Curr Oncol Rep. 2020;22:71.32537699 10.1007/s11912-020-00932-9
70. Boereboom C Doleman B Lund JN Williams JP Systematic review of pre-operative exercise in colorectal cancer patients Tech Coloproctol 2016 20 81 9 10.1007/s10151-015-1407-1 26614304
Boereboom C, Doleman B, Lund JN, Williams JP. Systematic review of pre-operative exercise in colorectal cancer patients. Tech Coloproctol. 2016;20:81–9.26614304 10.1007/s10151-015-1407-1
71. Lau CSM Chamberlain RS Prehabilitation Programs Improve Exercise Capacity Before and After Surgery in Gastrointestinal Cancer Surgery Patients: A Meta-Analysis J Gastrointest Surg 2020 24 2829 37 10.1007/s11605-019-04436-1 31768827
Lau CSM, Chamberlain RS. Prehabilitation Programs Improve Exercise Capacity Before and After Surgery in Gastrointestinal Cancer Surgery Patients: A Meta-Analysis. J Gastrointest Surg. 2020;24:2829–37.31768827 10.1007/s11605-019-04436-1
72. Sebio Garcia R Yáñez Brage MI Giménez Moolhuyzen E Granger CL Denehy L Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis Interact Cardiovasc Thorac Surg 2016 23 486 97 10.1093/icvts/ivw152 27226400
Sebio Garcia R, Yáñez Brage MI, Giménez Moolhuyzen E, Granger CL, Denehy L. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2016;23:486–97.27226400 10.1093/icvts/ivw152
73. Brownson-Smith R, Orange ST, Cresti N, Hunt K, Saxton J, Temesi J. Effect of exercise before and/or during taxane-containing chemotherapy treatment on chemotherapy-induced peripheral neuropathy symptoms in women with breast cancer: systematic review and meta-analysis. J Cancer Surviv. 2023. 10.1007/s11764-023-01450-w Online ahead of print.
74. Flores LE Westmark D Katz NB Hunter TL Silver EM Bryan KM Prehabilitation in radiation therapy: a scoping review Support Care Cancer 2024 32 83 10.1007/s00520-023-08262-9 38177946
Flores LE, Westmark D, Katz NB, Hunter TL, Silver EM, Bryan KM, et al. Prehabilitation in radiation therapy: a scoping review. Support Care Cancer. 2024;32:83.38177946 10.1007/s00520-023-08262-9
75. Yang L, Azam A, Friedenreich CM. Physical activity for cancer prehabilitation: a scoping review. Critical Rev Oncol Hematol. 2024;196:104319.
76. Kearney N Connolly D Begic S Mockler D Guinan E Feasibility metrics of exercise interventions during chemotherapy: A systematic review Crit Rev Oncol Hematol 2024 195 104272 10.1016/j.critrevonc.2024.104272 38272152
Kearney N, Connolly D, Begic S, Mockler D, Guinan E. Feasibility metrics of exercise interventions during chemotherapy: A systematic review. Crit Rev Oncol Hematol. 2024;195:104272.38272152 10.1016/j.critrevonc.2024.104272
77. Grosek A Grosek K Bloch W Safety and feasibility of exercise interventions in patients with hematological cancer undergoing chemotherapy: a systematic review Support Care Cancer 2023 31 335 10.1007/s00520-023-07773-9 37183201
Grosek A, Grosek K, Bloch W. Safety and feasibility of exercise interventions in patients with hematological cancer undergoing chemotherapy: a systematic review. Support Care Cancer. 2023;31:335.37183201 10.1007/s00520-023-07773-9
78. Zoth N, Tomanek A, Seuthe K, Pfister R, Baumann FT. Exercise as medicine could be a chance for early detection and prevention of Cardiotoxicity in cancer treatments - a narrative review. Oncol Res Treatment. 2023;46:131–9.
79. Ma Z-Y Yao S-S Shi Y-Y Lu N-N Cheng F Effect of aerobic exercise on cardiotoxic outcomes in women with breast cancer undergoing anthracycline or trastuzumab treatment: a systematic review and meta-analysis Suppor Care Cancer 2022 30 10323 34 10.1007/s00520-022-07368-w
Ma Z-Y, Yao S-S, Shi Y-Y, Lu N-N, Cheng F. Effect of aerobic exercise on cardiotoxic outcomes in women with breast cancer undergoing anthracycline or trastuzumab treatment: a systematic review and meta-analysis. Suppor Care Cancer. 2022;30:10323–34.10.1007/s00520-022-07368-w
80. Kendall SJ Langley JE Aghdam M Crooks BN Giacomantonio N Heinze-Milne S The Impact of Exercise on Cardiotoxicity in Pediatric and Adolescent Cancer Survivors: A Scoping Review Curr Oncol 2022 29 6350 63 10.3390/curroncol29090500 36135069
Kendall SJ, Langley JE, Aghdam M, Crooks BN, Giacomantonio N, Heinze-Milne S, et al. The Impact of Exercise on Cardiotoxicity in Pediatric and Adolescent Cancer Survivors: A Scoping Review. Curr Oncol. 2022;29:6350–63.36135069 10.3390/curroncol29090500
81. Correia IR Cardoso V Cargaleiro C Magalhaes JP Hetherington-Rauth M Rosa GB Effects of home-based exercise programs on physical fitness in cancer patients undergoing active treatment: A systematic review and meta-analysis of randomized controlled trials J Sci Med sport 2023 26 222 31 10.1016/j.jsams.2023.03.009 37002132
Correia IR, Cardoso V, Cargaleiro C, Magalhaes JP, Hetherington-Rauth M, Rosa GB, et al. Effects of home-based exercise programs on physical fitness in cancer patients undergoing active treatment: A systematic review and meta-analysis of randomized controlled trials. J Sci Med sport. 2023;26:222–31.37002132 10.1016/j.jsams.2023.03.009
82. Malveiro C Correia IR Cargaleiro C Magalhaes JP de Matos LV Hilario S Effects of exercise training on cancer patients undergoing neoadjuvant treatment: A systematic review J Sci Med Sport 2023 26 586 92 10.1016/j.jsams.2023.08.178 37696693
Malveiro C, Correia IR, Cargaleiro C, Magalhaes JP, de Matos LV, Hilario S, et al. Effects of exercise training on cancer patients undergoing neoadjuvant treatment: A systematic review. J Sci Med Sport. 2023;26:586–92.37696693 10.1016/j.jsams.2023.08.178
83. Yang L Morielli AR Heer E Kirkham AA Cheung WY Usmani N Effects of Exercise on Cancer Treatment Efficacy: A Systematic Review of Preclinical and Clinical Studies Cancer Res 2021 81 4889 95 10.1158/0008-5472.CAN-21-1258 34215623
Yang L, Morielli AR, Heer E, Kirkham AA, Cheung WY, Usmani N, et al. Effects of Exercise on Cancer Treatment Efficacy: A Systematic Review of Preclinical and Clinical Studies. Cancer Res. 2021;81:4889–95.34215623 10.1158/0008-5472.CAN-21-1258
84. Courneya KS Booth CM Exercise as cancer treatment: A clinical oncology framework for exercise oncology research Front Oncol 2022 12 957135 10.3389/fonc.2022.957135 36119508
Courneya KS, Booth CM. Exercise as cancer treatment: A clinical oncology framework for exercise oncology research. Front Oncol. 2022;12:957135.36119508 10.3389/fonc.2022.957135
85. Courneya KS Friedenreich CM Designing, analyzing, and interpreting observational studies of physical activity and cancer outcomes from a clinical oncology perspective Front Oncol 2023 13 1098278 10.3389/fonc.2023.1098278 37124538
Courneya KS, Friedenreich CM. Designing, analyzing, and interpreting observational studies of physical activity and cancer outcomes from a clinical oncology perspective. Front Oncol. 2023;13:1098278.37124538 10.3389/fonc.2023.1098278
86. Thomsen SN Lahart IM Thomsen LM Fridh MK Larsen A Mau-Sørensen M Harms of exercise training in patients with cancer undergoing systemic treatment: a systematic review and meta-analysis of published and unpublished controlled trials EClinicalMedicine 2023 59 101937 10.1016/j.eclinm.2023.101937 37096190
Thomsen SN, Lahart IM, Thomsen LM, Fridh MK, Larsen A, Mau-Sørensen M, et al. Harms of exercise training in patients with cancer undergoing systemic treatment: a systematic review and meta-analysis of published and unpublished controlled trials. EClinicalMedicine. 2023;59:101937.37096190 10.1016/j.eclinm.2023.101937
87. National Cancer Insititue. NCI Dictionaries. Rehabilitation. Available at: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/rehabilitation. Accessed July 05, 2023.
