Importance
Accumulating evidence indicates that common carcinogenic pathways may underlie digestive system cancers. Physical activity may influence these pathways, yet no previous study has evaluated the role of physical activity in overall digestive system cancer risk.
Objective
To examine the association between physical activity and digestive system cancer risk, accounting for amount, type (aerobic versus resistance), and intensity of physical activity.
Design
A prospective cohort study followed from 1986 to 2012.
Setting
Male health professionals living in the general community in the US
Participants
Eligible participants were 40 years or older, were free of cancer, and reported physical activity. Out of 51,529 individuals, 43,479 were followed-up, with follow-up rates exceeding 90% in each 2-year cycle.
Exposures
The amount of total physical activity expressed in metabolic equivalent of task [MET]-hours/week
Main Outcomes and Measures
Incident cancer of the digestive system encompassing the digestive tract (mouth, throat, esophagus, stomach, small intestine, and colorectum) and digestive accessory organs (pancreas, gallbladder, and liver).
Results
Over 686,924 person-years, we documented 1,370 incident digestive system cancers. Higher levels of physical activity were associated with lower digestive system cancer risk (hazard ratio [HR], 0.74 for 63+ versus ≤8.9 MET-hours/week; 95% confidence interval [CI], 0.59-0.93; P for trend, .003). The inverse association was more evident with digestive tract cancers (HR, 0.66 for 63+ versus ≤8.9 MET-hours/week; 95% CI, 0.51-0.87) than with digestive accessary organ cancers. Aerobic exercise was particularly beneficial against digestive system cancers, with the optimal benefit observed at approximately 30 MET-hours/week (HR, 0.68; 95% CI, 0.56-0.83; Pnon-linearity, 0.02). Moreover, as long as the same level of MET-hour score was achieved from aerobic exercise, the magnitude of risk reduction was similar regardless of intensity of aerobic exercise.
Conclusion and Relevance
Physical activity, as indicated by MET-hours/week, was inversely associated with the risk of digestive system cancers, particularly digestive tract cancers, in men. The optimal benefit was observed through aerobic exercise of any intensity at the equivalent of energy expenditure of approximately 10 hours/week of walking at average pace. Future studies are warranted to confirm our findings and to translate them into clinical and public health recommendation.