Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis

Mahmood, Shahıd; MacInnis, Robert J.; English, Dallas R.; Karahalios, Amalia; Lynch, Brigid M.

doi:10.1093/ije/dyx137

Cited by 77 publications

(67 citation statements)

References 86 publications

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“…By applying two-sample MR, we observed a causal effect of accelerometer-based PA on CRC and a suggestive association between self-reported PA and CRC [14]. The MR results for both types of PA were similar to the results from the meta-analyses of observational studies [5].…”

Section: Discussionsupporting

confidence: 75%

“…The self-reported PA related variants explained approximately 0.03% of PA. We fixed the type I error at α<0.05 and applied an assumed true effect estimate of OR=0.80 per 1 SD increase of the PA time. This assumed true effect estimate was obtained from the World Cancer Research Fund meta-analysis of cohort and case-control studies of PA on CRC risk [5]. Power was estimated to be less than 0.10 and F statistic was 14.22 for a sample size of 31 197 CRC cases and 61 770 controls.…”

Section: Power Calculationmentioning

confidence: 99%

“…Furthermore, a recent meta-analysis including 17 cohort and 21 case-control studies, found that four domains of PA (occupational activity, recreational activity, transport-related PA and reduced occupational sedentary behaviour) were associated with a lower colon cancer risk, the estimated relative risk (odds ratio) of recreational PA on colon cancer risk was 0.80 (95%CI: 0.71-0.89) and on rectum cancer risk was 0.87 (95%CI: 0.75-1.01) [5].…”

Section: Introductionmentioning

confidence: 99%

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Physical activity reduces colorectal cancer risk independent of BMI—A two-sample Mendelian randomisation study

Zhang

Τheodoratou

et al. 2019

Preprint

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Background: Evidence from observational studies suggests a protective role for physical activity (PA) against colorectal cancer (CRC) risk. However, it has yet to be established a causal relationship. We conducted a two-sample Mendelian randomisation (MR) study to examine causality between physical activity and CRC risk. Methods:We used common genetic variants associated with self-reported and accelerometerbased physical activity as instrumental variables (IVs) in this MR study. The IVs were derived from the largest available genome-wide association study (GWAS) of physical activity, namely UK Biobank. We analysed the effect of the IVs for physical activity in a large CRC GWAS that included 31 197 cases and 61 770 controls. We applied inverse variance weighted (IVW) method as the main analysis method.Results: Our results demonstrate a protective effect between accelerometer-based physical activity and CRC risk (the outlier-adjusted ORIVW was 0.92 per one standard deviation (SD) increase of accelerometer-base physical activity [95% CI: 0.87-0.98, P: 0.01]). The effect between self-reported physical activity and CRC risk was not statistically significant but was also supportive of an inverse association (the outlier-adjusted ORIVW was 0.61 per 1 SD increase of moderate-to-vigorous physical activity [95%CI: 0.36-1.06, P: 0.08]). Conclusions:The findings of this large MR study show for the first time that objectively measured physical activity is causally implicated in reducing CRC risk. The limitations of the study are that it is based on only two genetic instruments and that it has limited power, despite the study size. Nonetheless, at a population level, these findings provide strong reinforcing evidence to support public health policy measures that encourage exercise, even in obese individuals.

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Section: Discussionsupporting

confidence: 75%

Section: Power Calculationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Physical activity reduces colorectal cancer risk independent of BMI—A two-sample Mendelian randomisation study

Zhang

Τheodoratou

et al. 2019

Preprint

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“…1.04, 1.68) (17), although time spent using computers (excluding using a computer at work) was not associated with colorectal cancer risk in the UK Biobank cohort (17). The findings of a 2017 metaanalysis including six studies also demonstrated significant associations between the highest compared with the lowest levels of occupational sedentary behaviour, and risk of colon cancer (pooled RRs 1.44, 95% CI: 1.28, 1.62) (18). On the other hand, there was little evidence of an association between sedentary behaviour and rectal cancer risk (18).…”

Section: Introductionmentioning

confidence: 92%

The association between non-occupational TV and computer screen-time viewing and cancer risk: Findings from the UK Biobank, a large prospective cohort study

