BACKGROUND: Physical activity (PA) is beneficial in improving negative physical and psychological effects of cancer and cancer treatment, but adherence to PA guidelines is low. Computer-tailored PA interventions can reach large populations with little resources. They match with patients' preference for home-based, unsupervised PA programs and are thus promising for the growing population of cancer survivors. The current study assessed the efficacy of a computer-tailored PA intervention in (four subgroups of) prostate and colorectal cancer survivors. METHODS: Prostate and colorectal cancer patients and survivors were randomized to the OncoActive intervention group (n = 249), or a usual-care waiting-list control group (n = 229). OncoActive participants received a pedometer and computer-tailored PA advice, both web-based via an interactive website and with printed materials. Minutes moderate-to-vigorous PA (MVPA) and days >= 30 min PA were assessed with an accelerometer (ActiGraph) at baseline and 6 months. Further, questionnaires were used to assess self-reported PA, fatigue, distress, and quality of life at baseline, 3 and 6 months. Differences between both groups were assessed using linear regression analyses (complete cases and intention-to-treat). In addition, efficacy in relation to age, gender, education, type of cancer, and time since treatment was examined. RESULTS: Three months after baseline OncoActive participants significantly increased their self-reported PA (PA days d = 0.46; MVPA d = 0.23). Physical functioning (d = 0.23) and fatigue (d = -0.21) also improved significantly after three months. Six months after baseline, self-reported PA (PA days d = 0.51; MVPA d 0.37) and ActiGraph MVPA (d = 0.27) increased significantly, and ActiGraph days (d = 0.16) increased borderline significantly (p = 0.05; d = 0.16). Furthermore, OncoActive participants reported significantly improvements in physical functioning (d = 0.14), fatigue (d = -0.23) and depression (d = -0.32). Similar results were found for intention-to-treat analyses. Higher increases in PA were found for colorectal cancer participants at 3 months, and for medium and highly educated participants' PA at 6 months. Health outcomes at 6 months were more prominent in colorectal cancer participants and in women. CONCLUSIONS: The OncoActive intervention was effective at increasing PA in prostate and colorectal cancer patients and survivors. Health-related effects were especially apparent in colorectal cancer participants. The intervention provides opportunities to accelerate cancer recovery. Long-term follow-up should examine further sustainability of these effects. TRIAL REGISTRATION: The study was registered in the Dutch Trial Register (NTR4296) on October 17 2018.

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