{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:39:26Z","timestamp":1792708766118,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physical activity (PA) is important for improving life expectancy and is suggested as a prognostic factor for various diseases. However, the association between PA and mortality outcomes in survivors of lung cancer remains unclear. Therefore, this study aimed to determine the association of PA levels, including changes before and after diagnosis, with mortality outcomes among survivors of lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide cohort study involving 23\u2009257 individuals diagnosed with lung cancer between 1 January 2010 and 31 December 2016, who attended the National Health Screening Program within 2\u2009years before and after diagnosis. Pre\u2010 and postdiagnosis leisure\u2010time PA levels and changes in PA were assessed using self\u2010administered questionnaires. Individuals who reported engaging in moderate\u2010intensity exercise \u2265\u20095\u2009days\/week or vigorous\u2010intensity exercise \u2265\u20093\u2009days\/week were classified as physically active. The amount of PA was calculated as the metabolic equivalent of task (MET)\u2010min\/week for each individual. All participants were followed from the date of diagnosis to 31 December 2022, for the outcome of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the follow\u2010up period of 165\u2009344.0 person\u2010years, 9094 deaths occurred (6633 lung cancer\u2010specific and 2461 non\u2013lung cancer deaths). Multivariable analyses revealed that both pre\u2010 and postdiagnosis PA were associated with significantly reduced risk of all\u2010cause (aHR\u2009=\u20090.92, 95% CI\u2009=\u20090.88\u20130.97 for prediagnosis and aHR\u2009=\u20090.85, 95% CI\u2009=\u20090.81\u20130.89 for postdiagnosis) and lung cancer\u2010specific (aHR\u2009=\u20090.93, 95% CI\u2009=\u20090.88\u20130.99 for prediagnosis and aHR\u2009=\u20090.89, 95% CI\u2009=\u20090.84\u20130.94 for postdiagnosis) mortality compared with inactivity. Significant dose\u2013response relationships were observed between PA levels and mortality risk reduction. Compared with individuals who were consistently inactive before and after diagnosis, significant mortality risk reduction was seen in those who maintained PA (aHR\u2009=\u20090.77, 95% CI\u2009=\u20090.71\u20130.83 for all\u2010cause and aHR\u2009=\u20090.81, 95% CI\u2009=\u20090.75\u20130.89 for lung cancer\u2010specific mortality) and those who promoted PA after lung cancer diagnosis (aHR\u2009=\u20090.91, 95% CI\u2009=\u20090.85\u20130.96 for all\u2010cause and aHR\u2009=\u20090.94, 95% CI\u2009=\u20090.88\u20131.00 for lung cancer\u2010specific mortality). However, individuals who were active before diagnosis but became inactive after diagnosis showed no significant difference in survival outcomes compared with those who were consistently inactive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both pre\u2010 and postdiagnosis PA are associated with reduced mortality in survivors of lung cancer in a dose\u2013response manner. Maintenance and promotion of PA after diagnosis are key to achieving optimal benefits in overall survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70092","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T09:00:38Z","timestamp":1760691638000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of Pre\u2010 and Postdiagnosis Physical Activity, Promotion and Maintenance With Lung Cancer Survival: A Nationwide Cohort Study"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8333-4812","authenticated-orcid":false,"given":"Yeon\u00a0Wook","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyeong\u00a0Im","family":"Kwak","sequence":"additional","affiliation":[{"name":"Big Data Center Seoul National University Bundang Hospital  Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A\u2010Reum","family":"Choi","sequence":"additional","affiliation":[{"name":"Big Data Center Seoul National University Bundang Hospital  Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eung\u00a0Joo","family":"Park","sequence":"additional","affiliation":[{"name":"Big Data Center Seoul National University Bundang Hospital  Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian\u00a0J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Big Data Center Seoul National University Bundang Hospital  Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon\u00a0Joo","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choon\u2010Taek","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Republic of Korea"},{"name":"Emeritus Professor, Seoul National University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2022.264"},{"key":"e_1_2_10_4_1","unstructured":"Korean National Caner Information CenterCancer Statisticshttps:\/\/www.cancer.go.kr\/lay1\/S1T648C652\/contents.do(2024)."},{"key":"e_1_2_10_5_1","volume-title":"Annual Report of Cancer Statistics in Korea in 2021","author":"Korea Central Cancer Registry, National Cancer Center","year":"2023"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.4.1088"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2019.08.025"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2020.09.003"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.14854"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00058"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.1355"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.6590"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21579"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2325"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002116"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-016-0461-3"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-024-03108-4"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctarc.2018.01.001"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkac009"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002117"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.7110"},{"key":"e_1_2_10_23_1","first-page":"799","article-title":"Data Resource Profile: The National Health Information Database of the National Health Insurance Service in South Korea","volume":"46","author":"Seong S. C.","year":"2017","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016640"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.16501"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.1684"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.4082\/kjfm.2012.33.3.144"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz564"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003659"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.3926"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03472-2"},{"key":"e_1_2_10_32_1","volume-title":"ACSM'S Guidelines for Exercise Testing and Prescription","author":"Pescatello L. S. R. D.","year":"2014"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e31821ece12"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu012"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.12.032"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkz080"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja18.00199"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001937"},{"key":"e_1_2_10_40_1","article-title":"Dose\u2010Response Associations Between Accelerometry Measured Physical Activity and Sedentary Time and All Cause Mortality: Systematic Review and Harmonised Meta\u2010Analysis","volume":"366","author":"Ekelund U.","year":"2019","journal-title":"BMJ (Clinical Research Ed.)"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2017.09.015"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxx007"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-210947"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-205944"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2015.09.009"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T20:00:24Z","timestamp":1763928024000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.70092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":44,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/jcsm.70092"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.70092","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-03-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70092"}}