Physical Activity Participation in Ovarian Cancer Survivors: Prevalence, Determinants and Association with Patient Reported Outcomes
Objectives: The primary objectives were (1) to estimate the prevalence of meeting physical activity (PA) guidelines among ovarian cancer survivors in the post-treatment period and (2) to identify the determinants of meeting PA guidelines in this study population. The secondary objective was to explore the association between PA and patient reported outcomes (PROs), specifically health-related quality of life (HRQOL), anxiety and depression symptoms. Methods: The Lifestyle Habits and the PRognosis of Ovarian Cancer in Quebec (HPROQ) Study is a prospective cohort study that was conducted in Montreal (2015-2018). For this thesis, a cross-sectional study was conducted on the baseline cohort. 112 ovarian cancer survivors were interviewed 6 months after treatment completion. Modified Poisson regression was used to estimate the prevalence ratio (PRs) and 95% confidence intervals (CIs) to describe the association between patient characteristics and the prevalence of meeting PA guidelines. Multivariable linear and logistic regressions were used to examine the association between meeting PA guidelines and PROs. Results: 42.0% (95% CI: 32.8-51.1%) of ovarian cancer survivors met the PA guidelines of at least 150 minutes of moderate PA per week. There was no evidence of a statistically significant association between any of the potential determinants and meeting PA guidelines. Employment had the highest PR, suggesting that women who were employed had a prevalence of meeting PA guidelines that was 1.49 times greater than women who were unemployed (PR=1.49; 95% CI:0.87-2.55). There was no statistical evidence of an association between meeting PA guidelines and better HRQOL or reduced anxiety and depressive symptoms. PA was most protective for depressive symptoms, suggesting that women who met PA guidelines had odds of depressive symptoms that were 0.30 times greater than women who did not meet PA guidelines. Conclusions: The prevalence of meeting PA guidelines 6 months after treatment was higher than reported in previous studies. None of the potential determinants were significantly associated with meeting PA guidelines, nor was meeting PA guidelines significantly associated with improved PROs. Due to the small sample size the study was underpowered, making it difficult to exclude chance as an explanation for some of the more suggestive associations observed in this thesis.