Physical activity level and its determinants in patients with cancer: a secondary analysis using a decision-tree approach
- 1Department of Neurosciences, Biomedicine and Movement Science, University of Verona, P.Le L.A. Scuro 10, 37134 Verona, Italy
- 2Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, and University and Hospital Trust (AOUI) of Verona, Verona, Italy
- 3Facility of Epidemiology and Biostatistics, G-STeP, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Abstract
Purpose: Low physical activity is associated with poorer outcomes in patients with cancer. Understanding the determinants of physical activity is essential to designing targeted interventions. This study aimed to identify the determinants of total, aerobic, and resistance physical activity among patients with cancer using a decision-tree machine learning approach.
Methods: This secondary analysis pooled data from three harmonized cross-sectional studies conducted between 2018 and 2024, including adult patients (aged ≥ 18 years) with any cancer type and stage. Physical activity was assessed through validated self-report questionnaires and classified according to current guidelines. Sociodemographic and clinical variables were considered as potential correlates. Decision-tree models using the Classification and Regression Trees method were applied to identify predictors of adherence to aerobic and resistance exercise recommendations.
Results: A total of 1132 patients were included. Only 17.5% met aerobic activity recommendations (i.e., 150 min/week or ACSM guidelines), and 12.7% met resistance training recommendations (i.e., 2 times/week); 2.6% met both. cancer site emerged as the primary determinant of both aerobic and resistance activity. Occupational status, body mass index, and educational level further influenced adherence patterns. Neither cancer stage nor treatment timing significantly predicted physical activity behavior. Distinct determinants were identified for aerobic versus resistance exercise.
Conclusions: Among the factors included in the decision-tree models, physical activity was mainly influenced by cancer site and sociodemographic characteristics. Aerobic and resistance activities are governed by different predictors, underscoring the need for modality-specific assessment and intervention strategies.
Implications for Cancer Survivors: Tailored, cancer-specific supports that account for sociodemographic context and address barriers to both aerobic and resistance exercise are urgently needed to increase participation in physical activity and optimize survivorship outcomes.
Related
- Sociodemographic, Self-Efficacy, and Health-Related Factors According to the Stages of Change in Physical Activity and Dietary Management Among Patients with Metabolic Syndrome: A Secondary Analysis of a Cross-Sectional Study.
- Associations of outdoor physical activity, screen time, and sleep characteristics with myopia among primary and secondary school students
- Multi-factorial determinants of physical activity, sedentary behaviour, and mental well-being in the South Tyrolean population
- Associations Between Leisure-Time Physical Activity, Diet Type/Kind of Diet, and Body Weight Status Among Austrian Secondary School Pupils
- Effect of physical activity on placental glucose transporter expression in women with early gestational diabetes (eGDM): a secondary analysis of the randomised clinical trial
BibTeX
@article{avancini2026physical,
title = {{Physical activity level and its determinants in patients with cancer: a secondary analysis using a decision-tree approach}},
author = {Alice Avancini and Diana Giannarelli and Anita Borsati and Christian Ciurnelli and Michele Milella and Sara Pilotto and Federico Schena},
journal = {Journal of Cancer Survivorship},
year = {2026},
month = jun,
doi = {10.1007/s11764-026-02055-9},
url = {https://doi.org/10.1007/s11764-026-02055-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Physical activity level and its determinants in patients with cancer: a secondary analysis using a decision-tree approach
AU - Alice Avancini
AU - Diana Giannarelli
AU - Anita Borsati
AU - Christian Ciurnelli
AU - Michele Milella
AU - Sara Pilotto
AU - Federico Schena
PY - 2026
DA - 2026/06/08
JO - Journal of Cancer Survivorship
DO - 10.1007/s11764-026-02055-9
UR - https://doi.org/10.1007/s11764-026-02055-9
AB - Purpose: Low physical activity is associated with poorer outcomes in patients with cancer. Understanding the determinants of physical activity is essential to designing targeted interventions. This study aimed to identify the determinants of total, aerobic, and resistance physical activity among patients with cancer using a decision-tree machine learning approach. Methods: This secondary analysis pooled data from three harmonized cross-sectional studies conducted between 2018 and 2024, including adult patients (aged ≥ 18 years) with any cancer type and stage. Physical activity was assessed through validated self-report questionnaires and classified according to current guidelines. Sociodemographic and clinical variables were considered as potential correlates. Decision-tree models using the Classification and Regression Trees method were applied to identify predictors of adherence to aerobic and resistance exercise recommendations. Results: A total of 1132 patients were included. Only 17.5% met aerobic activity recommendations (i.e., 150 min/week or ACSM guidelines), and 12.7% met resistance training recommendations (i.e., 2 times/week); 2.6% met both. cancer site emerged as the primary determinant of both aerobic and resistance activity. Occupational status, body mass index, and educational level further influenced adherence patterns. Neither cancer stage nor treatment timing significantly predicted physical activity behavior. Distinct determinants were identified for aerobic versus resistance exercise. Conclusions: Among the factors included in the decision-tree models, physical activity was mainly influenced by cancer site and sociodemographic characteristics. Aerobic and resistance activities are governed by different predictors, underscoring the need for modality-specific assessment and intervention strategies. Implications for Cancer Survivors: Tailored, cancer-specific supports that account for sociodemographic context and address barriers to both aerobic and resistance exercise are urgently needed to increase participation in physical activity and optimize survivorship outcomes.
SN - 1932-2259
SN - 1932-2267
ER -