Scoping Review of Cardiorespiratory Fitness in Adolescent and Young Adult Cancer Survivors

Advancements in cancer research, treatment protocols, and supportive care interventions have contributed to an increasing population of adolescent and young adult cancer survivors (AYA-CS). Impaired cardiorespiratory fitness is a key modifiable risk factor in AYA-CS, linked to several conditions, in particular cardiovascular disease. This scoping review describes and synthesizes previously published data that has documented the cardiorespiratory fitness in AYA-CS. Secondary objectives were to synthesize the assessment methodologies used to measure cardiorespiratory fitness and to explore whether exercise interventions improve AYA-CS fitness. CINAHL, EMBASE, MEDLINE, and SPORTDiscus were systematically searched from [28/02/2025]. Original articles that assessed cardiorespiratory fitness in AYA-CS (aged between 15 and 39 at the time of cancer diagnosis and had completed treatment) were eligible. A total of 3049 articles were identified from the database search. After screening, 10 studies were included, representing 494 participants (59.7% female). AYA-CS exhibit markedly reduced cardiorespiratory fitness with peak oxygen uptake values 20-47% below healthy controls when measured via cardiopulmonary exercise test. There was wide variability in both the measures used to assess cardiorespiratory fitness and the types and mode of prescribed exercise interventions. Exercise interventions were primarily individualized and aerobic, demonstrating good feasibility and high acceptability among AYA-CS. This scoping review highlights that AYA-CS experience persistent impairments in cardiorespiratory fitness post-treatment. Future research is required to standardize fitness assessment measures, establishing cardiorespiratory fitness norms to help guide clinical interventions and the development of targeted interventions aimed at improving fitness and health outcomes.