title: European Code against Cancer 4th Edition: Physical activity and cancer.
abstract: Physical activity is a complex, multidimensional behavior, the precise measurement of which is challenging in free-living individuals. Nonetheless, representative survey data show that 35% of the European adult population is physically inactive. Inadequate levels of physical activity are disconcerting given substantial epidemiologic evidence showing that physical activity is associated with decreased risks of colon, endometrial, and breast cancers. For example, insufficient physical activity levels are thought to cause 9% of breast cancer cases and 10% of colon cancer cases in Europe. By comparison, the evidence for a beneficial effect of physical activity is less consistent for cancers of the lung, pancreas, ovary, prostate, kidney, and stomach. The biologic pathways underlying the association between physical activity and cancer risk are incompletely defined, but potential etiologic pathways include insulin resistance, growth factors, adipocytokines, steroid hormones, and immune function. In recent years, sedentary behavior has emerged as a potential independent determinant of cancer risk. In cancer survivors, physical activity has shown positive effects on body composition, physical fitness, quality of life, anxiety, and self-esteem. Physical activity may also carry benefits regarding cancer survival, but more evidence linking increased physical activity to prolonged cancer survival is needed. Future studies using new technologies - such as accelerometers and e-tools - will contribute to improved assessments of physical activity. Such advancements in physical activity measurement will help clarify the relationship between physical activity and cancer risk and survival. Taking the overall existing evidence into account, the fourth edition of the European Code against Cancer recommends that people be physically active in everyday life and limit the time spent sitting.
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Leitzmann
authors.affiliation: Department of Oncology, University of Sheffield, Sheffield S10 2RX, United Kingdom.
authors.forename: Hilary
authors.initials: H
authors.lastname: Powers
authors.affiliation: Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee DD1 9SY, Scotland, United Kingdom.
authors.forename: Annie S
authors.initials: AS
authors.lastname: Anderson
authors.affiliation: International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
authors.forename: Chiara
authors.initials: C
authors.lastname: Scoccianti
authors.affiliation: Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.affiliation: Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.affiliation: Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France.
authors.forename: Michele
authors.initials: M
authors.lastname: Cecchini
authors.affiliation: International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
authors.forename: Carolina
authors.initials: C
authors.lastname: Espina
authors.affiliation: Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, United Kingdom.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom.
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
authors.affiliation: World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1B 3HH, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Wiseman
authors.affiliation: International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France. Electronic address: secretariat-cancer-code-europe@iarc.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
mesh_terms: D000328:Adult; D005062:European Union; D005081:Exercise Therapy; D017408:Guidelines as Topic / Q000592:standards*; D006801:Humans; D009369:Neoplasms / Q000517:prevention & control*; D011788:Quality of Life; D040242:Risk Reduction Behavior
keywords: Carcinogenesis; Disease; Europe; Exercise; Motor activity; Neoplasms; Primary prevention; Sedentary lifestyle