Physical Activity Levels And Menstrual Cycle Disruptions Among Female Patients Diagnosed With Early-onset Cancers

Menstrual cycle disruptions are common side-effects of cancer treatments and may be particularly challenging for younger females diagnosed with cancer. PURPOSE: To quantify self-reported physical activity (PA) levels in female patients diagnosed with cancer before age 50 (early-onset; EO) and to explore patterns between patients who are and are not experiencing cancer-related menstrual cycle disruptions and irregularities. METHODS: The Reproductive Health After Cancer Diagnosis and Treatment (REACT) Study recruited eligible adults over an 8-week period (October to December 2021) in cooperation with 23 community partners and multiple patient advocates. Patient-reported questions, including menstrual cycle, PA, and clinicodemographics, were prospectively collected via survey using a secure, web-based application and used to define four exploratory groups: Natural menopause (NM; n = 24), Cancer-induced menstrual cessation (CM; n = 30), Premenopause, no irregularity (P; n = 54), and Premenopause, some menopausal irregularity (P-I; n = 108). Chi-squared and ANOVA tests were used to compare characteristics across menopausal groups. RESULTS: Across 216 female patients with a first primary EO cancer between 2016-2021 and complete menstrual data, patients in the NM group were significantly older at cancer diagnosis (years: 41.1 ± 5.9 (NM) vs 38.2 ± 8.1 (CM) vs 37.0 ± 7.4 (P) vs 36.1 ± 7.6 (P-I), p = 0.027). No significant differences were observed by race/ethnicity, cancer stage, current body mass index (BMI) or BMI at cancer diagnosis between groups. Patients were relatively active, with 51.9% meeting leisure-time PA guidelines. There were no significant differences between groups in volume of leisure-time PA (149.4 ± 238.1 (NM) vs 172 ± 161.8 (CM) vs 151.9 ± 210.6 (P) vs 192.1 ± 204.5 (P-I), p = 0.61), volume of total moderate-to-vigorous PA (MVPA), or the proportion of each group meeting PA guidelines. By cancer treatment status, patients not actively undergoing treatment had greater leisure-time PA in P-I compared to NM (128.1 ± 131.3 vs 232.2 ± 118.8; p = 0.04), but no other differences among groups were observed. CONCLUSION: Leisure-time PA levels did not differ between female EO cancer patients who did or did not experience menstrual cycle disruptions—which may have been influenced by current treatment effects.