Physical activity in the prevention and treatment of colorectal carcinoma.
BACKGROUND
Colorectal carcinoma is the most common type of tumor in Western countries. The risk of developing colorectal carcinoma depends both on genetic factors (familial predisposition) and on lifestyle-related factors such as body-mass index, level of physical activity, and nutritional behavior. Regular physical activity is important in primary prevention, and there is also evidence that the prognosis after treatment of a colorectal carcinoma can be improved by exercise.


METHODS
The PubMed database was searched for relevant articles that appeared in the last 10 years, and selected articles were evaluated.


RESULTS
Cross-sectional studies have shown that regular physical activity (ca. 7 hours of brisk walking per week) lowers the risk of colon carcinoma by 40%. Physical activity also improves the outcome of patients already diagnosed with colorectal carcinoma: for example, patients with advanced disease (UICC stage II or III) have been found to survive significantly longer if they perform 4 hours of brisk walking per week, or the equivalent degree of physical exercise.


CONCLUSIONS
Cross-sectional studies show that physically active persons are less likely to develop colorectal carcinoma than physically inactive persons, and that they have better outcomes in the event that they do develop the disease. The positive findings with respect to secondary prevention still need to be confirmed in interventional trials, but in primary prevention, at least, physical activity should be actively promoted, along with other beneficial lifestyle habits and screening measures.
Halle
Martin
M
Preventive and Rehabilitative Sports Medicine, Hospital rechts der Isar, Technische Universität München, Munich, Germany. halle@sport.med.tum.de
Schoenberg
Michael H
MH
D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000517:prevention & control*; D015444:Exercise; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D009043:Motor Activity; D039781:PubMed / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome