Anne McTiernan1,2, Christine M Friedenreich3,4,5, Peter T Katzmarzyk6, Kenneth E Powell7, Richard Macko8, David Buchner9, Linda S Pescatello10, Bonny Bloodgood11, Bethany Tennant11, Alison Vaux-Bjerke12, Stephanie M George13, Richard P Troiano14, Katrina L Piercy12. 1. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA. 2. Schools of Public Health and Medicine, Departments of Epidemiology and Medicine (Geriatrics), University of Washington, Seattle, WA. 3. Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, CANADA. 4. Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CANADA. 5. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CANADA. 6. Pennington Biomedical Research Center, Baton Rouge, LA. 7. Centers for Disease Control, Georgia Department of Public Health, Atlanta, GA. 8. Department of Neurology, University of Maryland School of Medicine University Maryland Rehabilitation & Orthopedics Institute Maryland Exercise & Robotics Center of Excellence, Veterans Affairs Maryland Health Care System Geriatrics Research, Education, and Clinical Center, Veterans Affairs Medical Center, Baltimore, MD. 9. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL. 10. Department of Kinesiology, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT. 11. ICF, Fairfax, VA. 12. Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Rockville, MD. 13. Office of Disease Prevention, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD. 14. Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD.
Abstract
PURPOSE: This article reviews and updates the evidence on the associations between physical activity and risk for cancer, and for mortality in persons with cancer, as presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. METHODS: Systematic reviews of meta-analyses, systematic reviews, and pooled analyses were conducted through December 2016. An updated systematic review of such reports plus original research through February 2018 was conducted. This article also identifies future research needs. RESULTS: In reviewing 45 reports comprising hundreds of epidemiologic studies with several million study participants, the report found strong evidence for an association between highest versus lowest physical activity levels and reduced risks of bladder, breast, colon, endometrial, esophageal adenocarcinoma, renal, and gastric cancers. Relative risk reductions ranged from approximately 10% to 20%. Based on 18 systematic reviews and meta-analyses, the report also found moderate or limited associations between greater amounts of physical activity and decreased all-cause and cancer-specific mortality in individuals with a diagnosis of breast, colorectal, or prostate cancer, with relative risk reductions ranging almost up to 40% to 50%. The updated search, with five meta-analyses and 25 source articles reviewed, confirmed these findings. CONCLUSIONS: Levels of physical activity recommended in the 2018 Guidelines are associated with reduced risk and improved survival for several cancers. More research is needed to determine the associations between physical activity and incidence for less common cancers and associations with survival for other cancers. Future studies of cancer incidence and mortality should consider these associations for population subgroups, to determine dose-response relationships between physical activity and cancer risk and prognosis, and to establish mechanisms to explain these associations.
PURPOSE: This article reviews and updates the evidence on the associations between physical activity and risk for cancer, and for mortality in persons with cancer, as presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. METHODS: Systematic reviews of meta-analyses, systematic reviews, and pooled analyses were conducted through December 2016. An updated systematic review of such reports plus original research through February 2018 was conducted. This article also identifies future research needs. RESULTS: In reviewing 45 reports comprising hundreds of epidemiologic studies with several million study participants, the report found strong evidence for an association between highest versus lowest physical activity levels and reduced risks of bladder, breast, colon, endometrial, esophageal adenocarcinoma, renal, and gastric cancers. Relative risk reductions ranged from approximately 10% to 20%. Based on 18 systematic reviews and meta-analyses, the report also found moderate or limited associations between greater amounts of physical activity and decreased all-cause and cancer-specific mortality in individuals with a diagnosis of breast, colorectal, or prostate cancer, with relative risk reductions ranging almost up to 40% to 50%. The updated search, with five meta-analyses and 25 source articles reviewed, confirmed these findings. CONCLUSIONS: Levels of physical activity recommended in the 2018 Guidelines are associated with reduced risk and improved survival for several cancers. More research is needed to determine the associations between physical activity and incidence for less common cancers and associations with survival for other cancers. Future studies of cancer incidence and mortality should consider these associations for population subgroups, to determine dose-response relationships between physical activity and cancer risk and prognosis, and to establish mechanisms to explain these associations.
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