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Periop- Reduces cancer mortality and risk of cancer recurrence

Evidence Summary
A systematic review and meta-analysis has demonstrated reduced overall mortality for patients surviving colorectal and breast cancer related to physical activity, with a decrease in total mortality seen with any increase in physical activity levels (1). A similar systematic review of 22 prospective cohort studies examining the benefits of physical activity on patients with breast cancer demonstrated reduced risk of breast cancer events (recurrence, new primaries and progression) in those with increased levels of pre- and/or post-operative physical activity (2). A review of 26 studies of colorectal, breast and prostate cancer patients identified a 37% reduction in cancer-related mortality between those most and least active, and reduced risk of recurrence or cancer-specific death (3).

Quality of Evidence
Grade A

Strength of Recommendation
Grade 1 – strong

Physical activity has been shown to reduce the risk of cancer. For patients with a diagnosis of cancer, pre- and post-operative physical activity has been shown to reduce recurrence and overall cancer related mortality.


  1. Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol [Internet]. 2014 Jul 1;25(7):1293–311.
  2. Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncol (Madr) [Internet]. 2015 May 28;54(5):635–54.
  3. Friedenreich CM, Neilson HK, Farris MS, Courneya KS. Physical Activity and Cancer Outcomes: A Precision Medicine Approach. Clin Cancer Res [Internet]. 2016 Oct 1;22(19):4766 LP – 4775.