Baseline Characteristics of Participants in the Exercise for Cancer to Enhance Living Well ( EXCEL ) Study: A Canada‐Wide Rural–Urban Analysis

INTRODUCTION: Exercise interventions improve quality of life and survival for individuals living with and beyond cancer (ILWBC), yet equitable access remains limited. Evidence on characteristics of who enrolls in exercise oncology programs is scarce, leaving gaps for equity-focused recruitment and scale-up, particularly in rural and underserved settings. The EXercise for Cancer to Enhance Living Well (EXCEL) study offers a unique opportunity to examine these issues across a Canada-wide cohort. METHODS: EXCEL is an 8-12-week tailored exercise intervention delivered primarily to ILWBC in rural/remote communities, with additional enrollment of urban participants lacking exercise oncology resources. Adults with any cancer type or stage were eligible if pre-treatment, receiving treatment, or within 3 years post-treatment. This analysis describes baseline demographic, lifestyle, medical, and fitness factors by rural versus urban residence using descriptive statistics. RESULTS: Of 1495 participants enrolled in the EXCEL program (rural n = 1085; urban n = 400), baseline characteristics differed modestly by geography. Age did not differ significantly between rural and urban participants. Rural participants were more often male, had lower educational attainment, and demonstrated higher BMI than urban participants. Urban participants exhibited greater ethnic diversity and higher levels of education. Physical activity levels were similar with 78% classified as physically active at baseline. CONCLUSION: This Canada-wide baseline analysis reveals rural-urban variations in age, treatment status, disease burden, education, and lifestyle, yet comparable physical activity and functional capacity levels. These findings provide descriptive evidence to inform recruitment strategies and considerations for exercise oncology program delivery across geographic settings.