Cited by 1,487Cancer Risks and FactorsPhysical Activity and HealthGlobal Cancer Incidence and Screening

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Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults

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Abstract

IMPORTANCE: Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood. OBJECTIVE: To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking. DESIGN, SETTING, AND PARTICIPANTS: We pooled data from 12 prospective US and European cohorts with self-reported physical activity (baseline, 1987-2004). We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals for associations of leisure-time physical activity with incidence of 26 types of cancer. Leisure-time physical activity levels were modeled as cohort-specific percentiles on a continuous basis and cohort-specific results were synthesized by random-effects meta-analysis. Hazard ratios for high vs low levels of activity are based on a comparison of risk at the 90th vs 10th percentiles of activity. The data analysis was performed from January 1, 2014, to June 1, 2015. EXPOSURES: Leisure-time physical activity of a moderate to vigorous intensity. MAIN OUTCOMES AND MEASURES: Incident cancer during follow-up. RESULTS: A total of 1.44 million participants (median [range] age, 59 [19-98] years; 57% female) and 186 932 cancers were included. High vs low levels of leisure-time physical activity were associated with lower risks of 13 cancers: esophageal adenocarcinoma (HR, 0.58; 95% CI, 0.37-0.89), liver (HR, 0.73; 95% CI, 0.55-0.98), lung (HR, 0.74; 95% CI, 0.71-0.77), kidney (HR, 0.77; 95% CI, 0.70-0.85), gastric cardia (HR, 0.78; 95% CI, 0.64-0.95), endometrial (HR, 0.79; 95% CI, 0.68-0.92), myeloid leukemia (HR, 0.80; 95% CI, 0.70-0.92), myeloma (HR, 0.83; 95% CI, 0.72-0.95), colon (HR, 0.84; 95% CI, 0.77-0.91), head and neck (HR, 0.85; 95% CI, 0.78-0.93), rectal (HR, 0.87; 95% CI, 0.80-0.95), bladder (HR, 0.87; 95% CI, 0.82-0.92), and breast (HR, 0.90; 95% CI, 0.87-0.93). Body mass index adjustment modestly attenuated associations for several cancers, but 10 of 13 inverse associations remained statistically significant after this adjustment. Leisure-time physical activity was associated with higher risks of malignant melanoma (HR, 1.27; 95% CI, 1.16-1.40) and prostate cancer (HR, 1.05; 95% CI, 1.03-1.08). Associations were generally similar between overweight/obese and normal-weight individuals. Smoking status modified the association for lung cancer but not other smoking-related cancers. CONCLUSIONS AND RELEVANCE: Leisure-time physical activity was associated with lower risks of many cancer types. Health care professionals counseling inactive adults should emphasize that most of these associations were evident regardless of body size or smoking history, supporting broad generalizability of findings.

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Crossref · 10.1001/jamainternmed.2016.1548

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Metadata

Authors
Moore, S. C., Lee, I.-M., Weiderpass, E., Campbell, P. T., Sampson, J. N., Kitahara, C. M., Keadle, S. K., Arem, H., Berrington de Gonzalez, A., Hartge, P., Adami, H.-O., Blair, C. K., Borch, K. B., Boyd, E., Check, D. P., Fournier, A., Freedman, N. D., Gunter, M., Johannson, M., Khaw, K.-T., Linet, M. S., Orsini, N., Park, Y., Riboli, E., Robien, K., Schairer, C., Sesso, H., Spriggs, M., Van Dusen, R., Wolk, A., Matthews, C. E., & Patel, A. V.
Affiliations
  • National Cancer Institute (US)
  • Brigham and Women's Hospital (US)
  • Karolinska Institutet (SE)
  • American Cancer Society (US)
  • United States Agency for International Development (US)
  • Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
  • Harvard University (US)
  • University of New Mexico (US)
  • UiT The Arctic University of Norway (NO)
  • Information Management Services (US)
  • Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France
  • Centre international de recherche sur le cancer (FR)
  • University of Cambridge (GB)
  • Washington University in St. Louis (US)
  • Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, England
  • George Washington University (US)
  • Information Management Services, Inc, Rockville, Maryland
Corresponding author
Moore, Steven C.
Venue
JAMA Internal Medicine
Published
2016-06-01
Volume
176
Issue
6
Pages
816
ISSN
2168-6106 (ISSN-L)
OpenAlex
W2402756356
Cited by
1,487
References
48
Citations by year
2026: 113 · 2025: 139 · 2024: 144 · 2023: 163 · 2022: 154 · 2021: 155 · 2020: 175 · 2019: 184 · 2018: 134 · 2017: 107 · 2016: 18
FWCI
79.65
Type
journal article
Language
en
Open access
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Spiral (Imperial College London) (submittedVersion)
Funders
  • World Health Organization
  • Cancer Research UK (14136)
  • National Institute for Health and Care Research (NF-SI-0512-10114)
  • National Institutes of Health (Z99 CA999999)
  • Medical Research Council (MR/N003284/1)
  • National Cancer Institute (R01CA039742)
Topics
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords
leisure-time physical activity, cancer incidence, cancer risk, moderate-to-vigorous physical activity, body size, smoking, esophageal adenocarcinoma, liver cancer, lung cancer, kidney cancer, gastric cardia cancer, endometrial cancer, myeloid leukemia, breast cancer, colorectal cancer, colorectal adenoma, colorectal polyps, recurrent colorectal cancer, colorectal cancer mortality
MeSH terms
Adult, European Union, Female, Follow-Up Studies, Humans, Leisure Activities, Male, Middle Aged, Neoplasms, Retrospective Studies, Risk Factors, United States, Meta-Analysis as Topic, Exercise, Body Mass Index, Incidence, Risk Assessment, Evidence-Based Medicine

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