Association of Sedentary Behavior With Cancer Mortality in Middle-aged and Older US Adults

Abstract

IMPORTANCESedentary behavior is associated with several health outcomes, including diabetes, cardiovascular disease, and all-cause mortality. Less is known about the association between objectively measured sedentary behavior and cancer mortality, as well as the association with physical activity.OBJECTIVE To examine the association between accelerometer-measured sedentary behavior (total volume and accrual in prolonged, uninterrupted bouts) and cancer mortality. DESIGN, SETTING, AND PARTICIPANTSA prospective cohort study conducted in the contiguous US included 8002 black and white adults aged 45 years or older enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The present analysis was performed from April 18, 2019, to April 21, 2020.EXPOSURES Sedentary time, light-intensity physical activity (LIPA), and moderate-to vigorous-intensity physical activity (MVPA) were measured using a hip-mounted accelerometer worn for 7 consecutive days. MAIN OUTCOMES AND MEASURES Cancer mortality.RESULTS Of the 8002 study participants, 3668 were men (45.8%); mean (SD) age was 69.8 (8.5) years. Over a mean (SD) follow-up of 5.3 (1.5) years, 268 participants (3.3%) died of cancer. In multivariable-adjusted models, including MVPA, greater total sedentary time was associated with a greater risk of cancer mortality (tertile 2 vs tertile 1: hazard ratio [HR], 1.45; 95% CI, 1.00-2.11; tertile 3 vs tertile 1: HR, 1.52; 95% CI, 1.01-2.27). Longer sedentary bout duration was not significantly associated with greater cancer mortality risk: after adjustment for MVPA (tertile 2 vs tertile 1: HR, 1.26; 95% CI, 0.90-1.78; tertile 3 vs tertile 1: HR, 1.36; 95% CI, 0.96-1.93). Replacing 30 minutes of sedentary time with LIPA was significantly associated with an 8% (per 30 minutes: HR, 0.92; 95% CI, 0.86-0.97) lower risk of cancer mortality; MVPA was significantly associated with a 31% (per 30 minutes: HR, 0.69; 95% CI, 0.48-0.97) lower risk of cancer mortality. CONCLUSIONS AND RELEVANCEIn this cohort study, greater sedentary time, as measured with accelerometry, appeared to be independently associated with cancer mortality risk. Replacing sedentary time with either LIPA or MVPA may be associated with a lower risk of cancer mortality. These findings suggest that the total volume of sedentary behavior is a potential cancer mortality risk factor and support the public health message that adults should sit less and move more to promote longevity.

Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks

“…56) However, replacing 30 minutes of sedentary time with LIPA reduced the cancer mortality by 8% (HR, 0.92; 95% CI, 0.86-0.97) and replacing it with MVPA reduced it by 31% (HR, 0.69; 95% CI, 0.48-0.97). 56)…”

“…A recently published study showed that sedentary behavior was independently associated with cancer mortality risk, where a higher sedentary time led to a greater cancer mortality risk. In this study, the individuals in the top 1/3 of the sedentary group showed a substantially higher cancer mortality risk than those in the bottom 1/3 (adjusted HR, 1.52; 95% CI, 1.01–2.27) [ 56 ]. However, replacing 30 minutes of sedentary time with LIPA reduced the cancer mortality by 8% (HR, 0.92; 95% CI, 0.86–0.97) and replacing it with MVPA reduced it by 31% (HR, 0.69; 95% CI, 0.48–0.97) [ 56 ].…”

Muscle Health: The Gateway to Population Health Management

“…One area of research that has increased dramatically focuses on muscle mass and strength related to cancer treatment and prevention [18][19][20][21][22][23][24][25][26][27][28]. Caan and associates in 2018 showed that women with non-metastatic breast cancer had 41% better chance of surviving with a healthier muscle mass compared to sarcopenic non-metastatic breast cancer patients [18].…”

“…The figures also show after the 40-49 age group there is a rapid decrease in absolute strength which supports the concept of loss of muscle mass and strength with aging along with an increase in sedentary lifestyles. Interestingly, the youngest age group (20)(21)(22)(23)(24)(25)(26)(27)(28)(29) had the greatest deficit for the shoulder and knee strength when compared to the three age groups between 30 and 59. This is a reflection on the sedentary lifestyles found in children and youth which then carries over into industry.…”

Sedentary behavior shown to independently predict cancer mortality

“…Published in JAMA Oncology , the study was the first to examine the connection and show a strong association between these 2 objective measures 1 . Furthermore, the amount of time that a person spends sitting before a cancer diagnosis is predictive of the time to cancer death, notes lead author Susan Gilchrist, MD, a professor of clinical cancer prevention at MD Anderson.…”