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Physical activity, sedentary behavior, and the risk of colon and rectal cancer in the NIH-AARP Diet and Health Study

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Abstract

Objective

In order to prospectively investigate physical activity at varying intensities and sedentary behavior in relation to colorectal cancer.

Methods

We considered 488,720 participants of the NIH-AARP Diet and Health Study who were aged 50–71 years at baseline in 1995–1996. Through 31 December, 2003, we identified 3,240 and 1,482 colorectal cancers among men and women, respectively. We estimated multivariable relative risks (RR) and 95% confidence intervals (CI) of colorectal cancer using Cox regression.

Results

Engaging in exercise/sports five or more times per week compared to never or rarely exercising was associated with a reduced risk of colon cancer among men (= 0.001; RR = 0.79, 95% CI = 0.68–0.91) and a suggestive decrease in risk among women (= 0.376; RR = 0.85, 95% CI = 0.70–1.04). Engaging in exercise/sports was also associated with a decreased risk of rectal cancer in men (= 0.074; RR comparing extreme categories = 0.76, 95% CI = 0.61–0.94). In men, we observed inverse relations of both low intensity (= 0.017; RR = 0.81, 95% CI = 0.65–1.00 for ≥7 h/week) and moderate to vigorous intensity activity (= 0.037; RR = 0.82, 95% CI = 0.67–0.99 for ≥7 h/week) to colon cancer risk. In contrast, sedentary behavior (time spent watching television/videos) was positively associated with colon cancer (< 0.001; RR = 1.61, 95% CI = 1.14–2.27 for ≥9 h/day) among men. Similar, but less pronounced relations were observed in women.

Conclusion

Engaging in physical activity of any intensity is associated with reductions in colon and rectal cancer risk. Conversely, time spent sedentary is associated with increased colon cancer risk.

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References

  1. American Cancer Society (2007) Cancer facts and figures 2007. American Cancer Society, Atlanta, GA

  2. Friedenreich CM (2001) Physical activity and cancer prevention: from observational to intervention research. Cancer Epidemiol Biomarkers Prev 10:287–301

    PubMed  CAS  Google Scholar 

  3. Slattery ML (2004) Physical activity and colorectal cancer. Sports Med 34:239–252

    Article  PubMed  Google Scholar 

  4. Samad AKA, Taylor RS, Marshall T, Chapman MAS (2005) A meta-analysis of the association of physical activity with reduced risk of colorectal cancer. Colorectal Dis 7:204–213

    Article  PubMed  CAS  Google Scholar 

  5. Harriss DJ, Cable NT, George K, Reilly T, Renehan AG, Haboubi N (2007) Physical activity before and after diagnosis of colorectal cancer: disease risk, clinical outcomes, response pathways and biomarkers. Sports Med 37:947–960

    Article  PubMed  Google Scholar 

  6. Wu AH, Paganini-Hill A, Ross RK, Henderson BE (1987) Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study. Br J Cancer 55:687–694

    PubMed  CAS  Google Scholar 

  7. Albanes D, Blair A, Taylor PR (1989) Physical activity and risk of cancer in the NHANES I population. Am J Public Health 79:744–750

    Article  PubMed  CAS  Google Scholar 

  8. Ballard-Barbash R, Schatzkin A, Albanes D et al (1990) Physical activity and risk of large bowel cancer in the Framingham study. Cancer Res 50:3610–3613

    PubMed  CAS  Google Scholar 

  9. Lee IM, Paffenbarger RS, Hsieh CC (1991) Physical activity and risk of developing colorectal cancer among college alumni. J Natl Cancer Inst 83:1324–1329

    Article  PubMed  CAS  Google Scholar 

  10. Thun MJ, Calle EE, Namboodiri MM et al (1992) Risk factors for fatal colon cancer in a large prospective study. J Natl Cancer Inst 84:1491–1500

    Article  PubMed  CAS  Google Scholar 

  11. Bostick RM, Potter JD, Kushi LH et al (1994) Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States). Cancer Causes Control 5:38–52

    Article  PubMed  CAS  Google Scholar 

  12. Thune I, Lund E (1996) Physical activity and risk of colorectal cancer in men and women. Br J Cancer 73:1134–1140

    PubMed  CAS  Google Scholar 

  13. Martinez ME, Giovannucci E, Spiegelman D, Hunter DJ, Willett WC, Colditz GA (1997) Leisure-time physical activity, body size, and colon cancer in women. J Natl Cancer Inst 89:948–955

    Article  PubMed  CAS  Google Scholar 

  14. Lee IM, Manson JE, Ajani U, Paffenbarger RS, Hennekens CH, Buring JE (1997) Physical activity and risk of colon cancer: the Physician’s Health Study (United States). Cancer Causes Control 8:568–574

