A landmark global study has found that structured exercise could reduce colon cancer deaths by 37 percent and dramatically increase overall survival rates.
Published in the New England Journal of Medicine, the international study was a collaborative effort between experts in Australia and Canada. The research team included the study’s co-chair, Professor Janette Vardy from the Faculty of Medicine and Health, Professor Haryana Dhillon from the Faculty of Science, as well as leading experts from the Canadian Cancer Trials Group.
Colorectal cancer is the third most common cancer worldwide, and the second leading cause of cancer-related death. In 2022, over one million people were diagnosed with colon cancer, and over half died of the disease. It also has a high recurrence rate, with 30 percent of people diagnosed with stage III colon cancer having a recurrence after treatment.
The study took place over 17 years and followed 889 colon cancer patients across six countries, including Australia, Canada and the UK.
The participants, who had all been previously treated using surgery and chemotherapy, were randomly assigned either to a three-year structured exercise program or a health education program where they received materials promoting physical activity and healthy nutrition.
Building on the University of Sydney’s legacy of cancer research breakthroughs, the study found that people who took part in structured exercise programs experienced significantly higher rates of long-term survival.
Professor Janette Vardy, international co-chair of the study and Senior Research Fellow at Sydney Medical School and medical oncologist at the Sydney Cancer Survivorship Centre, Concord Repatriation General Hospital, said: “Our findings will change the way we treat colon cancer.
“We found a significant improvement in disease-free survival among participants who completed the exercise program, compared to those who received only health education materials, which is currently the standard of care for cancer treatment.
“After eight years, people who took part in structured exercise had a 90 percent chance of survival compared to 83 percent for those who did not.
“This shows that exercise isn’t just beneficial, it can be lifesaving. Something as simple as physical activity can significantly improve life expectancy and long-term outcomes for people with colon cancer.”
Study co-chair, Dr Christopher Booth, Medical Oncologist at Kingston Health Sciences Centre and Professor of Oncology at Queen’s University, said: “As oncologists, one of the most common questions we’re asked by patients is what else they can do to improve their outcomes.
“The CHALLENGE (CO21) trial provides an answer: an exercise program after surgery and chemotherapy reduces the risk of recurrent or new cancer and improves survival, allowing patients to live longer and better lives.”
Changing behaviour to improve cancer survival
Participants chose their own forms of moderate-intensity exercise with the goal of adding two and a half hours of exercise per week to their usual routine and maintaining this for three years and beyond.
“The average age of colon cancer patients is 68, and we focused on individuals who weren’t already meeting the recommended exercise levels of 150 minutes of moderate activity a week, so we wanted to make sure we were giving them the best chance at changing their exercise habits,” said Professor Haryana Dhillon, Australian co-chair and Senior Research Fellow at the School of Psychology.
“By learning what kind of aerobic exercise each patient preferred, we were able to provide a personalised exercise plan that was not only effective, but enjoyable and sustainable.”
Reversing cancer-related deaths
Study co-chair Dr Kerry Courneya, Professor and Canada Research Chair in Physical Activity and Cancer at the University of Alberta, said: “Our study shows that exercise is no longer just a quality-of-life intervention – it is a treatment for colon cancer that must be made available to all patients.”
“We urge policy makers and health authorities to embed these findings into global clinical practice guidelines,” said Professor Vardy. “We need a complete paradigm shift – one that provides equitable access to supported exercise programs, including structured, evidence-based interventions for cancer survivors.
“By positioning exercise alongside chemotherapy and surgery as standard practice for colon cancer care, and supporting patients through these lifestyle changes, we can dramatically improve outcomes.”
Declaration
Australian participation in the study was supported by the National Health and Medical Research Council. Canadian participation in the study was supported by the Canadian Cancer Society. United Kingdom participation in the study was supported by Cancer Research UK. The authors declare no conflicts of interest.
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