Physical activity and cancer etiology: associations and mechanisms

McTiernan, Anne; Ulrich, Cornelia; Slate, Shelley; Potter, John

doi:10.1023/a:1008853601471

Cited by 302Cancer Risks and FactorsPhysical Activity and HealthMetabolism, Diabetes, and Cancer

Physical activity and cancer etiology: associations and mechanisms

McTiernan, Anne, Ulrich, Cornelia, Slate, Shelley, Potter, John·1998·Cancer Causes & Control

DOI 10.1023/a:1008853601471

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Abstract

Objectives This paper reviews the epidemiologic data of associations between physical activity and cancer risk, describes potential mechanisms for a physical activity cancer link, and proposes future directions for research.Methods We reviewed English-language published papers on physical activity and cancer through Medline searches for epidemiologic studies, and through references on individual reports. We reviewed general texts on effects of exercise on human biology and applied the concepts to the biology of cancer in humans to describe potential mechanisms for a physical activity-cancer association.Results Considerable epidemiologic evidence has accrued linking increased physical activity with reduced occurrence of cancers of the breast and colon. The association between physical activity and cancers of other sites is unclear. Potential mechanisms for the association between physical activity and reduced risk for breast and colon cancer are varied: they range from bias due to physical activity's strong correlations with other health factors (e.g., diet, smoking, alcohol use, use of medications) to the metabolic effects resulting from increased physical activity and fitness, such as reduced obesity, hormonal and reproductive effects, mechanical effects, and enhancement of the immune system.Conclusions The elucidation of biologic mechanisms for an association between physical activity and cancer may provide biological support for the association. It will contribute information to determine the type, frequency, and duration of exercise needed to maximize protection. This information will be needed before large-scale community interventions are begun, in order to choose the correct interventions for the desired effect of reduced incidence of the most common cancers.

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Physical activity reduces the risk of breast and colon cancers and may reduce the risk of several other types of cancer.
“Physical activity reduces the risk of breast and colon cancers and may reduce the risk of several other types of cancer.109 -113”
From Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association (2004) · cites this paper as [111]
For colon cancer, physical activity causes food to move more quickly through the intestine, which reduces the length of time that the bowel lining is exposed to potential mutagens.
“For colon cancer, physical activity causes food to move more quickly through the intestine, which reduces the length of time that the bowel lining is exposed to potential mutagens.111”
From Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association (2004) · cites this paper as [111]
Moderate to vigorous activity for at least 45 minutes on 5 or more days per week may further reduce the risk of breast and colon cancers and also may reduce the risk of kidney, endometrial, and esophageal cancers.
“Moderate to vigorous activity for at least 45 minutes on 5 or more days per week may further reduce the risk of breast and colon cancers and also may reduce the risk of kidney, endometrial, and esophageal cancers.110,111,113,119,120”
From Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association (2004) · cites this paper as [111]
For breast cancer, vigorous physical activity may decrease the exposure of breast tissue to circulating ovarian hormones.
“For breast cancer, vigorous physical activity may decrease the exposure of breast tissue to circulating ovarian hormones.”
From Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association (2004) · cites this paper as [111]

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American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity
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American Cancer Society guidelines on nutrition and physical activity for cancer prevention
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Recreational Physical Activity and the Risk of Breast Cancer in Postmenopausal Women
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Influence of Pre- and Postdiagnosis Physical Activity on Mortality in Breast Cancer Survivors: The Health, Eating, Activity, and Lifestyle Study
Irwin, M. L., Smith, A. W., McTiernan, A., Ballard-Barbash, R. R., Cronin, K. A., Gilliland, F. D., Baumgartner, R., Baumgartner, K. B., & Bernstein, L. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.15.9822 · Cited by 563 · see citing works
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Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association
Eyre, H., Kahn, R., Robertson, R. M., the ACS/ADA/AHA Collaborative Writing Committee, ACS/ADA/AHA Collaborative Writing Committee Members, Clark, N. G., Doyle, C., Hong, Y., Gansler, T., Glynn, T., et al. (2004) · Circulation · doi:10.1161/01.cir.0000133321.00456.00 · Cited by 542 · see citing works
Epidemiology of Endocrine-Related Risk Factors for Breast Cancer
Bernstein, L. (2002) · Journal of Mammary Gland Biology and Neoplasia · doi:10.1023/a:1015714305420 · Cited by 402 · see citing works
Epidemiology of Breast Cancer in Women
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American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity
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Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association
Eyre, H. J., Kahn, R., Robertson, R. M., Clark, N. G., Doyle, C., Gansler, T. S., Glynn, T., Hong, Y., Smith, R. A., Taubert, K. A., et al. (2004) · CA A Cancer Journal for Clinicians · doi:10.3322/canjclin.54.4.190 · Cited by 328 · see citing works
Relation of BMI and physical activity to sex hormones in postmenopausal women
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Sunlight and mortality from breast, ovarian, colon, prostate, and non-melanoma skin cancer: a composite death certificate based case-control study
Freedman, D. M., Dosemeci, M., & McGlynn, K. A. (2002) · Occupational and Environmental Medicine · doi:10.1136/oem.59.4.257 · Cited by 325 · see citing works
Obesity and cancer risk among white and black United States veterans
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Modifiable risk factors for cancer
Stein, C. J., & Colditz, G. A. (2004) · British Journal of Cancer · doi:10.1038/sj.bjc.6601509 · Cited by 311 · see citing works
Physical Activity and Survival in Postmenopausal Women with Breast Cancer: Results from the Women's Health Initiative
Irwin, M. L., McTiernan, A., Manson, J. E., Thomson, C. A., Sternfeld, B., Stefanick, M. L., Wactawski‐Wende, J., Craft, L. L., Lane, D. S., Martin, L. W., et al. (2011) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-10-0295 · Cited by 298 · see citing works
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Genetic influence on daily wheel running activity level.
Lightfoot, J., Turner, M. J., Daves, M., Vordermark, A., & Kleeberger, S. (2004) · Physiological Genomics · doi:10.1152/physiolgenomics.00125.2004 · Cited by 259 · see citing works
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Ten Years of Life: Is It a Matter of Choice?
Fraser, G. E., & Shavlik, D. J. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.13.1645 · Cited by 237 · see citing works
Physical Activity and Colorectal Cancer
Slattery, M. L. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg134 · Cited by 234 · see citing works
Physical Activity and Risk of Colon and Rectal Cancers: The European Prospective Investigation into Cancer and Nutrition
Friedenreich, C. M., Norat, T., Steindorf, K., Boutron‐Ruault, M., Pischon, T., Mazuir, M., Clavel‐Chapelon, F., Linseisen, J., Boeing, H., Bergman, M. M., et al. (2006) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-06-0595 · Cited by 234 · see citing works
An obligation for primary care physicians to prescribe physical activity to sedentary patients to reduce the risk of chronic health conditions.
Chakravarthy, M., Joyner, M., & Booth, F. (2002) · Mayo Clinic proceedings · doi:10.4065/77.2.165 · Cited by 210 · see citing works
Validity and reproducibility of self-reported total physical activity—differences by relative weight
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Body size, physical activity, and breast cancer hormone receptor status: results from two case-control studies.
Enger, S. M., Ross, R. K., Paganini‐Hill, A., Carpenter, C. L., & Bernstein, L. (2000) · PubMed · Cited by 204 · see citing works
Behavioral Risk Factors in Breast Cancer: Can Risk Be Modified?
McTiernan, A. (2003) · The Oncologist · doi:10.1634/theoncologist.8-4-326 · Cited by 195 · see citing works
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Physical Activity and Colorectal Cancer
Slattery, M. L. (2004) · Sports Medicine · doi:10.2165/00007256-200434040-00004 · Cited by 187 · see citing works
Physical activity and cancer risk
Hardman, A. E. (2001) · Proceedings of The Nutrition Society · doi:10.1079/pns200076 · Cited by 186 · see citing works
Lifestyle Factors in Cancer Survivorship
Ligibel, J. A. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2012.42.0638 · Cited by 183 · see citing works
Physical activity and risk of cancer in middle-aged men
Wannamethee, S. G., Shaper, A. G., & Walker, M. (2001) · British Journal of Cancer · doi:10.1054/bjoc.2001.2096 · Cited by 179 · see citing works
Physical activity interventions for cancer survivors: Figure 1
Irwin, M. L. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2008.053843 · Cited by 179 · see citing works
Body mass index, physical activity, and colorectal cancer by anatomical subsites
Robsahm, T. E., Aagnes, B., Hjartåker, A., Langseth, H., Bray, F., & Larsen, I. K. (2013) · European Journal of Cancer Prevention · doi:10.1097/cej.0b013e328360f434 · Cited by 176 · see citing works
Exposures in Childhood, Adolescence and Early Adulthood and Breast Cancer Risk: a Systematic Review of the Literature
Okasha, M., McCarron, P., Gunnell, D., & Smith, G. D. (2003) · Breast Cancer Research and Treatment · doi:10.1023/a:1022988918755 · Cited by 166 · see citing works
Physical Activity and Ovarian Cancer Risk: the European Prospective Investigation into Cancer and Nutrition
Lahmann, P. H., Friedenreich, C. M., Schulz, M., Cust, A. E., Lukanova, A., Kaaks, R., Tjønneland, A. M., Johnsen, N. F., Overvad, K., Fournier, A., et al. (2009) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-08-0958 · Cited by 162 · see citing works
Framework PEACE: An organizational model for examining physical exercise across the cancer experience
Courneya, K. S., & Friedenreich, C. M. (2001) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2304_5 · Cited by 159 · see citing works
Long-term Recreational Physical Activity and Risk of Invasive and In Situ Breast Cancer
Dallal, C. M. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.4.408 · Cited by 159 · see citing works
Physical activity, sedentary behavior, and endometrial cancer risk in the NIH‐AARP Diet and Health Study
Gierach, G. L., Chang, S., Brinton, L. A., Lacey, J. V., Hollenbeck, A. R., Schatzkin, A. G., & Leitzmann, M. F. (2008) · International Journal of Cancer · doi:10.1002/ijc.24059 · Cited by 148 · see citing works
Lifetime physical activity and breast cancer risk in a multiethnic population: the San Francisco Bay area breast cancer study.
John, E. M., Horn‐Ross, P. L., & Koo, J. (2003) · PubMed · Cited by 146 · see citing works
Effect of family history, obesity and exercise on breast cancer risk among postmenopausal women
Carpenter, C. L., Ross, R. K., Paganini‐Hill, A., & Bernstein, L. (2003) · International Journal of Cancer · doi:10.1002/ijc.11186 · Cited by 145 · see citing works
Fasting C-Peptide Levels and Death Resulting From All Causes and Breast Cancer: The Health, Eating, Activity, and Lifestyle Study
Irwin, M. L., Duggan, C. R., Wang, C., Smith, A. W., McTiernan, A., Baumgartner, R., Baumgartner, K. B., Bernstein, L., & Ballard-Barbash, R. R. (2010) · Journal of Clinical Oncology · doi:10.1200/jco.2010.28.4752 · Cited by 142 · see citing works
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Preventing Cancer, Cardiovascular Disease, and Diabetes
Eyre, H. J., Kahn, R., & Robertson, R. M. (2004) · Stroke · doi:10.1161/01.str.0000133321.00456.00 · Cited by 136 · see citing works
Exercise and Biomarkers for Cancer Prevention Studies
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Preventing Cancer, Cardiovascular Disease, and Diabetes
Eyre, H. J., Kahn, R., & Robertson, R. M. (2004) · Diabetes Care · doi:10.2337/diacare.27.7.1812 · Cited by 133 · see citing works
Physical activity in leisure-time and risk of cancer: 14-year follow-up of 28,000 Danish men and women
Schnohr, P., Grønbæk, M., Petersen, L. V., Hein, H. O., & Sørensen, T. I. A. (2005) · Scandinavian Journal of Public Health · doi:10.1080/14034940510005752 · Cited by 130 · see citing works
Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study
Bertram, L. A. C., Stefanick, M. L., Saquib, N., Natarajan, L., Patterson, R. E., Bardwell, W. A., Flatt, S. W., Newman, V. A., Rock, C. L., Thomson, C. A., et al. (2010) · Cancer Causes & Control · doi:10.1007/s10552-010-9714-3 · Cited by 128 · see citing works
A Model of Practical Cancer Prevention for Out-patients Visiting a Hospital: the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC).
Tajima, K., Hirose, K., Inoue, M., Takezaki, T., Hamajima, N., & Kuroishi, T. (2000) · PubMed · Cited by 126 · see citing works
Physical Activity and Breast Cancer Risk: The European Prospective Investigation into Cancer and Nutrition
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Current Perspective on the Global and United States Cancer Burden Attributable to Lifestyle and Environmental Risk Factors
Schottenfeld, D., Beebe‐Dimmer, J., Buffler, P. A., & Omenn, G. S. (2013) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031912-114350 · Cited by 123 · see citing works
Physical Activity and Health During the Menopausal Transition
Sternfeld, B., & Dugan, S. A. (2011) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2011.05.008 · Cited by 119 · see citing works
Review of Factors Related to the Thyroid Cancer Epidemic
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Physical activity in relation to cancer of the colon and rectum in a cohort of male smokers.
Colbert, L. H., Hartman, T. J., Malila, N., Limburg, P. J., Pietinen, P., Virtamo, J., Taylor, P. R., & Albanes, D. (2001) · PubMed · Cited by 114 · see citing works
Melanoma risk in relation to height, weight, and exercise (United States)
Shors, A. R., Solomon, C. C., McTiernan, A., & White, E. (2001) · Cancer Causes & Control · doi:10.1023/a:1011211615524 · Cited by 113 · see citing works
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Recreational Physical Activity and Risk of Postmenopausal Breast Cancer Based on Hormone Receptor Status
Bardia, A. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.22.2478 · Cited by 112 · see citing works
Perioperative exercise for chronic liver injury patients with hepatocellular carcinoma undergoing hepatectomy
Kaibori, M., Ishizaki, M., Matsui, K., Nakatake, R., Yoshiuchi, S., Kimura, Y., & Kwon, A. (2013) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2012.07.035 · Cited by 111 · see citing works
Epidemiologic Methods in Physical Activity Studies
Lee, I. (2008) · doi:10.1093/acprof:oso/9780195183009.001.0001 · Cited by 100 · see citing works
Variants of the Adiponectin and Adiponectin Receptor 1 Genes and Breast Cancer Risk
Kaklamani, V., Sadim, M. S., Hsi, A., Offit, K., Oddoux, C., D, H. O. M., Ahsan, H., Pasche, B., & Mantzoros, C. S. (2008) · Cancer Research · doi:10.1158/0008-5472.can-08-0533 · Cited by 110 · see citing works
A review of physical activity and prostate cancer risk
Friedenreich, C. M., & Thune, I. (2001) · Cancer Causes & Control · doi:10.1023/a:1011210121901 · Cited by 104 · see citing works
Relationship of Obesity and Physical Activity with C-Peptide, Leptin, and Insulin-Like Growth Factors in Breast Cancer Survivors
Irwin, M. L., McTiernan, A., Bernstein, L., Gilliland, F. D., Baumgartner, R., Baumgartner, K. B., & Ballard-Barbash, R. R. (2005) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-05-0185 · Cited by 106 · see citing works
Self-citation
Physical Activity After Cancer: Physiologic Outcomes
McTiernan, A. (2004) · Cancer Investigation · doi:10.1081/cnv-120027581 · Cited by 102 · see citing works
Self-citation
Recreational Physical Activity and Epithelial Ovarian Cancer: A Case-Control Study, Systematic Review, and Meta-analysis
Olsen, C. M., Bain, C. J., Jordan, S. J., Nagle, C. M., Green, A. C., Whiteman, D. C., Webb, P. M., & Australian Cancer Study (Ovarian Cancer) and Australian Ovarian Cancer Study Group (2007) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-07-0566 · Cited by 102 · see citing works
Urinary calcium excretion in the monitoring of bone metastases from prostatic carcinoma
Francini, G., Petrioli, R., Gonnelli, S., Correale, P., Pozzessere, D., Marsili, S., Montagnani, A., Lucani, B., Rossi, S., Monaco, R. D., et al. (2001) · Cancer · doi:10.1002/1097-0142(20010915)92:6 · Cited by 15 · see citing works
Physical activity and cancer-specific mortality in the NIH-AARP Diet and Health Study cohort
Arem, H. E., Moore, S. C., Park, Y., Ballard-Barbash, R. R., Hollenbeck, A. R., Leitzmann, M. F., & Matthews, C. E. (2013) · International Journal of Cancer · doi:10.1002/ijc.28659 · Cited by 97 · see citing works
Physical activity, insulin-like growth factor 1, insulin-like growth factor binding protein 3, and survival from colorectal cancer
Haydon, A. M., MacInnis, R. J., English, D. R., Morris, H. A., & Giles, G. G. (2005) · Gut · doi:10.1136/gut.2005.081547 · Cited by 98 · see citing works
Metabolic Syndrome and Triple-Negative Breast Cancer: A New Paradigm
Davis, A. A., & Kaklamani, V. (2011) · International Journal of Breast Cancer · doi:10.1155/2012/809291 · Cited by 95 · see citing works
Weight control and the management of obesity after menopause: the role of physical activity
Dubnov‐Raz, G., Brzezinski, A., & Berry, E. M. (2003) · Maturitas · doi:10.1016/s0378-5122(02)00328-6 · Cited by 94 · see citing works
The Physical Activity for Total Health (PATH) Study: rationale and design
McTiernan, A., Ulrich, C. M., Yancey, D. M., Slate, S., Nakamura, H., Oestreicher, N., Bowen, D. J., Yasui, Y., Potter, J. D., & Schwartz, R. S. (1999) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199909000-00012 · Cited by 91 · see citing works
Self-citation
Physical Activity in Different Periods of Life and the Risk of Breast Cancer: The Norwegian-Swedish Women's Lifestyle and Health Cohort Study
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Authors: McTiernan, A., Ulrich, C., Slate, S., & Potter, J.
Affiliations: Fred Hutch Cancer Center (US)
University of Washington (US)
ORCID: McTiernan, Anne
Ulrich, Cornelia
Potter, John
Venue: Cancer Causes & Control
Publisher: Springer Science and Business Media LLC
Published: 1998-10
Volume: 9
Issue: 5
Pages: 487-509
ISSN: 0957-5243 (ISSN-L)
1573-7225
DOI: 10.1023/a:1008853601471
OpenAlex: W1577435804
Cited by: 302
References: 211
Citations by year: 2025: 2 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 10 · 2015: 4 · 2014: 10 · 2013: 14 · 2012: 15
FWCI: 1.78
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Cancer Causes & Control (publishedVersion)
PubMed (publishedVersion)
Funders: National Cancer Institute (R01 CA/AG69334, 5 P30 CA15704, P30CA015704)
Topics: Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Health Sciences › Medicine › Physiology › Physical Activity and Health
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Keywords: physical activity, cancer risk, breast cancer, colon cancer, biological mechanisms, obesity, endocrine effects, reproductive factors, immune system, cancer prevention, exercise intervention
MeSH terms: Adult, Aged, Aged, 80 and over, Data Collection, Female, Humans, Life Style, Male, Middle Aged, Neoplasms, Prognosis, Cohort Studies, Exercise, Incidence, Survival Rate, Risk Assessment

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