title: Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults.
abstract: Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood.
  
  
  
  To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking.
  
  
  
  We pooled data from 12 prospective US and European cohorts with self-reported physical activity (baseline, 1987-2004). We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals for associations of leisure-time physical activity with incidence of 26 types of cancer. Leisure-time physical activity levels were modeled as cohort-specific percentiles on a continuous basis and cohort-specific results were synthesized by random-effects meta-analysis. Hazard ratios for high vs low levels of activity are based on a comparison of risk at the 90th vs 10th percentiles of activity. The data analysis was performed from January 1, 2014, to June 1, 2015.
  
  
  
  Leisure-time physical activity of a moderate to vigorous intensity.
  
  
  
  Incident cancer during follow-up.
  
  
  
  A total of 1.44 million participants (median [range] age, 59 [19-98] years; 57% female) and 186 932 cancers were included. High vs low levels of leisure-time physical activity were associated with lower risks of 13 cancers: esophageal adenocarcinoma (HR, 0.58; 95% CI, 0.37-0.89), liver (HR, 0.73; 95% CI, 0.55-0.98), lung (HR, 0.74; 95% CI, 0.71-0.77), kidney (HR, 0.77; 95% CI, 0.70-0.85), gastric cardia (HR, 0.78; 95% CI, 0.64-0.95), endometrial (HR, 0.79; 95% CI, 0.68-0.92), myeloid leukemia (HR, 0.80; 95% CI, 0.70-0.92), myeloma (HR, 0.83; 95% CI, 0.72-0.95), colon (HR, 0.84; 95% CI, 0.77-0.91), head and neck (HR, 0.85; 95% CI, 0.78-0.93), rectal (HR, 0.87; 95% CI, 0.80-0.95), bladder (HR, 0.87; 95% CI, 0.82-0.92), and breast (HR, 0.90; 95% CI, 0.87-0.93). Body mass index adjustment modestly attenuated associations for several cancers, but 10 of 13 inverse associations remained statistically significant after this adjustment. Leisure-time physical activity was associated with higher risks of malignant melanoma (HR, 1.27; 95% CI, 1.16-1.40) and prostate cancer (HR, 1.05; 95% CI, 1.03-1.08). Associations were generally similar between overweight/obese and normal-weight individuals. Smoking status modified the association for lung cancer but not other smoking-related cancers.
  
  
  
  Leisure-time physical activity was associated with lower risks of many cancer types. Health care professionals counseling inactive adults should emphasize that most of these associations were evident regardless of body size or smoking history, supporting broad generalizability of findings.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Moore
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: I-Min
authors.initials: IM
authors.lastname: Lee
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden4Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway5Genetic Epidemiology Group, Folkh.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Campbell
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Sampson
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Cari M
authors.initials: CM
authors.lastname: Kitahara
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Keadle
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland8now with USAID Bureau for Global Health, Washington, DC.
authors.forename: Hannah
authors.initials: H
authors.lastname: Arem
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Amy
authors.initials: A
authors.lastname: Berrington de Gonzalez
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden9Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Hans-Olov
authors.initials: HO
authors.lastname: Adami
authors.affiliation: Division of Epidemiology, Biostatistics, and Preventive Medicine, University of New Mexico, Albuquerque.
authors.forename: Cindy K
authors.initials: CK
authors.lastname: Blair
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway.
authors.forename: Kristin B
authors.initials: KB
authors.lastname: Borch
authors.affiliation: Information Management Services, Inc, Rockville, Maryland.
authors.forename: Eric
authors.initials: E
authors.lastname: Boyd
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: David P
authors.initials: DP
authors.lastname: Check
authors.affiliation: Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Fournier
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Neal D
authors.initials: ND
authors.lastname: Freedman
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, England14now with Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Gunter
authors.affiliation: Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France16Department of Biobank Research, Umeå University, Umeå, Sweden.
authors.forename: Mattias
authors.initials: M
authors.lastname: Johannson
authors.affiliation: Cambridge Institute of Public Health, University of Cambridge, Cambridge, England.
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Nicola
authors.initials: N
authors.lastname: Orsini
authors.affiliation: Division of Public Health Sciences, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, England.
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.affiliation: Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Kim
authors.initials: K
authors.lastname: Robien
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Schairer
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Howard
authors.initials: H
authors.lastname: Sesso
authors.affiliation: Information Management Services, Inc, Rockville, Maryland.
authors.forename: Michael
authors.initials: M
authors.lastname: Spriggs
authors.affiliation: Information Management Services, Inc, Rockville, Maryland.
authors.forename: Roy
authors.initials: R
authors.lastname: Van Dusen
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Matthews
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
authors.forename: Alpa V
authors.initials: AV
authors.lastname: Patel
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005062:European Union / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007899:Leisure Activities; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology