Krasimira Aleksandrova1, Mazda Jenab2, Michael Leitzmann3, Bas Bueno-de-Mesquita4,5,6,7, Rudolf Kaaks8, Antonia Trichopoulou9,10, Christina Bamia9,10, Pagona Lagiou9,11, Sabina Rinaldi2, Heinz Freisling2, Marion Carayol2, Tobias Pischon12, Dagmar Drogan13, Elisabete Weiderpass14,15,16,17, Paula Jakszyn18, Kim Overvad19, Christina C Dahm19, Anne Tjønneland20, Marie-Christine Bouton-Ruault21,22,23, Tilman Kühn24, Eleni Peppa9, Elissavet Valanou9, Carlo La Vecchia9,25, Domenico Palli26, Salvatore Panico27, Carlotta Sacerdote28, Claudia Agnoli29, Rosario Tumino30, Anne May31, Jonna van Vulpen31, Kristin Benjaminsen Borch14, Sunday Oluwafemi Oyeyemi14, J Ramón Quirós32, Catalina Bonet18, María-José Sánchez33,34, Miren Dorronsoro35, Carmen Navarro34,36,37, Aurelio Barricarte34,38,39, Bethany van Guelpen40, Patrik Wennberg41, Timothy J Key42, Kay-Tee Khaw43, Nicholas Wareham44, Nada Assi2, Heather A Ward6, Dagfinn Aune6, Elio Riboli6, Heiner Boeing45. 1. Nutrition, Immunity and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. 2. International Agency for Research on Cancer (IARC-WHO), Lyon, France. 3. Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany. 4. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 5. Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands. 6. Division of Epidemiology, Public Health and Primary Care, Imperial College, London, UK. 7. Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia. 8. Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany. 9. Hellenic Health Foundation, Athens, Greece. 10. WHO Collaborating Center for Nutrition and Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens (NKUA), Athens, Greece. 11. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. 12. Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine (MDC), Berlin-Buch, Germany. 13. Quality and Health Services Research Unit, AOK Research Institute, Berlin, Germany. 14. Department of Community Medicine, University of Tromsø, Tromsø, Norway. 15. Department of Research, Cancer Registry of Norway, Oslo, Norway. 16. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 17. Genetic Epidemiology Group, Folkhalsan Research Center, Helsinki, Finland. 18. Cancer Epidemiology Research Program, Catalan Institute of Oncology and Bellvitge Biomedical Research Institute, Barcelona, Spain. 19. Department of Public Health, Aarhus University, Aarhus, Denmark. 20. Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark. 21. Centre for Research in Epidemiology and Population Health, Villejuif, France. 22. Universite Paris Sud, UMRS 1018, F-94805, Villejuif, France. 23. IGR, F-94805, Villejuif, France. 24. German Cancer Research Center, Division of Cancer Epidemiology, Heidelberg, Germany. 25. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy. 26. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy. 27. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. 28. Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy. 29. Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy. 30. Cancer Registry and Histopathology Unit, 'M.P. Arezzo' Hospital, Ragusa, Italy. 31. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 32. Public Health Directorate, Asturias, Oviedo, Spain. 33. Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria de Granada, Granada, Spain. 34. Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain. 35. Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain. 36. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. 37. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. 38. Navarre Public Health Institute, Pamplona, Navarra, Spain. 39. Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. 40. Department of Radiation Sciences Oncology, Umeå University, Umeå, Sweden. 41. Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden. 42. Nuffield Department of Population Health, University of Oxford, Oxford, UK. 43. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. 44. MRC Epidemiology Unit, Addenbrooke's Hospital, Cambridge, UK. 45. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Abstract
Background: There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer. Methods: We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline. Results: High physical activity was associated with a lower risk of colon cancer: relative risk ≥91 MET-h/week vs <91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively. Conclusions: Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.
Background: There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer. Methods: We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline. Results: High physical activity was associated with a lower risk of colon cancer: relative risk ≥91 MET-h/week vs <91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively. Conclusions: Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.
Authors: Elizabeth A Hibler; Christine L Sardo Molmenti; Qi Dai; Lindsay N Kohler; Shaneda Warren Anderson; Peter W Jurutka; Elizabeth T Jacobs Journal: Bone Date: 2015-11-24 Impact factor: 4.398
Authors: E de Vries; I Soerjomataram; V E P P Lemmens; J W W Coebergh; J J Barendregt; A Oenema; H Møller; H Brenner; Andrew G Renehan Journal: Eur J Cancer Date: 2010-09 Impact factor: 9.162
Authors: E Riboli; K J Hunt; N Slimani; P Ferrari; T Norat; M Fahey; U R Charrondière; B Hémon; C Casagrande; J Vignat; K Overvad; A Tjønneland; F Clavel-Chapelon; A Thiébaut; J Wahrendorf; H Boeing; D Trichopoulos; A Trichopoulou; P Vineis; D Palli; H B Bueno-De-Mesquita; P H M Peeters; E Lund; D Engeset; C A González; A Barricarte; G Berglund; G Hallmans; N E Day; T J Key; R Kaaks; R Saracci Journal: Public Health Nutr Date: 2002-12 Impact factor: 4.022
Authors: Mazda Jenab; H Bas Bueno-de-Mesquita; Pietro Ferrari; Franzel J B van Duijnhoven; Teresa Norat; Tobias Pischon; Eugène H J M Jansen; Nadia Slimani; Graham Byrnes; Sabina Rinaldi; Anne Tjønneland; Anja Olsen; Kim Overvad; Marie-Christine Boutron-Ruault; Françoise Clavel-Chapelon; Sophie Morois; Rudolf Kaaks; Jakob Linseisen; Heiner Boeing; Manuela M Bergmann; Antonia Trichopoulou; Gesthimani Misirli; Dimitrios Trichopoulos; Franco Berrino; Paolo Vineis; Salvatore Panico; Domenico Palli; Rosario Tumino; Martine M Ros; Carla H van Gils; Petra H Peeters; Magritt Brustad; Eiliv Lund; María-José Tormo; Eva Ardanaz; Laudina Rodríguez; Maria-José Sánchez; Miren Dorronsoro; Carlos A Gonzalez; Göran Hallmans; Richard Palmqvist; Andrew Roddam; Timothy J Key; Kay-Tee Khaw; Philippe Autier; Pierre Hainaut; Elio Riboli Journal: BMJ Date: 2010-01-21
Authors: Mazda Jenab; Elio Riboli; Rebecca J Cleveland; Teresa Norat; Sabina Rinaldi; Alexandra Nieters; Carine Biessy; Ann Tjønneland; Anja Olsen; Kim Overvad; Henning Grønbaek; Françoise Clavel-Chapelon; Marie-Christine Boutron-Ruault; Jakob Linseisen; Heiner Boeing; Tobias Pischon; Dimitrios Trichopoulos; Eleni Oikonomou; Antonia Trichopoulou; Salvatore Panico; Paolo Vineis; Franco Berrino; Rosario Tumino; Giovanna Masala; Petra H Peters; Carla H van Gils; H Bas Bueno-de-Mesquita; Marga C Ocké; Eiliv Lund; Michelle A Mendez; María José Tormo; Aurelio Barricarte; Carmen Martínez-García; Miren Dorronsoro; José Ramón Quirós; Göran Hallmans; Richard Palmqvist; Göran Berglund; Jonas Manjer; Timothy Key; Naomi E Allen; Sheila Bingham; Kay-Tee Khaw; Anne Cust; Rudolf Kaaks Journal: Int J Cancer Date: 2007-07-15 Impact factor: 7.396
Authors: Priyanka A Pophali; Andrew Ip; Melissa C Larson; Allison C Rosenthal; Matthew J Maurer; Christopher R Flowers; Brian K Link; Umar Farooq; Andrew L Feldman; Cristine Allmer; Susan L Slager; Thomas E Witzig; Thomas M Habermann; Jonathon B Cohen; James R Cerhan; Carrie A Thompson Journal: Am J Hematol Date: 2018-10-17 Impact factor: 10.047
Authors: Krasimira Aleksandrova; Robin Reichmann; Rudolf Kaaks; Mazda Jenab; H Bas Bueno-de-Mesquita; Christina C Dahm; Anne Kirstine Eriksen; Anne Tjønneland; Fanny Artaud; Marie-Christine Boutron-Ruault; Gianluca Severi; Anika Hüsing; Antonia Trichopoulou; Anna Karakatsani; Eleni Peppa; Salvatore Panico; Giovanna Masala; Sara Grioni; Carlotta Sacerdote; Rosario Tumino; Sjoerd G Elias; Anne M May; Kristin B Borch; Torkjel M Sandanger; Guri Skeie; Maria-Jose Sánchez; José María Huerta; Núria Sala; Aurelio Barricarte Gurrea; José Ramón Quirós; Pilar Amiano; Jonna Berntsson; Isabel Drake; Bethany van Guelpen; Sophia Harlid; Tim Key; Elisabete Weiderpass; Elom K Aglago; Amanda J Cross; Konstantinos K Tsilidis; Elio Riboli; Marc J Gunter Journal: BMC Med Date: 2021-01-04 Impact factor: 8.775