88. National Cancer Insititue. NCI Dictionaries. Recover. Available at: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/recover, Accessed July 05, 2023.
89. World Health Organization. Health Promotion. Available at: https://www.who.int/westernpacific/about/how-we-work/programmes/health-promotion. Accessed July 05, 2023.
90. World Health Organization. Health promotion and disease prevention through population-based interventions, including action to address social determinants and health inequity. Available at:https://www.emro.who.int/about-who/public-health-functions/health-promotion-disease-prevention.html. Accessed July 05, 2023.
91. Goldschmidt S Schmidt ME Steindorf K Long-term effects of exercise interventions on physical activity in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials Support Care Cancer 2023 31 130 10.1007/s00520-022-07485-6 36692626
Goldschmidt S, Schmidt ME, Steindorf K. Long-term effects of exercise interventions on physical activity in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer. 2023;31:130.36692626 10.1007/s00520-022-07485-6
92. Cariolou M Abar L Aune D Balducci K Becerra-Tomas N Greenwood DC Postdiagnosis recreational physical activity and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis Int J Cancer 2023 152 600 15 10.1002/ijc.34324 36279903
Cariolou M, Abar L, Aune D, Balducci K, Becerra-Tomas N, Greenwood DC, et al. Postdiagnosis recreational physical activity and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis. Int J Cancer. 2023;152:600–15.36279903 10.1002/ijc.34324
93. Rendeiro JA Rodrigues CAMP de Barros Rocha L Rocha RSB da Silva ML da Costa Cunha K Physical exercise and quality of life in patients with prostate cancer: systematic review and meta-analysis Support Care Cancer 2021 29 4911 9 10.1007/s00520-021-06095-y 33649920
Rendeiro JA, Rodrigues CAMP, de Barros Rocha L, Rocha RSB, da Silva ML, da Costa Cunha K. Physical exercise and quality of life in patients with prostate cancer: systematic review and meta-analysis. Support Care Cancer. 2021;29:4911–9.33649920 10.1007/s00520-021-06095-y
94. Reimer N Zopf EM Bowe R Baumann FT Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer - A Systematic Review J Sex Med 2021 18 1899 914 10.1016/j.jsxm.2021.09.001 34654674
Reimer N, Zopf EM, Bowe R, Baumann FT. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer - A Systematic Review. J Sex Med. 2021;18:1899–914.34654674 10.1016/j.jsxm.2021.09.001
95. Neil-Sztramko SE Medysky ME Campbell KL Bland KA Winters-Stone KM Attention to the principles of exercise training in exercise studies on prostate cancer survivors: a systematic review BMC Cancer 2019 19 321 10.1186/s12885-019-5520-9 30953460
Neil-Sztramko SE, Medysky ME, Campbell KL, Bland KA, Winters-Stone KM. Attention to the principles of exercise training in exercise studies on prostate cancer survivors: a systematic review. BMC Cancer. 2019;19:321.30953460 10.1186/s12885-019-5520-9
96. Machado P Morgado M Raposo J Mendes M Silva CG Morais N Effectiveness of exercise training on cancer-related fatigue in colorectal cancer survivors: a systematic review and meta-analysis of randomized controlled trials Support Care Cancer 2022 30 5601 13 10.1007/s00520-022-06856-3 35107601
Machado P, Morgado M, Raposo J, Mendes M, Silva CG, Morais N. Effectiveness of exercise training on cancer-related fatigue in colorectal cancer survivors: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer. 2022;30:5601–13.35107601 10.1007/s00520-022-06856-3
97. Mbous YP Patel J Kelly KM A systematic review and meta-analysis of physical activity interventions among colorectal cancer survivors Transl Behav Med 2020 10 1134 43 10.1093/tbm/ibz176 33044539
Mbous YP, Patel J, Kelly KM. A systematic review and meta-analysis of physical activity interventions among colorectal cancer survivors. Transl Behav Med. 2020;10:1134–43.33044539 10.1093/tbm/ibz176
98. Teba P-P Esther M-G Raquel S-G Association between physical activity and patient-reported outcome measures in patients with lung cancer: a systematic review and meta-analysis Qual Life Res 2022 31 1963 76 10.1007/s11136-021-03053-3 35059948
Teba P-P, Esther M-G, Raquel S-G. Association between physical activity and patient-reported outcome measures in patients with lung cancer: a systematic review and meta-analysis. Qual Life Res. 2022;31:1963–76.35059948 10.1007/s11136-021-03053-3
99. Medysky ME Bland KA Neil-Sztramko SE Campbell KL Sullivan DR Winters-Stone KM Attention to the Principles of Exercise Training in Exercise Studies of Persons With Lung Cancer: A Systematic Review J Aging Phys Act 2021 29 1042 52 10.1123/japa.2020-0269 33963092
Medysky ME, Bland KA, Neil-Sztramko SE, Campbell KL, Sullivan DR, Winters-Stone KM. Attention to the Principles of Exercise Training in Exercise Studies of Persons With Lung Cancer: A Systematic Review. J Aging Phys Act. 2021;29:1042–52.33963092 10.1123/japa.2020-0269
100. Wogksch MD Goodenough CG Finch ER Partin RE Ness KK Physical activity and fitness in childhood cancer survivors: a scoping review Aging Cancer 2021 2 112 28 10.1002/aac2.12042 35098147
Wogksch MD, Goodenough CG, Finch ER, Partin RE, Ness KK. Physical activity and fitness in childhood cancer survivors: a scoping review. Aging Cancer. 2021;2:112–28.35098147 10.1002/aac2.12042
101. Moberg L Fritch J Westmark D Mina DS Krause C Bilek L Effect of physical activity on fatigue in childhood cancer survivors: a systematic review Support Care Cancer 2022 30 6441 9 10.1007/s00520-022-06960-4 35306606
Moberg L, Fritch J, Westmark D, Mina DS, Krause C, Bilek L, et al. Effect of physical activity on fatigue in childhood cancer survivors: a systematic review. Support Care Cancer. 2022;30:6441–9.35306606 10.1007/s00520-022-06960-4
102. Campbell KL Winters-Stone KM Wiskemann J May AM Schwartz AL Courneya KS Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable Med Sci Sports Exerc 2019 51 2375 90 10.1249/MSS.0000000000002116 31626055
Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019;51:2375–90.31626055 10.1249/MSS.0000000000002116
103. Caru M Levesque A Rao P Dandekar S Terry C Brown V A scoping review to map the evidence of physical activity interventions in post-treatment adolescent and young adult cancer survivors Crit Rev Oncol Hematol 2022 171 103620 10.1016/j.critrevonc.2022.103620 35104634
Caru M, Levesque A, Rao P, Dandekar S, Terry C, Brown V, et al. A scoping review to map the evidence of physical activity interventions in post-treatment adolescent and young adult cancer survivors. Crit Rev Oncol Hematol. 2022;171:103620.35104634 10.1016/j.critrevonc.2022.103620
104. Boutron I Dutton S Ravaud P Altman DG Reporting and Interpretation of Randomized Controlled Trials With Statistically Nonsignificant Results for Primary Outcomes JAMA 2010 303 2058 64 10.1001/jama.2010.651 20501928
Boutron I, Dutton S, Ravaud P, Altman DG. Reporting and Interpretation of Randomized Controlled Trials With Statistically Nonsignificant Results for Primary Outcomes. JAMA. 2010;303:2058–64.20501928 10.1001/jama.2010.651
105. Chen T Li C Qin R Wang Y Yu D Dodd J Comparison of Clinical Trial Changes in Primary Outcome and Reported Intervention Effect Size Between Trial Registration and Publication JAMA Netw 2019 2 e197242-e 10.1001/jamanetworkopen.2019.7242
Chen T, Li C, Qin R, Wang Y, Yu D, Dodd J, et al. Comparison of Clinical Trial Changes in Primary Outcome and Reported Intervention Effect Size Between Trial Registration and Publication. JAMA Netw. 2019;2:e197242-e.10.1001/jamanetworkopen.2019.7242
106. Wang S Yang T Qiang W Shen A Zhao Z Chen X Effectiveness of physical exercise on the cardiovascular system in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials Complementary Therapies Clin Pr 2021 44 101426 10.1016/j.ctcp.2021.101426
Wang S, Yang T, Qiang W, Shen A, Zhao Z, Chen X, et al. Effectiveness of physical exercise on the cardiovascular system in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Complementary Therapies Clin Pr. 2021;44:101426.10.1016/j.ctcp.2021.101426
107. Abbasi F Pourjalali H do Nascimento IJB Zargarzadeh N Mousavi SM Eslami R The effects of exercise training on inflammatory biomarkers in patients with breast cancer: A systematic review and meta-analysis Cytokine 2022 149 155712 10.1016/j.cyto.2021.155712 34644675
Abbasi F, Pourjalali H, do Nascimento IJB, Zargarzadeh N, Mousavi SM, Eslami R, et al. The effects of exercise training on inflammatory biomarkers in patients with breast cancer: A systematic review and meta-analysis. Cytokine. 2022;149:155712.34644675 10.1016/j.cyto.2021.155712
108. Kong L Gao R Aerobic exercise combined with resistance exercise training improves cardiopulmonary function and blood lipid of patients with breast cancer: A systematic review and meta-analysis Medicine 2022 101 e32391 10.1097/MD.0000000000032391 36595800
Kong L, Gao R. Aerobic exercise combined with resistance exercise training improves cardiopulmonary function and blood lipid of patients with breast cancer: A systematic review and meta-analysis. Medicine. 2022;101:e32391.36595800 10.1097/MD.0000000000032391
109. Kang D-W Lee J Suh S-H Ligibel J Courneya KS Jeon JY Effects of Exercise on Insulin, IGF Axis, Adipocytokines, and Inflammatory Markers in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Soc Preventive Oncol 2017 26 355 65
Kang D-W, Lee J, Suh S-H, Ligibel J, Courneya KS, Jeon JY. Effects of Exercise on Insulin, IGF Axis, Adipocytokines, and Inflammatory Markers in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American. Soc Preventive Oncol. 2017;26:355–65.
110. Friedenreich CM, Morielli AR, Lategan I, Ryder-Burbidge C, Yang L. Physical Activity and Breast Cancer Survival-Epidemiologic Evidence and Potential Biologic Mechanisms. Curr Nutr Rep. 2022;11:717–41.
111. Sarfati D Koczwara B Jackson C The impact of comorbidity on cancer and its treatment CA Cancer J Clin 2016 66 337 50 10.3322/caac.21342 26891458
Sarfati D, Koczwara B, Jackson C. The impact of comorbidity on cancer and its treatment. CA Cancer J Clin. 2016;66:337–50.26891458 10.3322/caac.21342
112. Spratt DE Shore N Sartor O Rathkopf D Olivier K Treating the patient and not just the cancer: therapeutic burden in prostate cancer Prostate Cancer Prostatic Dis 2021 24 647 61 10.1038/s41391-021-00328-1 33603236
Spratt DE, Shore N, Sartor O, Rathkopf D, Olivier K. Treating the patient and not just the cancer: therapeutic burden in prostate cancer. Prostate Cancer Prostatic Dis. 2021;24:647–61.33603236 10.1038/s41391-021-00328-1
113. Cooper KB, Lapierre S, Carrera Seoane M, Lindstrom K, Pritschmann R, Donahue M, et al. Behavior change techniques in digital physical activity interventions for breast cancer survivors: a systematic review. Transl Behav Med. 2023;13:268–80.
114. Rossi A Friel C Carter L Garber CE Effects of Theory-Based Behavioral Interventions on Physical Activity Among Overweight and Obese Female Cancer Survivors: A Systematic Review of Randomized Controlled Trials Integr cancer Therapies 2018 17 226 36 10.1177/1534735417734911
Rossi A, Friel C, Carter L, Garber CE. Effects of Theory-Based Behavioral Interventions on Physical Activity Among Overweight and Obese Female Cancer Survivors: A Systematic Review of Randomized Controlled Trials. Integr cancer Therapies. 2018;17:226–36.10.1177/1534735417734911
115. Finne E Glausch M Exner A-K Sauzet O Stolzel F Seidel N Behavior change techniques for increasing physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials Cancer Manag Res 2018 10 5125 43 10.2147/CMAR.S170064 30464612
Finne E, Glausch M, Exner A-K, Sauzet O, Stolzel F, Seidel N. Behavior change techniques for increasing physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials. Cancer Manag Res. 2018;10:5125–43.30464612 10.2147/CMAR.S170064
116. Amireault S Fong AJ Sabiston CM Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors Am J Lifestyle Med 2018 12 184 99 10.1177/1559827616661490 30202391
Amireault S, Fong AJ, Sabiston CM. Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors. Am J Lifestyle Med. 2018;12:184–99.30202391 10.1177/1559827616661490
117. Liu MG Davis GM Kilbreath SL Yee J Physical activity interventions using behaviour change theories for women with breast cancer: a systematic review and meta-analysis J Cancer Surviv 2022 16 1127 48 10.1007/s11764-021-01104-9 34491527
Liu MG, Davis GM, Kilbreath SL, Yee J. Physical activity interventions using behaviour change theories for women with breast cancer: a systematic review and meta-analysis. J Cancer Surviv. 2022;16:1127–48.34491527 10.1007/s11764-021-01104-9
118. Hailey V Rojas-Garcia A Kassianos AP A systematic review of behaviour change techniques used in interventions to increase physical activity among breast cancer survivors Breast Cancer 2022 29 193 208 10.1007/s12282-021-01323-z 34989962
Hailey V, Rojas-Garcia A, Kassianos AP. A systematic review of behaviour change techniques used in interventions to increase physical activity among breast cancer survivors. Breast Cancer. 2022;29:193–208.34989962 10.1007/s12282-021-01323-z
119. Hallward L Patel N Duncan LR Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review J Health Psychol 2020 25 105 22 10.1177/1359105318756501 29446325
Hallward L, Patel N, Duncan LR. Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review. J Health Psychol. 2020;25:105–22.29446325 10.1177/1359105318756501
120. Finlay A Wittert G Short CE A systematic review of physical activity-based behaviour change interventions reaching men with prostate cancer J Cancer Surviv 2018 12 571 91 10.1007/s11764-018-0694-8 29770953
Finlay A, Wittert G, Short CE. A systematic review of physical activity-based behaviour change interventions reaching men with prostate cancer. J Cancer Surviv. 2018;12:571–91.29770953 10.1007/s11764-018-0694-8
121. Roberts AL Fisher A Smith L Heinrich M Potts HWW Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis J Cancer Surviv 2017 11 704 19 10.1007/s11764-017-0632-1 28779220
Roberts AL, Fisher A, Smith L, Heinrich M, Potts HWW. Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2017;11:704–19.28779220 10.1007/s11764-017-0632-1
122. Werts SJ, Robles-Morales R, Bea JW, Thomson CA. Characterization and efficacy of lifestyle behavior change interventions among adult rural cancer survivors: a systematic review. J Cancer Survivor. 2023.
123. de Vries-Ten Have J Winkels RM Kampman E Winkens LHH Behaviour change techniques used in lifestyle interventions that aim to reduce cancer-related fatigue in cancer survivors: a systematic review Int J Behav Nutr Phys Act 2023 20 126 10.1186/s12966-023-01524-z 37833784
de Vries-Ten Have J, Winkels RM, Kampman E, Winkens LHH. Behaviour change techniques used in lifestyle interventions that aim to reduce cancer-related fatigue in cancer survivors: a systematic review. Int J Behav Nutr Phys Act. 2023;20:126.37833784 10.1186/s12966-023-01524-z
124. Rogers LQ Pekmezi D Schoenberger-Godwin Y-M Fontaine KR Ivankova NV Kinsey AW Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors Digital Health 2023 9 20552076231182805 10.1177/20552076231182805 37434730
Rogers LQ, Pekmezi D, Schoenberger-Godwin Y-M, Fontaine KR, Ivankova NV, Kinsey AW, et al. Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors. Digital Health. 2023;9:20552076231182805.37434730 10.1177/20552076231182805
125. Brunet J Wurz A Nader PA Belanger M A systematic review summarizing the effect of health care provider-delivered physical activity interventions on physical activity behaviour in cancer survivors Patient Educ Counsel 2020 103 1287 301 10.1016/j.pec.2020.02.002
Brunet J, Wurz A, Nader PA, Belanger M. A systematic review summarizing the effect of health care provider-delivered physical activity interventions on physical activity behaviour in cancer survivors. Patient Educ Counsel. 2020;103:1287–301.10.1016/j.pec.2020.02.002
126. Meyer-Schwickerath C Morawietz C Baumann FT Huber G Wiskemann J Efficacy of face-to-face behavior change counseling interventions on physical activity behavior in cancer survivors - a systematic review and meta-analysis Disabil Rehabilit 2022 44 5386 401 10.1080/09638288.2021.1938247
Meyer-Schwickerath C, Morawietz C, Baumann FT, Huber G, Wiskemann J. Efficacy of face-to-face behavior change counseling interventions on physical activity behavior in cancer survivors - a systematic review and meta-analysis. Disabil Rehabilit. 2022;44:5386–401.10.1080/09638288.2021.1938247
127. Swartz MC Lewis ZH Lyons EJ Jennings K Middleton A Deer RR Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis Arch Phys Med Rehabilit 2017 98 1652 65 10.1016/j.apmr.2017.03.017
Swartz MC, Lewis ZH, Lyons EJ, Jennings K, Middleton A, Deer RR, et al. Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabilit. 2017;98:1652–65.10.1016/j.apmr.2017.03.017
128. Covington KR Hidde MC Pergolotti M Leach HJ Community-based exercise programs for cancer survivors: a scoping review of practice-based evidence Support Care Cancer 2019 27 4435 50 10.1007/s00520-019-05022-6 31418074
Covington KR, Hidde MC, Pergolotti M, Leach HJ. Community-based exercise programs for cancer survivors: a scoping review of practice-based evidence. Support Care Cancer. 2019;27:4435–50.31418074 10.1007/s00520-019-05022-6
129. Wagoner CW Lee JT Battaglini CL Community-based exercise programs and cancer-related fatigue: a systematic review and meta-analysis Support Care Cancer 2021 29 4921 9 10.1007/s00520-021-06135-7 33751225
Wagoner CW, Lee JT, Battaglini CL. Community-based exercise programs and cancer-related fatigue: a systematic review and meta-analysis. Support Care Cancer. 2021;29:4921–9.33751225 10.1007/s00520-021-06135-7
130. Neil-Sztramko SE Smith-Turchyn J Fong A Kauffeldt K Tomasone JR Community-Based Exercise Programs for Cancer Survivors: A Scoping Review of Program Characteristics Using the Consolidated Framework for Implementation Research Arch Phys Med Rehabilit 2022 103 542 58.e10 10.1016/j.apmr.2021.06.026
Neil-Sztramko SE, Smith-Turchyn J, Fong A, Kauffeldt K, Tomasone JR. Community-Based Exercise Programs for Cancer Survivors: A Scoping Review of Program Characteristics Using the Consolidated Framework for Implementation Research. Arch Phys Med Rehabilit. 2022;103:542–58.e10.10.1016/j.apmr.2021.06.026
131. Groen WG van Harten WH Vallance JK Systematic review and meta-analysis of distance-based physical activity interventions for cancer survivors (2013–2018): We still haven’t found what we’re looking for Cancer Treat Rev 2018 69 188 203 10.1016/j.ctrv.2018.07.012 30077954
Groen WG, van Harten WH, Vallance JK. Systematic review and meta-analysis of distance-based physical activity interventions for cancer survivors (2013–2018): We still haven’t found what we’re looking for. Cancer Treat Rev. 2018;69:188–203.30077954 10.1016/j.ctrv.2018.07.012
132. National Cancer Insititue. NCI Dictionaries. Palliative care. Available at https://www.cancer.gov/publications/dictionaries/cancer-terms/def/palliative-care: Accessed July 05, 2023.
133. Toohey K, Chapman M, Rushby A-M, Urban K, Ingham G, Singh B. The effects of physical exercise in the palliative care phase for people with advanced cancer: a systematic review with meta-analysis. J Cancer Surviv. 2023;17:399–415.
134. Tanriverdi A Ozcan Kahraman B Ergin G Karadibak D Savci S Effect of exercise interventions in adults with cancer receiving palliative care: a systematic review and meta-analysis Support Care Cancer 2023 31 205 10.1007/s00520-023-07655-0 36882538
Tanriverdi A, Ozcan Kahraman B, Ergin G, Karadibak D, Savci S. Effect of exercise interventions in adults with cancer receiving palliative care: a systematic review and meta-analysis. Support Care Cancer. 2023;31:205.36882538 10.1007/s00520-023-07655-0
135. Rogers-Shepp I Bhattacharya S Mennillo HA Kumar R Hsieh B Anandarajah G Exercise interventions for advanced cancer palliative care patients: A systematic literature review and descriptive evidence synthesis of randomized controlled trials Palliat Med 2023 37 677 91 10.1177/02692163231162888 37029686
Rogers-Shepp I, Bhattacharya S, Mennillo HA, Kumar R, Hsieh B, Anandarajah G. Exercise interventions for advanced cancer palliative care patients: A systematic literature review and descriptive evidence synthesis of randomized controlled trials. Palliat Med. 2023;37:677–91.37029686 10.1177/02692163231162888
136. Besseling J, van Velzen M, Wierdsma N, Alonso-Duin KS, Weijs P, May AM, et al. Exercise and Nutritional Interventions in Patients with Advanced Gastroesophageal Cancer: A Systematic Review. J Gastrointestinal Cancer. 2022:54:1006–9.
137. Barnes O, Wilson RL, Gonzalo-Encabo P, Kang D-W, Christopher CN, Bentley T, et al. The Effect of Exercise and Nutritional Interventions on Body Composition in Patients with Advanced or Metastatic Cancer: A Systematic Review. Nutrients. 2022;14:2110.
138. Shallwani SM Ranger M-C Thomas R Brosseau L Poitras S Sikora L A scoping review of studies exploring leisure-time physical activity in adults diagnosed with advanced cancer Palliat Support Care 2021 19 615 30 10.1017/S1478951520001327 33308368
Shallwani SM, Ranger M-C, Thomas R, Brosseau L, Poitras S, Sikora L, et al. A scoping review of studies exploring leisure-time physical activity in adults diagnosed with advanced cancer. Palliat Support Care 2021;19:615–30.33308368 10.1017/S1478951520001327
139. Geng Z Wang J Zhang Y Wu F Yuan C Physical activity in the context of advanced breast cancer: An integrative review J Adv Nurs 2021 77 2119 43 10.1111/jan.14709 33314310
Geng Z, Wang J, Zhang Y, Wu F, Yuan C. Physical activity in the context of advanced breast cancer: An integrative review. J Adv Nurs. 2021;77:2119–43.33314310 10.1111/jan.14709
140. De Lazzari N, Niels T, Tewes M, Gotte M. A Systematic Review of the Safety, Feasibility and Benefits of Exercise for Patients with Advanced Cancer. Cancers. 2021;13:4478.
141. Chen Y-J Li X-X Ma H-K Zhang X Wang B-W Guo T-T Exercise Training for Improving Patient-Reported Outcomes in Patients With Advanced-Stage Cancer: A Systematic Review and Meta-Analysis J Pain Symptom Manag 2020 59 734 49.e10 10.1016/j.jpainsymman.2019.09.010
Chen Y-J, Li X-X, Ma H-K, Zhang X, Wang B-W, Guo T-T, et al. Exercise Training for Improving Patient-Reported Outcomes in Patients With Advanced-Stage Cancer: A Systematic Review and Meta-Analysis. J Pain Symptom Manag. 2020;59:734–49.e10.10.1016/j.jpainsymman.2019.09.010
142. Sheill G Guinan E Brady L Hevey D Hussey J Exercise interventions for patients with advanced cancer: A systematic review of recruitment, attrition, and exercise adherence rates Palliat Support Care 2019 17 686 96 10.1017/S1478951519000312 31109383
Sheill G, Guinan E, Brady L, Hevey D, Hussey J. Exercise interventions for patients with advanced cancer: A systematic review of recruitment, attrition, and exercise adherence rates. Palliat Support Care 2019;17:686–96.31109383 10.1017/S1478951519000312
143. Heywood R McCarthy AL Skinner TL Efficacy of Exercise Interventions in Patients With Advanced Cancer: A Systematic Review Arch Phys Med Rehabilit 2018 99 2595 620 10.1016/j.apmr.2018.04.008
Heywood R, McCarthy AL, Skinner TL. Efficacy of Exercise Interventions in Patients With Advanced Cancer: A Systematic Review. Arch Phys Med Rehabilit. 2018;99:2595–620.10.1016/j.apmr.2018.04.008
144. Heywood R McCarthy AL Skinner TL Safety and feasibility of exercise interventions in patients with advanced cancer: a systematic review Support Care Cancer 2017 25 3031 50 10.1007/s00520-017-3827-0 28741176
Heywood R, McCarthy AL, Skinner TL. Safety and feasibility of exercise interventions in patients with advanced cancer: a systematic review. Support Care Cancer. 2017;25:3031–50.28741176 10.1007/s00520-017-3827-0
145. Dittus KL Gramling RE Ades PA Exercise interventions for individuals with advanced cancer: A systematic review Prevent Med 2017 104 124 32 10.1016/j.ypmed.2017.07.015
Dittus KL, Gramling RE, Ades PA. Exercise interventions for individuals with advanced cancer: A systematic review. Prevent Med. 2017;104:124–32.10.1016/j.ypmed.2017.07.015
146. Wilk M Kepski J Kepska J Casselli S Szmit S Exercise interventions in metastatic cancer disease: a literature review and a brief discussion on current and future perspectives BMJ Support Palliat Care 2020 10 404 10 10.1136/bmjspcare-2020-002487 32943468
Wilk M, Kepski J, Kepska J, Casselli S, Szmit S. Exercise interventions in metastatic cancer disease: a literature review and a brief discussion on current and future perspectives. BMJ Support Palliat Care. 2020;10:404–10.32943468 10.1136/bmjspcare-2020-002487
147. van Doorslaer de Ten Ryen S, Deldicque L. The Regulation of the Metastatic Cascade by Physical Activity: A Narrative Review. Cancers. 2020;12:153.
148. Rincon-Castanedo C Morales JS Martin-Ruiz A Valenzuela PL Ramirez M Santos-Lozano A Physical exercise effects on metastasis: a systematic review and meta-analysis in animal cancer models Cancer Metastasis Rev 2020 39 91 114 10.1007/s10555-020-09851-4 31939049
Rincon-Castanedo C, Morales JS, Martin-Ruiz A, Valenzuela PL, Ramirez M, Santos-Lozano A, et al. Physical exercise effects on metastasis: a systematic review and meta-analysis in animal cancer models. Cancer Metastasis Rev. 2020;39:91–114.31939049 10.1007/s10555-020-09851-4
149. Duong H, Walker M, Maugham-Macan M. Exercise Intervention for Bone Metastasis: Safety, Efficacy and Method of Delivery. Cancers. 2023;15:1796.
150. Langbaum T Smith TJ Time to Study Metastatic-Cancer Survivorship N Engl J Med 2019 380 1300 2 10.1056/NEJMp1901103 30943335
Langbaum T, Smith TJ. Time to Study Metastatic-Cancer Survivorship. N Engl J Med. 2019;380:1300–2.30943335 10.1056/NEJMp1901103
151. Temel JS Greer JA Muzikansky A Gallagher ER Admane S Jackson VA Early palliative care for patients with metastatic non-small-cell lung cancer N Engl J Med 2010 363 733 42 10.1056/NEJMoa1000678 20818875
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363:733–42.20818875 10.1056/NEJMoa1000678
152. Campbell KL Cormie P Weller S Alibhai SMH Bolam KA Campbell A Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals JCO Oncol Pr 2022 18 e697 e709 10.1200/OP.21.00454
Campbell KL, Cormie P, Weller S, Alibhai SMH, Bolam KA, Campbell A, et al. Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals. JCO Oncol Pr. 2022;18:e697–e709.10.1200/OP.21.00454
153. Cao C Friedenreich CM Yang L Association of Daily Sitting Time and Leisure-Time Physical Activity With Survival Among US Cancer Survivors JAMA Oncol 2022 8 395 403 10.1001/jamaoncol.2021.6590 34989765
Cao C, Friedenreich CM, Yang L. Association of Daily Sitting Time and Leisure-Time Physical Activity With Survival Among US Cancer Survivors. JAMA Oncol. 2022;8:395–403.34989765 10.1001/jamaoncol.2021.6590
154. Courneya KS Booth CM Gill S O’Brien P Vardy J Friedenreich CM The Colon Health and Life-Long Exercise Change trial: a randomized trial of the National Cancer Institute of Canada Clinical Trials Group Curr Oncol 2008 15 279 85 19079628
Courneya KS, Booth CM, Gill S, O’Brien P, Vardy J, Friedenreich CM, et al. The Colon Health and Life-Long Exercise Change trial: a randomized trial of the National Cancer Institute of Canada Clinical Trials Group. Curr Oncol. 2008;15:279–85.19079628
155. Newton RU Kenfield SA Hart NH Chan JM Courneya KS Catto J Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4): a multicentre, randomised, controlled phase III study protocol BMJ Open 2018 8 e022899 10.1136/bmjopen-2018-022899 29764892
Newton RU, Kenfield SA, Hart NH, Chan JM, Courneya KS, Catto J, et al. Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4): a multicentre, randomised, controlled phase III study protocol. BMJ Open. 2018;8:e022899.29764892 10.1136/bmjopen-2018-022899
156. Courneya KS Vallance JK Culos-Reed SN McNeely ML Bell GJ Mackey JR The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors BMC Cancer 2012 12 525 10.1186/1471-2407-12-525 23153358
Courneya KS, Vallance JK, Culos-Reed SN, McNeely ML, Bell GJ, Mackey JR, et al. The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors. BMC Cancer. 2012;12:525.23153358 10.1186/1471-2407-12-525
157. Friedenreich CM Vallance JK McNeely ML Culos-Reed SN Matthews CE Bell GJ The Alberta moving beyond breast cancer (AMBER) cohort study: baseline description of the full cohort Cancer Causes Control 2022 33 441 53 10.1007/s10552-021-01539-6 35064432
Friedenreich CM, Vallance JK, McNeely ML, Culos-Reed SN, Matthews CE, Bell GJ, et al. The Alberta moving beyond breast cancer (AMBER) cohort study: baseline description of the full cohort. Cancer Causes Control. 2022;33:441–53.35064432 10.1007/s10552-021-01539-6
158. Courneya KS Vardy JL O’Callaghan CJ Friedenreich CM Campbell KL Prapavessis H Effects of a Structured Exercise Program on Physical Activity and Fitness in Colon Cancer Survivors: One Year Feasibility Results from the CHALLENGE Trial. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Soc Preventive Oncol 2016 25 969 77
Courneya KS, Vardy JL, O’Callaghan CJ, Friedenreich CM, Campbell KL, Prapavessis H, et al. Effects of a Structured Exercise Program on Physical Activity and Fitness in Colon Cancer Survivors: One Year Feasibility Results from the CHALLENGE Trial. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American. Soc Preventive Oncol. 2016;25:969–77.
159. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Physical Activity and the Risk of Cancer. Available at https://www.wcrf.org/diet-activity-and-cancer/accessed Dec 19, 2023.
160. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. 2008. Available at: http://www.health.gov/paguidelines.
161. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010.
162. Rock CL Thomson C Gansler T Gapstur SM McCullough ML Patel AV American Cancer Society guideline for diet and physical activity for cancer prevention CA Cancer J Clin 2020 70 245 71 10.3322/caac.21591 32515498
Rock CL, Thomson C, Gansler T, Gapstur SM, McCullough ML, Patel AV, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin. 2020;70:245–71.32515498 10.3322/caac.21591
163. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54:1451–62.
164. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans 2018 2nd edition Washington DC U.S. Department of Health and Human Services
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd edition. Washington DC: U.S. Department of Health and Human Services; 2018.
165. Ligibel JA Bohlke K May AM Clinton SK Demark-Wahnefried W Gilchrist SC Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline J Clin Oncol 2022 40 2491 507 10.1200/JCO.22.00687 35576506
Ligibel JA, Bohlke K, May AM, Clinton SK, Demark-Wahnefried W, Gilchrist SC, et al. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol. 2022;40:2491–507.35576506 10.1200/JCO.22.00687
166. Cormie P Atkinson M Bucci L Cust A Eakin E Hayes S Clinical Oncology Society of Australia position statement on exercise in cancer care Med J Aust 2018 209 184 7 10.5694/mja18.00199 29719196
Cormie P, Atkinson M, Bucci L, Cust A, Eakin E, Hayes S, et al. Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust. 2018;209:184–7.29719196 10.5694/mja18.00199
167. Cancer Research UK. Exercise guidelines for cancer patients. https://www.cancerresearchuk.org/about-cancer/coping/physically/exercise-guidelinesAccessed. March 8, 2024.
168. Rock CL Thomson CA Sullivan KR Howe CL Kushi LH Caan BJ American Cancer Society nutrition and physical activity guideline for cancer survivors CA Cancer J Clin 2022 72 230 62 10.3322/caac.21719 35294043
Rock CL, Thomson CA, Sullivan KR, Howe CL, Kushi LH, Caan BJ, et al. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin. 2022;72:230–62.35294043 10.3322/caac.21719
169. Stein KD Syrjala KL Andrykowski MA Physical and psychological long-term and late effects of cancer Cancer 2008 112 2577 92 10.1002/cncr.23448 18428205
Stein KD, Syrjala KL, Andrykowski MA. Physical and psychological long-term and late effects of cancer. Cancer. 2008;112:2577–92.18428205 10.1002/cncr.23448
170. Morishita S Hamaue Y Fukushima T Tanaka T Fu JB Nakano J Effect of Exercise on Mortality and Recurrence in Patients With Cancer: A Systematic Review and Meta-Analysis Integr Cancer Therapies 2020 19 1534735420917462 10.1177/1534735420917462
Morishita S, Hamaue Y, Fukushima T, Tanaka T, Fu JB, Nakano J. Effect of Exercise on Mortality and Recurrence in Patients With Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Therapies. 2020;19:1534735420917462.10.1177/1534735420917462
171. Byrne S Boyle T Ahmed M Lee SH Benyamin B Hyppönen E Lifestyle, genetic risk and incidence of cancer: a prospective cohort study of 13 cancer types Int J Epidemiol 2023 52 817 26 10.1093/ije/dyac238 36651198
Byrne S, Boyle T, Ahmed M, Lee SH, Benyamin B, Hyppönen E. Lifestyle, genetic risk and incidence of cancer: a prospective cohort study of 13 cancer types. Int J Epidemiol. 2023;52:817–26.36651198 10.1093/ije/dyac238
172. Sfm C Van Cauwenberg J Maenhout L Cardon G Lambert EV Van Dyck D Inequality in physical activity, global trends by income inequality and gender in adults Int J Behav Nutr Phys Act 2020 17 142 10.1186/s12966-020-01039-x 33239036
Sfm C, Van Cauwenberg J, Maenhout L, Cardon G, Lambert EV, Van Dyck D. Inequality in physical activity, global trends by income inequality and gender in adults. Int J Behav Nutr Phys Act. 2020;17:142.33239036 10.1186/s12966-020-01039-x
173. Tison GH Barrios J Avram R Kuhar P Bostjancic B Marcus GM Worldwide physical activity trends since COVID-19 onset Lancet Glob Health 2022 10 e1381 e2 10.1016/S2214-109X(22)00361-8 36057269
Tison GH, Barrios J, Avram R, Kuhar P, Bostjancic B, Marcus GM, et al. Worldwide physical activity trends since COVID-19 onset. Lancet Glob Health. 2022;10:e1381–e2.36057269 10.1016/S2214-109X(22)00361-8
174. Thomas G, Tahir MR, Bongers BC, Kallen VL, Slooter GD, van Meeteren NL. Prehabilitation before major intra-abdominal cancer surgery: A systematic review of randomised controlled trials. Eur J Anaesthesiol. 2019;36:933–45.
175. Michael CM Lehrer EJ Schmitz KH Zaorsky NG Prehabilitation exercise therapy for cancer: A systematic review and meta-analysis Cancer Med 2021 10 4195 205 10.1002/cam4.4021 34110101
Michael CM, Lehrer EJ, Schmitz KH, Zaorsky NG. Prehabilitation exercise therapy for cancer: A systematic review and meta-analysis. Cancer Med. 2021;10:4195–205.34110101 10.1002/cam4.4021
176. Gilbert A Piccinin C Velikova G Groenvold M Kuliś D Blazeby JM Linking the European Organisation for Research and Treatment of Cancer Item Library to the Common Terminology Criteria for Adverse Events J Clin Oncol 2022 40 3770 80 10.1200/JCO.21.02017 35973158
Gilbert A, Piccinin C, Velikova G, Groenvold M, Kuliś D, Blazeby JM, et al. Linking the European Organisation for Research and Treatment of Cancer Item Library to the Common Terminology Criteria for Adverse Events. J Clin Oncol. 2022;40:3770–80.35973158 10.1200/JCO.21.02017
177. Yang L Cao C Kantor ED Nguyen LH Zheng X Park Y Trends in Sedentary Behavior Among the US Population, 2001–2016 JAMA 2019 321 1587 97 10.1001/jama.2019.3636 31012934
Yang L, Cao C, Kantor ED, Nguyen LH, Zheng X, Park Y, et al. Trends in Sedentary Behavior Among the US Population, 2001–2016. JAMA. 2019;321:1587–97.31012934 10.1001/jama.2019.3636
178. Lane C McCrabb S Nathan N Naylor P-J Bauman A Milat A How effective are physical activity interventions when they are scaled-up: a systematic review Int J Behav Nutr Phys Act 2021 18 16 10.1186/s12966-021-01080-4 33482837
Lane C, McCrabb S, Nathan N, Naylor P-J, Bauman A, Milat A, et al. How effective are physical activity interventions when they are scaled-up: a systematic review. Int J Behav Nutr Phys Act. 2021;18:16.33482837 10.1186/s12966-021-01080-4
179. Czwikla G Boen F Cook DG de Jong J Harris T Hilz LK Equity-specific effects of interventions to promote physical activity among middle-aged and older adults: results from applying a novel equity-specific re-analysis strategy Int J Behav Nutr Phys Act 2021 18 65 10.1186/s12966-021-01131-w 34001171
Czwikla G, Boen F, Cook DG, de Jong J, Harris T, Hilz LK, et al. Equity-specific effects of interventions to promote physical activity among middle-aged and older adults: results from applying a novel equity-specific re-analysis strategy. Int J Behav Nutr Phys Act. 2021;18:65.34001171 10.1186/s12966-021-01131-w
180. Irwin ML McTiernan A Bernstein L Gilliland FD Baumgartner R Baumgartner K Relationship of Obesity and Physical Activity with C-Peptide, Leptin, and Insulin-Like Growth Factors in Breast Cancer Survivors Cancer Epidemiol Biomark Prev 2005 14 2881 8 10.1158/1055-9965.EPI-05-0185
Irwin ML, McTiernan A, Bernstein L, Gilliland FD, Baumgartner R, Baumgartner K, et al. Relationship of Obesity and Physical Activity with C-Peptide, Leptin, and Insulin-Like Growth Factors in Breast Cancer Survivors. Cancer Epidemiol Biomark Prev. 2005;14:2881–8.10.1158/1055-9965.EPI-05-0185
181. Meyskens FL, Jr., Mukhtar H, Rock CL, Cuzick J, Kensler TW, Yang CS, et al. Cancer Prevention: Obstacles, Challenges and the Road Ahead. J National Cancer Inst. 2016;108:djv309.
182. Atwood K Colditz GA Kawachi I From public health science to prevention policy: placing science in its social and political contexts Am J Public health 1997 87 1603 6 10.2105/AJPH.87.10.1603 9357339
Atwood K, Colditz GA, Kawachi I. From public health science to prevention policy: placing science in its social and political contexts. Am J Public health. 1997;87:1603–6.9357339 10.2105/AJPH.87.10.1603
183. Nau T Bauman A Smith BJ Bellew W A scoping review of systems approaches for increasing physical activity in populations Health Res Policy Syst 2022 20 104 10.1186/s12961-022-00906-2 36175916
Nau T, Bauman A, Smith BJ, Bellew W. A scoping review of systems approaches for increasing physical activity in populations. Health Res Policy Syst. 2022;20:104.36175916 10.1186/s12961-022-00906-2
184. Sallis JF, Owen N, Fisher EB. Ecological models of health behavior. Health behavior and health education: Theory, research, and practice, 4th ed. San Francisco, CA, US: Jossey-Bass; 2008. p. 465–85.
185. Schmitz KH Campbell AM Stuiver MM Pinto BM Schwartz AL Morris GS Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer CA Cancer J Clin 2019 69 468 84 10.3322/caac.21579 31617590
Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS, et al. Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. CA Cancer J Clin. 2019;69:468–84.31617590 10.3322/caac.21579
186. Ramsey I Chan A Charalambous A Cheung YT Darling HS Eng L Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners’ knowledge, practices, barriers, and facilitators Support Care Cancer 2022 30 9379 91 10.1007/s00520-022-07342-6 36173560
Ramsey I, Chan A, Charalambous A, Cheung YT, Darling HS, Eng L, et al. Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners’ knowledge, practices, barriers, and facilitators. Support Care Cancer. 2022;30:9379–91.36173560 10.1007/s00520-022-07342-6
187. Shaffer KM Turner KL Siwik C Gonzalez BD Upasani R Glazer JV Digital health and telehealth in cancer care: a scoping review of reviews Lancet Digital Health 2023 5 e316 27 10.1016/S2589-7500(23)00049-3 37100545
Shaffer KM, Turner KL, Siwik C, Gonzalez BD, Upasani R, Glazer JV, et al. Digital health and telehealth in cancer care: a scoping review of reviews. Lancet Digital Health. 2023;5:e316–27.37100545 10.1016/S2589-7500(23)00049-3
188. Molenaar CJL Minnella EM Coca-Martinez M ten Cate DWG Regis M Awasthi R Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical Trial JAMA Surg 2023 158 572 81 10.1001/jamasurg.2023.0198 36988937
Molenaar CJL, Minnella EM, Coca-Martinez M, ten Cate DWG, Regis M, Awasthi R, et al. Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical Trial. JAMA Surg. 2023;158:572–81.36988937 10.1001/jamasurg.2023.0198
189. Segal R Zwaal C Green E Tomasone JR Loblaw A Petrella T Exercise for people with cancer: a clinical practice guideline Curr Oncol 2017 24 40 6 10.3747/co.24.3376 28270724
Segal R, Zwaal C, Green E, Tomasone JR, Loblaw A, Petrella T. Exercise for people with cancer: a clinical practice guideline. Curr Oncol. 2017;24:40–6.28270724 10.3747/co.24.3376
190. Craig P Cooper C Gunnell D Haw S Lawson K Macintyre S Using natural experiments to evaluate population health interventions: new Medical Research Council guidance J Epidemiol Community Health 2012 66 1182 6 10.1136/jech-2011-200375 22577181
Craig P, Cooper C, Gunnell D, Haw S, Lawson K, Macintyre S, et al. Using natural experiments to evaluate population health interventions: new Medical Research Council guidance. J Epidemiol Community Health. 2012;66:1182–6.22577181 10.1136/jech-2011-200375
191. Ogilvie D Adams J Bauman A Gregg EW Panter J Siegel KR Using natural experimental studies to guide public health action: turning the evidence-based medicine paradigm on its head J Epidemiol Community Health 2020 74 203 8 10.1136/jech-2019-213085 31744848
Ogilvie D, Adams J, Bauman A, Gregg EW, Panter J, Siegel KR, et al. Using natural experimental studies to guide public health action: turning the evidence-based medicine paradigm on its head. J Epidemiol Community Health. 2020;74:203–8.31744848 10.1136/jech-2019-213085
192. Eldridge SM Chan CL Campbell MJ Bond CM Hopewell S Thabane L CONSORT 2010 statement: extension to randomised pilot and feasibility trials BMJ 2016 355 i5239 10.1136/bmj.i5239 27777223
Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ. 2016;355:i5239.27777223 10.1136/bmj.i5239
