Cost-effectiveness of physical activity interventions in cancer survivors of developed countries: a systematic review

J Cancer Surviv. 2021 Dec;15(6):961-975. doi: 10.1007/s11764-021-01002-0. Epub 2021 Feb 23.


Purpose: Physical activity has been shown to improve survival and quality of life of cancer patients. Due to differences in patient populations, healthcare settings, and types of intervention, cost-effectiveness analyses of physical activity interventions in cancer survivors are difficult to compare. Available evidence from breast cancer survivor research has shown inconsistent results, and transfer of results to other types of cancer is not straightforward. This paper systematically reviewed current evidence on the cost-effectiveness of physical activity interventions in cancer survivors independent of cancer type compared to usual care or another experimental intervention.

Methods: The literature search was conducted in seven databases and enhanced by a search for gray literature. Eligible studies were restricted to developed countries and assessed using the CHEERS, CHEC, and PHILIPS checklists. The study protocol was pre-published in PROSPERO.

Results: Seven studies, five cost-utility, and two combined cost-utility/cost-effectiveness analyses fully met the inclusion criteria. They covered eight different types of cancer and various interventions. The cost-effectiveness analyses were of moderate to high methodological quality. A high probability of cost-effectiveness was reported in two analyses. One intervention appeared to be not cost-effective, and one to be cost-effective only from an organizational perspective. Three other analyses reported a cost-effectiveness better than US$ 101,195 (€ 80,000) per QALY gained.

Conclusions: Physical activity interventions in cancer survivors of developed countries were cost-effective in some but not all clinical trials reviewed.

Implications for cancer survivors: Cost-effectiveness of physical activity interventions appear to depend upon the intensity of the activity.

Keywords: Cancer survivor; Cost-effectiveness; Cost-utility; Physical activity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Breast Neoplasms*
  • Cancer Survivors*
  • Cost-Benefit Analysis
  • Developed Countries
  • Exercise
  • Female
  • Humans
  • Quality of Life