Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition.
We investigated several aspects of the role of physical activity in colon and rectal cancer etiology that remain unclear in the European Prospective Investigation into Nutrition and Cancer. This cohort of 413,044 men and women had 1,094 cases of colon and 599 cases of rectal cancer diagnosed during an average of 6.4 years of follow-up. We analyzed baseline data on occupational, household, and recreational activity to examine associations by type of activity, tumor subsite, body mass index (BMI), and energy intake. The multivariate hazard ratio for colon cancer was 0.78 [95% confidence interval (95% CI), 0.59-1.03] among the most active participants when compared with the inactive, with evidence of a dose-response effect (P(trend) = 0.04). For right-sided colon tumors, the risk was 0.65 (95% CI, 0.43-1.00) in the highest quartile of activity with evidence of a linear trend (P(trend) = 0.004). Active participants with a BMI under 25 had a risk of 0.63 (95% CI, 0.39-1.01) for colon cancer compared with the inactive. Finally, an interaction between BMI and activity (P(interaction) = 0.03) was observed for right-sided colon cancers; among moderately active and active participants with a BMI under 25, a risk of 0.38 (95% CI, 0.21-0.68) was found as compared with inactive participants with BMI >30. No comparable decreased risks were observed for rectal cancer for any type of physical activity for any subgroup analyses or interactions considered. We found that physical activity reduced colon cancer risk, specifically for right-sided tumors and for lean participants, but not rectal cancer.
Friedenreich
Christine
C
Nutrition and Hormones Group, IARC, Lyon, France. chrisf@cancerboard.ab.ca
Norat
Teresa
T
Steindorf
Karen
K
Boutron-Ruault
Marie-Christine
MC
Pischon
Tobias
T
Mazuir
Mathieu
M
Clavel-Chapelon
Françoise
F
Linseisen
Jakob
J
Boeing
Heiner
H
Bergman
Manuela
M
Johnsen
Nina Fons
NF
Tjønneland
Anne
A
Overvad
Kim
K
Mendez
Michelle
M
Quirós
J Ramón
JR
Martinez
Carmen
C
Dorronsoro
Miren
M
Navarro
Carmen
C
Gurrea
Aurelio Barricarte
AB
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Allen
Naomi
N
Key
Tim
T
Trichopoulou
Antonia
A
Trichopoulos
Dimitrios
D
Orfanou
Natassa
N
Krogh
Vittorio
V
Palli
Domenico
D
Tumino
Rosario
R
Panico
Salvatore
S
Vineis
Paolo
P
Bueno-de-Mesquita
H Bas
HB
Peeters
Petra H M
PH
Monninkhof
Evelyn
E
Berglund
Göran
G
Manjer
Jonas
J
Ferrari
Pietro
P
Slimani
Nadia
N
Kaaks
Rudolf
R
Riboli
Elio
E
D015992:Body Mass Index; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D002149:Energy Intake; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D052756:Nutritional Sciences; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors