Prevalence of meeting aerobic physical activity and resistance training guidelines in advanced prostate cancer: a descriptive study of racial and regional disparities in the IRONMAN registry

Abstract Purpose To estimate guideline-based aerobic physical activity and resistance training participation in an international population of people with newly diagnosed metastatic hormone-sensitive or castration-resistant prostate cancer, and to assess racial and regional differences. Methods Participants in the international IRONMAN registry (NCT 03151629) of advanced prostate cancer reported leisure-time activity at 6, 18, and 30 months post-enrolment. The proportion meeting guidelines of ≥ 150 min/week moderate to vigorous physical activity and ≥ 2 weekly resistance training sessions were quantified. Mixed-effects logistic regression estimated odds of meeting guidelines averaged across timepoints using all follow-up data by self-identified race (White, Black, Other) and geographic region (Europe, Australia, North America, Africa, Other). Results Among 2485 participants, 58–63% met aerobic physical activity guidelines and 19–23% met resistance training guidelines across timepoints. Resistance training participation was especially low in African geographic regions (0–3%). Participants self-identifying as Black had lower odds of meeting aerobic physical activity guidelines than White participants (crude odds ratio [cOR] 0.23, 95% CI 0.15–0.36), and participants from Africa had lower odds than those from Europe (cOR 0.08, 95% CI 0.03–0.21). Crude patterns were similar for resistance training. Aerobic physical activity disparities persisted after multivariable adjustments, and in sensitivity analyses excluding Black participants from African geographic regions, while resistance training estimates were attenuated. Conclusions Targeted strategies are warranted to increase participation rates in aerobic physical activity and resistance training among advanced prostate cancer patients self-identifying as Black, or those from African geographic regions.