Physical activity and cancer risk: Findings from the UK Biobank, a large prospective cohort study

Abstract

Highlights▪ Moderate physical activity levels were associated with lower risk of oropharyngeal and lung cancers ▪ High physical activity levels were associated with lung, breast, hepatobiliary and colon cancers ▪ Sensitivity analyses showed associations with lower oesophageal and higher prostate cancer incidence ▪ Results varied by deprivation, smoking, or combined body fat and physical activity ▪ Promoting high levels of physical activity may be required for cancer prevention ABSTRACT Objectives: This study aimed to investigate the association between physical activity and site-specific cancer incidence.Methods: UK Biobank is a prospective population-based cohort study. 364,899 adults (51.6% females, mean age 56.0 years) were included. The exposure variable was physical activity level derived from the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Participants were categorised at 'high' (≥1,500 MET-minutes/week), 'moderate' (≥600 MET-minutes/week) or 'low' levels of activity following standardised IPAQ-SF scoring guidance. Primary outcome measures included incident cancers at 20 sites. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) showing relationships between physical activity and cancer.Results: 21,816 incident cancers were identified. Significant associations were identified between high physical activity levels and lower risk of lung (HR 0.81, 95% CI: 0.70, 0.94), breast (female only) (HR 0.85, 95% CI: 0.77, 0.94), hepatobiliary tract (HR 0.72, 95% CI: 0.53, 0.97), and colon (HR 0.86, 95% CI: 0.74, 0.99) cancers compared to low physical activity levels. Moderate levels of physical activity were associated with significantly lower risk of oropharyngeal (HR 0.71, 95% CI: 0.55, 0.93), and lung cancer (HR 0.86, 95% CI: 0.74, 0.99) compared to low physical activity levels. Sensitivity analyses showed associations of higher physical activity with lower oesophageal and higher prostate cancer incidence. Conclusions:Regular physical activity is significantly associated with reduced risk for lung, breast, hepatobiliary tract, colon and oropharyngeal cancers. Our findings highlight the importance of physical activity promotion, particularly high levels of physical activity, in cancer prevention.

An Investigation into the Physical Activity Experiences of People Living with and beyond Cancer during the COVID-19 Pandemic

“…Indeed, PA has been identified as being an important component of cancer survivorship [17,33] and the pandemic has resulted in a decrease in PA of PLWBC [25]. Recognising the importance of PA for prostate [34], breast [25] and other cancers [35], our research confirmed that the adapted CARE programme was an important ingredient in helping PLWBC to keep physically active during the COVID-19 restrictions. Regardless of whether attendees engaged CARE online or outdoors, sessions provided an important opportunity to secure the physical, social [1,19] and mental health benefits of PA [1,19,36,37].…”

Diet, weight status, and physical activity in cancer prevention

“…Moreover, sarcopenia (low muscle mass), a prevalent condition in obese cancer patients, may need further body composition assessments using sophisticated tools to explore the obesity paradox in cancer and the potential mechanisms that could explain it. Previous studies have demonstrated that people who engage in moderate to vigorous levels of physical activity are at a lower risk of developing several cancers including lung, breast, hepatobiliary tract, colon, and oropharyngeal cancers 13,90 . Nevertheless, for some cancers, this risk reduction may be independent of the direct effect of physical activity.…”

“…In addition, observational studies have shown that low 25hydroxyvitamin D levels, in women with early-stage breast cancer, are associated with an increased recurrence risk 100 . Since outdoor physical activity can increase 25-hydroxyvitamin D levels, this could be another mechanism linking physical activity to cancer 90 . Although there is irrefutable evidence that physical activity plays an important role in preventing many cancers, the type, intensity, duration, and frequency of physical activity that have optimal effects for cancer prevention remain unclear 95 .…”

“…Moreover, physical activity affects the metabolic profile of estrogens which results in reduced hormonal activity and increased anti-proliferative properties in cancer cells 89 . Regular physical activity is associated with a lower risk of most common malignancies, including lung, breast, hepatobiliary tract, endometrial, colon, oropharyngeal, kidney, and bladder cancers [89][90][91] . For example, physically active men and women were found to have about a 30%-40% reduction in the relative risk of developing colon cancer compared to their inactive peers.…”

Physical Activity and Cancer Status Among Middle-Aged and Older Chinese: A Population-Based, Cross-Sectional Study

“…Thus, attenuating secondary health problems in cancer survivors has become a major public health challenge. However, cancer incidence and recurrence can be prevented with a healthy lifestyle, including regular physical activity (PA), to some extent ( Loprinzi et al, 2012 ; Lahart et al, 2015 ; Murray et al, 2020 ). PA is a modifiable behavior that is linked to several cancers and has been shown to be effective in the primary prevention of cancer ( Moore et al, 2012 ; Hojman et al, 2018 ).…”