JMIR Publications

ABSTRACT

Background:

Although physical activity is recommended for patients with cancer, changes in physical activity across cancer diagnosis and treatment have not been objectively evaluated.

Objective:

To assess the impact of cancer diagnosis and treatment on physical activity levels.

Methods:

This was a retrospective study using a Japanese claims database provided by DeSC Healthcare Inc., in which daily step count data, collected using the Kencom smartphone application, are linked to the claims data. In this study, we included patients newly diagnosed with cancer and compared them with a control group of patients newly diagnosed with diabetes mellitus. We collected data between April 2014 and September 2021 and analyzed. The observation period spanned from 6 months before diagnosis to 12 months after diagnosis. We applied a generalized additive mixed model with a cubic spline to describe changes in step counts before and after diagnosis.

Results:

We analyzed the step count data of 326 patients with malignant solid tumors and 1388 patients with diabetes. Patients with cancer exhibited a 12.4% reduction in step counts from baseline at 3 months after diagnosis, with this reduction persisting at 7.1% at 12 months without returning to baseline. Conversely, in patients with diabetes, step counts remained relatively stable after diagnosis, with a slight upward trend, resulting in a change of +0.6% from baseline at 3 months after diagnosis. At 12 months after diagnosis, step counts remained decreased in the nonendoscopic subdiaphragmatic surgery group, with an 18.0% reduction, whereas step counts were almost back to baseline in the laparoscopic surgery group (+0.3%).

Conclusions:

The analysis of objective pre and postdiagnostic step count data provided fundamental information crucial for understanding changes in physical activity among patients with cancer. Cancer diagnosis and treatment reduced physical activity. The study findings may help tailor exercise recommendations based on lifelog data for patients with cancer in the future.