A structured exercise program more effectively increased physical activity among patients participating in a clinical trial compared with providing health education materials only, a study published online ahead of print in Cancer Epidemiology & Biomarkers has shown.1

Lifestyle interventions can improve outcomes for patients with cancer and interest in determine the effectiveness of interventions is strong. However, optimal methods for achieving behavior change among participants of large scale pragmatic trials is unknown. Researchers report on a prespecified interim analysis on the feasibility of exercise behavior change in 273 survivors from the Canadian Cancer Trials Group CO.21 (CHALLENGE) Trial with high-risk stage II and III colon cancer from 42 centers in Canada and Australia.

Participants were randomized to a structured exercise program (SEP; n=136) or health-education materials (HEM; n=137). Primary feasibility outcome of a difference of 5 or more metabolic equivalent task (MET)-hours/week in self-reported recreational physical activity after at least 250 participants reached the 1 year follow-up. Secondary outcomes included health-related fitness.

Participants in the SEP group reported an increase in recreational physical activity of 15.6 MET-hours/week compared with an increase of 5.1 MET-hours/week reported by those in the HEM group (mean difference, +10.5; 95% CI +3.1 to +17.9; P = .002). In addition, predicted VO2max (P = 0.068), 6-minute walk (P < .001), 30-second chair stand (P < .001), 8 foot up-and-go (P = .004), and sit-and-reach (P = .08) were improved in the SEP group.

Providing colon cancer survivors in the CHALLENGE Trial with a structured exercise program resulted in a substantial increase in self-reported recreational physical activity that met the feasibility criterion for trial continuation. Furthermore, the intervention resulted in objective fitness improvement consistent with the level of activity associated with improved colon cancer outcomes seen in observational studies.


1. Courneya KS, Vardy JL, O’Callaghan CJ, 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 [published online ahead of print April 8, 2016]. Cancer Epidemiol Biomarkers Prev. doi:10.1158/1055-9965.EPI-15-1267.