Background: Physical exercise is proven safe and effective in improving quality of life and reducing treatment-related side effects in oncology. However, patient adherence to international guidelines remains suboptimal. Investigating the knowledge, attitudes, and practices (KAP) regarding physical activity is crucial to identifying unmet educational needs and barriers.

Objective: This multicenter, cross-sectional observational study (ECOLE project) aims to assess KAP levels concerning exercise among cancer patients and explore the correlations between KAP scores and sociodemographic or clinical variables.

Methods: Over a 6-month period, an anonymous online survey (Microsoft Forms) will be administered to adult cancer patients (≥18 years old) at any disease or treatment stage. A minimum sample size of 370 participants is targeted. Statistical analyses will include Descriptive Statistics, Exploratory and Confirmatory Factor Analyses to validate KAP scales, and Multivariable Logistic Regression to identify predictors of adherence (≥150 minutes/week) and perceived barriers or facilitators.

Expected Results: The study will provide a comprehensive overview of physical activity perceptions and behaviors in oncology. These insights will support the design of targeted educational interventions and structured exercise programs, contributing to the development of a novel "Exercise Oncology Specialist" within supportive care teams.

Inclusion Criteria:

• Age ≥18 years
• Oncological diagnosis
• Ability to understand the language of the respective country of origin
• Electronic informed consent

Exclusion Criteria:

- Failure to accept the informed consent

Adult cancer patients (≥18 years old), at any stage of the oncological journey (undergoing treatment, posttreatment, or advanced disease).