Association Between Leisure-Time Physical Activity, Sedentary Behavior, and Mortality Risk Among Prostate Cancer Survivors in the United States

Abstract Objective To evaluate the relationship between leisure-time physical activity and daily sitting time with the mortality rate among US after a prostate cancer diagnosis. Methods: A prospective cohort of a nationally representative sample of prostate cancer survivors, age 40 years or older(n=617) from the US National Health and Nutrition Examination Survey from 2007 to 2018. Participants were linked to mortality data from their interview and physical examination date through December 31, 2019. Daily sitting time and leisure-time physical activity (LTPA) were self-reported using the Global Physical Activity Questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HRs) for mortality associated with physical activity and sedentary behavior, adjusting for potential covariates. Result During the follow-up period of up to 7.3 years, after adjusting for covariates, compared with those who sit for less than 8 hours per day, the HR for all-cause mortality among those who sit for 8 or more hours per day were 1.77(95% CI,1.20-2.61) respectively. Furthermore, each additional hour of daily sitting was associated with a 4% increase in the risk of all-cause mortality. Physically active survivors demonstrated a significantly lower risk of all-cause mortality compared to inactive survivors (HR=0.56; 95% CI, 0.36-0.87). In combined analyses, prostate cancer survivors who were inactive or insufficiently active and sat for 8 or more hours a day were 3.37 times (95% CI: 1.84–6.16) more likely to die from any cause compared to those who were active and sat for less than 6 hours a day. Conclusions An active engagement in LTPA coupled with a decrease in daily sedentary periods is associated with a reduced risk of mortality across the board, with a notable decrease in mortality from non-cancerous conditions. The findings suggest that embracing an active lifestyle could significantly enhance the health outcomes for prostate cancer survivors.