Physical activity recommendations for cancer prevention and control: a Brazilian consortium

ABSTRACT

Objective: This article describes the development process and summarizes the results of the Brazilian physical activity recommendations for cancer prevention and control, which was prepared to support health-care professionals.

Material and Methods: These recommendations were elaborated considering: (i) the effect of physical activity on cancer prevention in the general healthy population; and (ii) on all-cause and cancer-specific mortality in cancer survivors. The process of preparing the recommendations was systematized, transparent and reproducible, following the recommendations of the appraisal of guidelines for research and evaluation (AGREE-II). We appraised the certainty of evidence for breast, prostate, colorectal and lung cancers, which are among the most frequent in Brazil, using the grading of recommendations, assessment, development and evaluations (GRADE) approach.

Results: Regarding the risk of cancer, we found high certainty of evidence supporting the association between moderate-to-vigorous physical activity and lower risk of breast and colon cancer, moderate certainty of evidence for lung cancer and low certainty of evidence for prostate and rectal cancer. We found moderate certainty of evidence supporting the association between moderate-to-vigorous physical activity and reduction of all-cause and cancer-specific mortality from breast, colon and rectal cancer, and cancer-specific mortality from prostate cancer, when physical activity was performed after the disease diagnosis. We found low certainty of evidence for the association between physical activity and lung cancer mortality. Based on our findings, physical activity recommendations were proposed, including a step-by-step guide to support health-care professionals when recommending physical activity for all adults (including elderly people), with or without a diagnosis of cancer.

Conclusion: Our recommentations may be useful to support health-care professionals counselling for physical activity, which contribute to reductions in physical inactivity in the general population and in the growing population of cancer survivors.

RESUMO

Objetivo: Este artigo descreve o processo de desenvolvimento e resume os resultados das recomendações brasileiras de atividade física para prevenção e controle do câncer, elaboradas para apoiar os profissionais de saúde que atuam na promoção da atividade física.

Material e Métodos: Estas recomendações foram elaboradas considerando: (i) o efeito da atividade física na prevenção do câncer na população geral saudável; e (ii) sobre todas as causas e mortalidade específica por câncer em sobreviventes de câncer. O processo de elaboração das recomendações foi sistematizado, transparente e reprodutível, seguindo Appraisal of Guidelines for Research and Evaluation (AGREE-II). Avaliamos a certeza da evidência para câncer de mama, próstata, colorretal e pulmão, os que estão entre os tipos de câncer mais frequentes no Brasil, resultados usando a abordagem de gradação de The Grading of Recommendations, Assessment, Development and Evaluations GRADE.

Resultados: Em relação ao risco de câncer, encontramos alta certeza de evidência que apoia a associação entre atividade física moderada a vigorosa e o menor risco de câncer de mama e cólon, certeza moderada de evidência para câncer de pulmão e baixa certeza de evidência para câncer de próstata e reto. Encontramos certeza moderada de evidências que apoiam a associação entre atividade física moderada a vigorosa e redução de mortalidade por todas as causas e específica por câncer de mama, cólon e reto, e mortalidade específica por câncer de próstata, quando a atividade física foi realizada após o diagnóstico da doença. Encontramos baixa certeza de evidência para a associação entre atividade física e mortalidade por câncer de pulmão. Com base em nossos achados, foram propostas recomendações de atividade física, incluindo um guia passo a passo para apoiar os profissionais de saúde na recomendação de atividade física para todos os adultos (incluindo idosos), com ou sem diagnóstico de câncer.

Conclusão: Esperamos que essas recomendações sejam úteis para profissionais de saúde os profissionais de saúde na recomendação de atividade física, o que contribui para a redução da inatividade física na população em geral e na crescente população de sobreviventes de câncer.

Headings:

Prevention and control - Exercise - Mortality - Practice guideline - Consensus

Descritores:

Prevenção e controle - Exercício - Mortalidade - Orientação prática - Consenso

Conflict of Interests

Daniela Dornelles Rosa (last 5 years): consulting for: Roche, Novartis, AstraZeneca, Lilly, Libbs, Pfizer, Dr Reddy's, Teva, United Medical, MSD, Daiichi Sankyo. Fabio F. B. de Carvalho, Leandro Fórnias Machado de Rezende, Leandro Martin Totaro Garcia, Patricia Chakur Brum, Rachel Riera, Rafael Deminice, Renata Cangussú and Ronaldo Corrêa Ferreira da Silva declare that they have no conflict of interest.

Publication History

Received: 01 November 2021

Accepted: 14 November 2021

Article published online:
18 February 2022

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