Hunter¹,

Murray²,

Coleman³

2019

Preprint

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Background Evidence is suggestive of sedentary behaviour being associated with an increased risk of endometrial cancer, but the evidence base is too limited to draw any conclusions for other cancers. The aim of the study was to investigate the association between sedentary behaviour and total cancer incidence and site-specific cancer incidence.Methods This prospective population-based cohort study involved data from the UK Biobank (470 578 adults; 53.8% females; mean age 56.3 years). Sedentary behaviours including television viewing time, computer use time and daily total screen time were the exposure variables. Primary and secondary outcome measures included incident total cancer, and site-specific cancers identified from the International Classification of Diseases, 9th and 10th revisions (ICD-9 and ICD-10). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) showing the relationship between sedentary behaviour and cancer using continuous (hours/day) and categorical exposure variables. Partition models and isotemporal substitution models were used to investigate the impact of substituting sedentary behaviour with physical activity.Results During a mean follow-up time of 7.6 years, 28 992 incident cancers were identified. A 1-hour increase in daily TV screen time was associated with higher risk of oropharyngeal cancer (HR 1.06, 95% CI: 1.02, 1.11), stomach cancer (HR 1.06, 95% CI: 1.001, 1.13), oesophagus and stomach cancer (HR 1.04, 95% CI: 1.005, 1.09), and colon cancer (HR 1.04, 95% CI: 1.01, 1.06) in fully adjusted models. Participants who reported ≤1 hour/day of TV screen time had a lower risk of lung cancer (HR 0.85, 95% CI: 0.73, 0.997), breast (female only) cancer (HR 0.92, 95% CI: 0.85, 0.996), stomach cancer (HR 0.66, 95% CI: 0.45, 0.97), and oesophagus and stomach cancer (HR 0.78, 95% CI: 0.62, 0.98) compared to participants who reported 1-≤3 hours/day of TV screen time. Isotemporal substitution models showed reduced risk of total cancer (HR 0.97, 95% CI: 0.95, 0.99) and some site-specific cancers when replacing 1-hour/day of TV viewing with moderate-intensity physical activity or walking.Conclusions Our findings show that sedentary behaviours were associated with some site-specific cancers (including oropharyngeal, oesophagus and stomach, colon and lung cancer), particularly for TV viewing time. Our findings were less consistent for time spent on computer and daily total screen time. Substitution models showed that replacing 1-hour per day of TV viewing with 1-hour of moderate-intensity physical activity or walking was associated with lower risk of total cancer and lower risk of several site-specific cancers. Health promotion strategies should endorse the message to minimise sedentary behaviour, replacing it with health-enhancing physical activity, and to particularly target TV viewing.

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“…In contrast, higher levels of TV viewing time were associated with a greater risk of colon cancer in the same study population (HR for ≥5 hours per day vs ≤ 1 hour per day = 1.32, 95% CI: 1.04, 1.68) (17), although time spent using computers (excluding using a computer at work) was not associated with colorectal cancer risk in the UK Biobank cohort (17). The findings of a 2017 meta-analysis including six studies also demonstrated significant associations between the highest compared with the lowest levels of occupational sedentary behaviour, and risk of colon cancer (pooled RRs 1.44, 95% CI: 1.28, 1.62) (18). On the other hand, there was little evidence of an association between sedentary behaviour and rectal cancer risk (18).…”

Section: Introductionmentioning

confidence: 92%

The association between recreational sedentary behaviour and cancer risk: Findings from the UK Biobank, a large prospective cohort study

Hunter¹,

Murray²,

Coleman³

2020

Preprint

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Background Evidence is suggestive of sedentary behaviour being associated with an increased risk of endometrial cancer, but the evidence base is too limited to draw any conclusions for other cancers. The aim of the study was to investigate the association between recreational sedentary behaviour and site-specific, and total, cancer incidence. Methods We analysed data from the prospective UK Biobank cohort study. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) between recreational sedentary behaviour (including television (TV) viewing time, computer use time and daily total screen time) and cancer risk. Partition models and isotemporal substitution models investigated the impact of substituting recreational sedentary behaviour with physical activity. Results During a mean follow-up of 7.6 years, 28,992 incident cancers were identified among 470,578 adults. A 1-hour increase in daily TV viewing time was associated with higher risks of oropharyngeal, oesophago-gastric and colon cancer in fully adjusted models. Participants who reported ≤1, compared with 1-≤3, hours/day of TV viewing time had lower risks of lung, breast, and oesophago-gastric cancer. Findings were inconsistent for computer use and daily total screen time. The majority of observed associations were small, and were attenuated after excluding cancers diagnosed within the first two years of follow-up, except for oesophago-gastric and colon cancers (HR 1.05, 95% CI: 1.01-1.10; and HR 1.04, 95% CI: 1.01-1.07 per 1-hour increase in daily TV viewing time, respectively). However, isotemporal substitution models showed reduced risk of total cancer (HR 0.97, 95% CI: 0.95, 0.99) and some site-specific (oropharyngeal, lung, breast and colorectal) cancers when replacing 1-hour/day of TV viewing with 1-hour of moderate-intensity physical activity or walking. Conclusions Our findings show that recreational sedentary behaviours, particularly TV viewing, were associated with small increased risks of oesophago-gastric and colon cancer. Replacing 1-hour per day of TV viewing with 1-hour of moderate-intensity physical activity or walking was associated with lower risk of total cancer and oropharyngeal, lung, breast and colorectal cancers. Further research from other large prospective cohort studies is required, while mechanistic research is warranted to enhance the biological plausibility of these findings.

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Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis

Abstract: In addition to increasing occupational and recreational physical activity, promoting physical activity during transport and reducing sedentary behaviour in the workplace may also be useful colorectal cancer prevention strategies.

Cited by 77 publications

References 86 publications

Physical activity reduces colorectal cancer risk independent of BMI—A two-sample Mendelian randomisation study

Physical activity reduces colorectal cancer risk independent of BMI—A two-sample Mendelian randomisation study

The association between non-occupational TV and computer screen-time viewing and cancer risk: Findings from the UK Biobank, a large prospective cohort study

The association between recreational sedentary behaviour and cancer risk: Findings from the UK Biobank, a large prospective cohort study

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