Physical activity and lower extremity lymphedema among endometrial cancer survivors: A population-based cross-sectional study

Abstract

Objective

The aims of this cross-sectional study were to describe the prevalence of self-reported lower extremity lymphedema (LEL) by different physical activity (PA) levels and to examine if higher levels of PA are associated with lower odds of self-reported LEL among endometrial cancer survivors.

Methods

Women treated for assumed early-stage endometrial cancer between 2006 and 2021 were invited to complete the Lower Extremity Lymphedema Screening Questionnaire (LELSQ) and the Physical Activity Frequency, Intensity, and Duration (PAFID) questionnaire. Responses of PAFID were converted into metabolic equivalent of task minutes per week (MET-min/week), and participants were categorized into different PA levels: meeting (≥500 MET-min/week) versus not meeting PA guidelines; low active (<500 MET-min/week), active (500–1000 MET-min/week), and high active (>1000 MET-min/week); and PA quartiles.

Results

Among 1077 included, the prevalence of LEL was 48 %, 32 %, and 32 % among the low active, active, and high active survivors, respectively. Compared to the low active, the active survivors had 40 % lower odds of LEL (OR 0.60, 95 % CI 0.44–0.81), but no further reduction was observed among the high active survivors (OR 0.71, 95 % CI 0.47–1.06). According to PA quartiles, higher PA levels were associated with lower odds of LEL, but not in a linear dose-response way.

Conclusion

Findings suggest that regular PA according to the current PA guidelines is associated with decreased the odds of self-reported LEL among endometrial cancer survivors; however, causality of association needs to be verified in a longitudinal setting.