Physically active individuals have a 23% lower risk of any colorectal neoplasia and a 27% lower risk of advanced colorectal neoplasia than their non-active counterparts: systematic review and meta-analysis of observational studies

Abstract

BackgroundFew studies have examined the associations between physical activity (PA), sedentary behaviour (SB) and risk of colorectal neoplasia (CN).MethodsWe systematically searched Medline, Embase, PsyInfo, Cochrane and other sources from their inception to 30 September 2018 for cohort, case-control and cross-sectional studies that evaluated these associations in asymptomatic, average-risk subjects. Random-effect models were used to estimate relative risks (RRs) of any-type CN, advanced CN, and non-advanced CN, respectively, in individuals with the highest versus the lowest level of PA and SB. Dose-response analyses and subgroup analyses were conducted. The I2 statistic was used to examine heterogeneity among studies.ResultsWe identified 32 observational studies, including 17 cross-sectional studies, 10 case-control studies and five longitudinal studies. PA (highest vs lowest) was inversely associated with risk for any-type CN (n=23 studies) and advanced CN (n=15 studies), with a RR of 0.77 (95% CI=0.71 to 0.83, I2=57.5%) and 0.73 (95% CI=0.63 to 0.82, I2=45.5%), respectively. There was no association between PA and non-advanced CN (n=5 studies). There was an as association between PA and any-type CN in both sexes, and also for the distal colon. We found no dose–response relationship between PA and any-type or advanced CN. Based on three studies identified, SB time (longest vs shortest) was associated with an increased risk of advanced CN (RR=1.24, 95% CI 1.04 to 1.49, I2=14.4%). No publication bias was detected by Begg’s test.ConclusionWe report a 23% lower relative risk of any type of CN and a 27% lower risk of advanced CN in people with the highest level of PA compared with those in the lowest.

New global guidelines on sedentary behaviour and health for adults: broadening the behavioural targets

“…Bailey et al also found an increase in incident CVD risk (HR = 1.29 (95% CI, 1.27 to 1.30) with total sitting, which was attenuated following statistical adjustment for physical activity (HR = 1.14 (95% CI, 1.04 to 1.23)) [24]. Four new reviews [25,26,31,36] reporting on sedentary behaviour and cancer incidence all had very low to low certainty ratings, mostly attributable to a lack of adjustment for confounding variables, indirectness in terms of diversity of outcome assessment, and high statistical heterogeneity. However, evidence from three metaanalyses [37][38][39] previously summarized [9] provided moderate certainty evidence for an association between sedentary behaviour and type cancer incidence (endometrial, colon, and lung cancers).…”

The importance of physical activity in colorectal cancer prevention

“…Systematic research by Wang et al from 2018 was produced after searching Medline, Embase, PsyInfo, Cochrane, and other databases and included 32 observational studies, out of which 17 were cross-sectional, ten case-control, and five cohorts (9). It concluded that in people with the highest level of physical activity, there was a 23% lower relative risk of any colon cancer (CRC) and 27% for advanced CRC than those with the lowest level of physical activity.…”

A Physically Active Status Affects the Circulating Profile of Cancer-Associated miRNAs

“…Published articles on circulating miRNAs associated with cancer were selected on PubMed by searching for “serum miRNAs”, “serum microRNAs”, “plasma miRNAs”, “plasma microRNAs”, “circulating miRNAs”, “circulating microRNAs” with “cancer diagnosis” for five cancers: lung cancer (LC), prostate cancer (PC), colon cancer (CC), liver cancer (HC) and gastroesophageal cancer (GEC) and related subtypes. These cancers were chosen as the five most frequent cancers in males worldwide, according to the “Global Cancer Observatory” ( , accessed on 31 December 2020), for which exist evidence, through meta-analysis (published from 2010 to 2020), on association with physical activity (all-cancer risk/mortality [ 25 , 26 , 27 , 28 , 29 ]; LC [ 30 , 31 ]; PC [ 32 ]; CC [ 33 , 34 , 35 ]; HC [ 36 ]; GEC [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]). Only studies on human, published from 2010, and demonstrating a clinical relevance for single serum/plasma miRNA or serum/plasma miRNA signatures including at least one of the modulated miRNAs in our trained cohort were considered.…”