    Article  PubMed  CAS  Google Scholar 

  15. Nilsen TI, Vatten LJ (2001) Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis. Br J Cancer 84:417–422

    Article  PubMed  CAS  Google Scholar 

  16. Chao A, Connell CJ, Jacobs EJ et al (2004) Amount, type, and timing of recreational physical activity in relation to colon and rectal cancer in older adults: the Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev 3:2187–2195

    Google Scholar 

  17. Friedenreich C, Norat T, Steindorf K et al (2006) Physical activity and risk of colon and rectal cancers: The European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 15:2398–2407

    Article  PubMed  Google Scholar 

  18. Larsson SC, Rutegard J, Bergkvist L, Wolk A (2006) Physical activity, obesity, and risk of colon and rectal cancer in a cohort of Swedish men. Eur J Cancer 42:2590–2597

    Article  PubMed  Google Scholar 

  19. Slattery ML, Schumacher MC, Smith KR, West DW, Abd-Elghany N (1988) Physical activity, diet, and risk of colon cancer in Utah. Am J Epidemiol 128:989–999

    PubMed  CAS  Google Scholar 

  20. Gerhardsson de Verdier M, Steineck G, Hagman U, Rieger A, Norell SE (1990) Physical activity and colon cancer: a case-referent study in Stockholm. Int J Cancer 46:985–989

    Article  Google Scholar 

  21. Whittemore AS, Wu-Williams AH, Lee M et al (1990) Diet, physical activity, and colorectal cancer among Chinese in North America and China. J Natl Cancer Inst 82:915–926

    Article  PubMed  CAS  Google Scholar 

  22. Longnecker MP, Gerhardsson de Verdier M, Frumkin H, Carpenter C (1995) A case-control study of physical activity in relation to risk of cancer of the right colon and rectum in men. Int J Epidemiol 24:42–50

    Article  PubMed  CAS  Google Scholar 

  23. White E, Jacobs EJ, Daling JR (1996) Physical activity in relation to colon cancer in middle-aged men and women. Am J Epidemiol 144:42–50

    PubMed  CAS  Google Scholar 

  24. Levi F, Pasche C, Lucchini F, Tavani A, La Vecchia C (1999) Occupational and leisure-time physical activity and the risk of colorectal cancer. Eur J Cancer Prev 8:487–493

    Article  PubMed  CAS  Google Scholar 

  25. Tavani A, Braga C, La Vecchia C et al (1999) Physical activity and risk of cancers of the colon and rectum: an Italian case-control study. Br J Cancer 79:1912–1916

    Article  PubMed  CAS  Google Scholar 

  26. Steindorf K, Tobiasz-Adamczyk B, Popiela T et al (2000) Combined risk assessment of physical activity and dietary habits on the development of colorectal cancer. A hospital-based case-control study in Poland. Eur J Cancer Prev 9:309–316

    Article  PubMed  CAS  Google Scholar 

  27. Steindorf K, Jedrychowski W, Schmidt M et al (2005) Case-control study of lifetime occupational and recreational physical activity and risks of colon and rectal cancer. Eur J Cancer Prev 14:363–371

    Article  PubMed  CAS  Google Scholar 

  28. Pukkala E, Poskiparta M, Apter D, Vihko V (1993) Life-long physical activity and cancer risk among Finnish female teachers. Eur J Cancer Prev 2:369–376

    Article  PubMed  CAS  Google Scholar 

  29. Steenland K, Nowlin S, Palu S (1995) Cancer incidence in the National Health and Nutrition Survey I. Follow-up data: diabetes, cholesterol, pulse and physical activity. Cancer Epidemiol Biomarkers Prev 4:807–811

    PubMed  CAS  Google Scholar 

  30. Schnohr P, Gronbaek M, Petersen L, Hein HO, Sorensen TI (2005) Physical activity in leisure-time and risk of cancer: 14-year follow-up of 28,000 Danish men and women. Scand J Public Health 33:244–249

    Article  PubMed  Google Scholar 

  31. Johnsen NF, Christensen J, Thomsen BL et al (2006) Physical activity and risk of colon cancer in a cohort of Danish middle-aged men and women. Eur J Epidemiol 21:877–884

    Article  PubMed  Google Scholar 

  32. Calton BA, Lacey JV, Schatzkin A et al (2006) Physical activity and the risk of colon cancer among women: a prospective cohort study (United States). Int J Cancer 119:385–391

    Article  PubMed  CAS  Google Scholar 

  33. Lee KJ, Inoue M, Otani T, Iwasaki M, Sasazuki S, Tsugane S (2007) Physical activity and risk of colorectal cancer in Japanese men and women: the Japan Public Health Cancer-based prospective Study. Cancer Causes Control 18:199–209

    Article  PubMed  Google Scholar 

  34. Mai PL, Sullivan-Halley J, Ursin G et al (2007) Physical activity and colon cancer risk among women in the California Teachers Study. Cancer Epidemiol Biomarkers Prev 16:517–525

