Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Structured Exercise, Physical Activity, and Fear of Cancer Recurrence Among Cancer Survivors: A Systematic Review (145969)

David Mizrahi 1 2 , Jiayu Ji 3 , Wenli Hu 3 , Miranda Quenby 3 , Chrissie Ho 1 , Michael Krasovitsky 4 , Katherine A Wright 5 , Janette L Vardy 2 , Bogda Koczwara 2 , Cristiane D Bergerot 6 , Youngjee Choi 7 , Ben Smith 8
  1. Daffodil Centre, Cancer Council NSW, University of Sydney, Sydney, NSW, Australia
  2. Australian Research Centre for Cancer Survivorship (ARCCS), UNSW Sydney, Sydney, NSW, Australia
  3. University of Sydney, Sydney, Australia
  4. The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, Australia
  5. Department of Medical Oncology, Campbelltown Hospital, Sydney, Australia
  6. Oncoclínicas & Co, Medica Scientia Innovation Research (MEDSIR), São Paulo, Brazil
  7. School of Medicine, Johns Hopkins University , Baltimore, United States
  8. Daffodil Centre, Cancer Council NSW, University of Sydney, Sydney, NSW, Australia

Background: Fear of cancer recurrence (FCR) is a prevalent concern among cancer survivors, contributing to reduced quality of life and increased healthcare utilisation. While physical activity and exercise provide established physical and psychological benefits, their role in mitigating FCR remains unclear. Understanding this relationship may inform accessible strategies to support psychosocial wellbeing in survivorship.

Aim: To systematically evaluate the effects of structured exercise interventions and associations of physical activity with FCR in people with cancer.

Methods: MEDLINE, Embase, CINAHL, PsycINFO and SportDiscus were searched from inception to 8 November 2025. Eligible studies were intervention or observational studies including adults with any cancer diagnosis reporting FCR outcomes alongside physical activity or exercise interventions. Two reviewers independently screened, extracted data, and assessed risk of bias (Cochrane Risk of Bias 2 for trials; Joanna Briggs Institute tools for observational studies). Findings were synthesised narratively.

Results: 716 records were screened, with nineteen studies included (n=20,041 participants; median study size n=166; range n=20–10,969), comprising 10 exercise intervention (n=7 randomised control trials, n=3 pre-post single-arm trials) and nine observational studies. Cancer types were predominantly breast (n=5), colorectal (n=3), prostate (n=3) and mixed cohorts (n=6). Among intervention studies, n=7/10 included aerobic exercise, and n=3/10 included resistance exercise. Among interventions, modest within-group reductions were reported in FCR (7/10 trials), and significant between-group effects observed in some studies (4/7 trials). Over half of observational studies (5/9) identified small but significant inverse associations between physical activity and FCR.

Conclusions: Physical activity and structured exercise may contribute to modest reductions in FCR, supporting their role as scalable strategies to improve psychological health in cancer survivorship. However, heterogeneity in study design limits interpretation. Well-powered trials with FCR as a primary endpoint are needed to determine optimal exercise prescriptions and strengthen prevention-focused survivorship care.