Post-diagnosis physical activity in relation to mortality among prostate cancer survivors: a systematic review and meta-analysis

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Background Physical activity after cancer diagnosis may reduce mortality. However, systematic evidence for this association for men living with prostate cancer remains limited. Methods We searched PubMed, Embase, and CINAHL data bases from start to June 2025. Random-effects meta-analyses estimated summary hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality and prostate-cancer-specific mortality to assess the association between post-diagnosis physical activity, measured in metabolic equivalents of task-hours per week (MET-hr/week), and mortality among prostate cancer survivors. Results We included ten studies with more than 50,144 participants (one study did not report the number of prostate cancer cases included in the meta-analysis) and 28,044 deaths. Higher levels of post-diagnosis physical activity (≥ 7.5 MET-hr/week) were associated with lower all-cause mortality (HR = 0.69; 95% CI: 0.62–0.77), compared to lower levels (< 7.5 MET-hr/week). Meta-analysis of five studies showed an inverse association between post-diagnosis physical activity and prostate cancer-specific mortality (HR = 0.77; 95% CI: 0.66–0.89). Meta-analysis of four studies showed that moderate-to-vigorous physical activity was inversely associated with mortality (HR = 0.62; 95% CI: 0.51–0.74). Conclusion Higher post-diagnosis physical activity, including activity at higher intensities, was associated with lower all-cause and prostate cancer-specific mortality among men living with prostate cancer. Our findings suggest that physical activity may complement cancer care for prostate cancer patients.

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