The role of physical activity and exercise in gynecologic cancer care: protocol for an umbrella review

Abstract

Background: Gynecologic cancers are associated with long-term physical and psychological challenges. Physical activity (PA) and exercise are increasingly recognized as important components of cancer care. However, no umbrella review has synthesized evidence across gynecologic cancers. This review aims to evaluate the effectiveness of PA and exercise in improving health outcomes. Methods: This umbrella review will include systematic reviews and meta-analyses assessing the impact of PA and exercise on physical and psychological outcomes. Searches will be conducted in MEDLINE, CINAHL, Embase, ProQuest Health and Medical Collection, Scopus, Web of Science, Thai Journal Online (ThaiJO), and gray literature. Two reviewers will independently screen, extract data, and assess methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool. Overlap of primary studies will be quantified using the Graphical Representation of Overlap for OVErviews (GROOVE) method. Findings will be synthesized narratively and summarized using two approaches: (1) a traffic light system will be used to visually indicate the effectiveness of each intervention (green = benefit, orange = no effect or inconclusive, red = harm or lower effectiveness) and (2) the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework will be applied to rate the certainty of evidence for each intervention–outcome as high, moderate, low, or very low. Discussion: This review will provide the first comprehensive synthesis of PA and exercise interventions in gynecologic cancers, generating evidence-based recommendations to guide tailored survivorship care. Systematic review registration: PROSPERO CRD42024548933.