Aims: The strength of exercise oncology evidence was considered sufficiently strong for the American College of Sports Medicine (ACSM) to support a specific exercise prescription of aerobic and/or resistance training for improvements in health-related quality-of-life, physical function, anxiety, depressive symptoms, and fatigue following cancer. The aim of this review was to evaluate and describe the characteristics of participants who contributed to the studies that support these exercise recommendations and to determine the representativeness of the sample to the wider cancer population.
Methods: All exercise oncology trials (directly cited or cited within systematic reviews and meta-analyses) that informed the 2019 ACSM exercise prescription recommendations were included in the current review. Individual participant characteristics of the included trials (gender, cancer type, and disease stage) were extracted and summarised descriptively.
Results: Data from 18419 participants (from 231 trials) contributed to the 2019 recommendations, with the majority (n=14635, 79%) being female. Breast cancer was the most included cancer type (n=12827, 70%), followed by prostate (n=1747, 9%) and haematological cancers (n=1357, 7%). Less than 14% of participants (n=2488) represented at least 20 other cancer types. Approximately one in four participants were specifically described as having early-stage disease at diagnosis (n=5201, 28%) and 7% were described as having late-stage (n=1307), while stage of disease at diagnosis was unclear for 43% (described as ‘mixed’; n=7895) and unknown for 22% (n=4016) of the sample.
Conclusions: Findings demonstrate the over-representation of women with breast cancer in exercise oncology research and the lack of clarity regarding the disease stage of those participating in exercise oncology trials. Effective, feasible, and safe integration of exercise into cancer care for all will require future research to evaluate the safety, feasibility, and effect of exercise on representative samples of people within and across cancer types.