    Article  PubMed  Google Scholar 

  35. Wolin KY, Lee IM, Colditz GA, Glynn RJ, Fuchs C, Giovannucci E (2007) Leisure-time physical activity patterns and risk of colon cancer in women. Int J Cancer 121:2776–2781

    Article  PubMed  CAS  Google Scholar 

  36. Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ, Willett WC (1995) Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med 122:327–334

    PubMed  CAS  Google Scholar 

  37. Colbert LH, Hartman TJ, Malila N et al (2001) Physical activity in relation to cancer of the colon and rectum in a cohort of male smokers. Cancer Epidemiol Biomarkers Prev 10:265–268

    PubMed  CAS  Google Scholar 

  38. Marcus PM, Newcomb PA, Storer BE (1994) Early adulthood physical activity and colon cancer risk among Wisconsin women. Cancer Epidemiol Biomarkers Prev 3:641–644

    PubMed  CAS  Google Scholar 

  39. Schatzkin A, Subar AF, Thompson FE et al (2001) Design and serendipity in establishing a large cohort with wide dietary intake distributions: the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol 154:371–374

    Article  Google Scholar 

  40. Ainsworth BE, Haskell WL, Leon AS et al (1993) Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 25:71–80

    Article  PubMed  CAS  Google Scholar 

  41. Pereira MA, FitzerGerald SJ, Gregg EW et al (1997) A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc 29(6 Suppl):S1–205

    PubMed  CAS  Google Scholar 

  42. Michaud DS, Midthune D, Hermansen S et al (2005) Comparison of cancer registry case ascertainment with SEER estimates and self-reporting in a subset of the NIH-AARP Diet and Health Study. J Regist Manag 32:70–75

    Google Scholar 

  43. Rich-Edwards JW, Corsano KA, Stampfer MJ (1994) Test of the National Death Index and Equifax Nationwide Death Search. Am J Epidemiol 140:1016–1019

    PubMed  CAS  Google Scholar 

  44. Korn EL, Graubard BI, Midthune D (1997) Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. Am J Epidemiol 145:72–80

    PubMed  CAS  Google Scholar 

  45. Ainsworth BE, Irwin ML, Addy CL, Whitt MC, Stolarczyk LM (1998) Moderate physical acitivity patterns of minority women: The Cross-Cultural Activity Participation Study. J Womens Health Gend Based Med 8:805–813

    Article  Google Scholar 

  46. Schor JB (1992) The overworked American. Harper Collins, New York

    Google Scholar 

  47. Ainsworth BE (2000) Challenges in measuring physical activity in women. Exerc Sport Sci Rev 28:93–96

    PubMed  CAS  Google Scholar 

  48. Gerhardsson de Verdier M, Norell SE, Kiviranta H, Pedersen NL, Ahlbom A (1986) Sedentary jobs and colon cancer. Am J Epidemiol 123:775–780

    Google Scholar 

  49. Severson RK, Nomura AM, Grove JS, Stemmermann GN (1989) A prospective analysis of physical activity and cancer. Am J Epidemiol 130:522–529

    PubMed  CAS  Google Scholar 

  50. Iacopetta B (2002) Are there two sides to colorectal cancer? Int J Cancer 101:403–408

    Article  PubMed  CAS  Google Scholar 

  51. Isomura K, Kono S, Moore MA et al (2006) Physical activity and colorectal cancer: the Fukuoka Colorectal Cancer Study. Cancer Sci 97:1099–1104

    Article  PubMed  CAS  Google Scholar 

  52. Slattery ML, Edwards S, Curtin K et al (2003) Physical activity and colorectal cancer. Am J Epidemiol 158:214–224

    Article  PubMed  CAS  Google Scholar 

  53. Le Marchand L, Wilkens LR, Kolonel LN, Hankin JH, Lyu LC (1997) Associations of sedentary lifestyle, obesity, smoking, alcohol use, and diabetes with the risk of colorectal cancer. Cancer Res 57:4787–4794

    PubMed  CAS  Google Scholar 

  54. Slattery ML, David R, Jacobs J (1995) Assessment of ability to recall physical activity of several years ago. Ann Epidemiol 5:292–296

    Article  PubMed  CAS  Google Scholar 

  55. Wei EK, Giovannucci E, Wu K et al (2004) Comparison of risk factors for colon and rectal cancer. Int J Cancer 108:433–442

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Regan A. Howard.

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Howard, R.A., Freedman, D.M., Park, Y. et al. Physical activity, sedentary behavior, and the risk of colon and rectal cancer in the NIH-AARP Diet and Health Study. Cancer Causes Control 19, 939–953 (2008). https://doi.org/10.1007/s10552-008-9159-0

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  • DOI: https://doi.org/10.1007/s10552-008-9159-0

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