Epidemiology | Published:

Physical activity, sedentary behaviour and colorectal cancer risk in the UK Biobank

British Journal of Cancer volume 118, pages 920929 (20 March 2018) | Download Citation

Abstract

Background:

Observational studies have shown that physical activity levels are inversely, and sedentary behaviours are positively, associated with colorectal cancer risk; however, whether these relationships are consistent across anatomical subsites is uncertain.

Methods:

We investigated the associations between colorectal cancer and physical activity (metabolic equivalents (METs)-hours per week), and indicators of sedentary behaviour (television watching time and time spent using computers) among 430 584 men and women enroled in the UK Biobank. Multivariable hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models.

Results:

After a median follow-up time of 5.6 years, 2391 incident colorectal cancer cases were recorded. High (60-MET-hours per week) vs low (<10-MET-hours per week) total physical activity was associated with a lower colon cancer risk (HR=0.84, 95% CI: 0.72–0.98; p-trend=0.04), with comparable relationships observed for proximal and distal colon tumours, but no association for rectal cancer. Higher levels of television watching time were associated with greater colon cancer risk (HR for 5 h per day vs 1 h per day=1.32, 95% CI: 1.04–1.68; p-trend=0.007). Time spent using computers was not associated with colorectal cancer risk.

Conclusions:

Higher levels of physical activity were associated with lower colon cancer risk, with no heterogeneity by colonic subsite. Sedentary behaviour (television watching) was associated with elevated colon cancer risk.

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Change history

  • Corrected online 20 March 2018

References

  1. , , , , , , , , , (2011) Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc 43: 1575–1581.

  2. , , , , , , , , , , , (2012) UK Biobank: current status and what it means for epidemiology. Health Policy Technol 1: 123–126.

  3. , , , , , , , , , Million women study, C (2017) Heterogeneity of colorectal cancer risk by tumour characteristics: large prospective study of UK women. Int J Cancer 140: 1082–1090.

  4. , , , , , , , , , , (2003) International physical activity questionnaire: 12-Country reliability and validity. Med Sci Sports Exerc 35: 1381–1395.

  5. , , , , , , , , , , , , , , , (2017) Large scale population assessment of physical activity using wrist worn accelerometers: the UK biobank study. PLOS ONE 12: e0169649.

  6. , , , , , , (2007) Association of television viewing with fasting and 2-h postchallenge plasma glucose levels in adults without diagnosed diabetes. Diabetes Care 30: 516–522.

  7. , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , (2006) Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomark Prev 15: 2398–2407.

  8. , , (2010) State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer 46: 2593–2604.

  9. , , , , (2009) Objectively measured sedentary time may predict insulin resistance independent of moderate- and vigorous-intensity physical activity. Diabetes 58: 1776–1779.

  10. , , , , , (2008) Physical activity, sedentary behavior, and the risk of colon and rectal cancer in the NIH-AARP Diet and Health Study. Cancer Causes Control 19: 939–953.

  11. (2001) Type of activity: resistance, aerobic and leisure versus occupational physical activity. Med Sci Sports Exerc 33: S364–S369.

  12. IARC-WHO (2015) GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012.

  13. IPAQ research committee (2005) Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ)—Short and Long Forms.

  14. , , , , , , , , , (2000) Serum C-peptide, insulin-like growth factor (IGF)-I, IGF-binding proteins, and colorectal cancer risk in women. J Natl Cancer Inst 92: 1592–1600.

  15. , (2007) Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 86: 556–565.

  16. , , , , (2010) Physical activity and weight gain prevention. J Am Med Assoc 303: 1173–1179.

  17. , , , , , (2007) Physical activity and risk of colorectal cancer in Japanese men and women: the Japan Public Health Center-based prospective Study. Cancer Causes Control 18: 199–209.

  18. , , , , , , , , , , , , , , , , (2010) Cigarette smoking and colorectal cancer risk by molecularly defined subtypes. J Natl Cancer Inst 102: 1012–1022.

  19. , , , , , (2014) Development and testing of a past year measure of sedentary behavior: the SIT-Q. BMC Public Health 14: 899.

  20. , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , (2012) Combined impact of lifestyle factors on prospective change in body weight and waist circumference in participants of the EPIC-PANACEA study. PLOS ONE 7: e50712.

  21. , , (2007) Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomark Prev 16: 2533–2547.

  22. , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , (2016) Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Int Med 176: 816–825.

  23. , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , (2016) A nested case−control study of metabolically defined body size phenotypes and risk of colorectal cancer in the european prospective investigation into cancer and nutrition (EPIC). PLoS Med 13: e1001988.

  24. Office for National Statistics (2006) The Time Use Survey, 2005. How We Spend Our Time. London.

  25. , , , (2000) Environmental determinants of physical activity and sedentary behavior. Exerc Sport Sci Rev 28: 153–158.

  26. , (2014) Television viewing and time spent sedentary in relation to cancer risk: a meta-analysis. J Natl Cancer Inst 106: dju098–dju098.

  27. (1982) Partial residuals for the proportional hazards regression model. Biometrika 69: 239–241.

  28. (2004) Physical activity and colorectal cancer. Sports Med 34: 239–252.

  29. , , , (2010) Inflammation and colon cancer. Gastroenterology 138: 2101–2114.e5.

  30. UK-Biobank (2010) UK Biobank. Protocol for a large-scale prospective epidemiological resources [Online] Accessed 10 July 2016.

  31. WCRF-AICR (2011) World Cancer Research Fund-American Institute for Cancer Research. Continuous Update Project Report Summary. Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer.

  32. , , , , , , , , , (2017) A comprehensive model of colorectal cancer by risk factor status and subsite using data From the nurses’ health study. Am J Epidemiol 185: 224–237.

  33. , , , , , , (2004) Comparison of risk factors for colon and rectal cancer. Int J Cancer 108: 433–442.

  34. , , , , , (2006) When children eat what they watch: impact of television viewing on dietary intake in youth. Arch Pediatr Adolesc Med 160: 436–442.

  35. , , , , , , (2014) Reliability and validity of a domain-specific last 7-d sedentary time questionnaire. Med Science in Sports Exerc 46: 1248–1260.

  36. , , , (2009) Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer 100: 611–616.

  37. , , (2006) Exercise, inflammation, and innate immunity. Neurol Clin 24: 585–599.

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Acknowledgements

This work has been conducted using the UK Biobank Resource under Application Number 25897 and we express our gratitude to the participants and those involved in building the resource. UK Biobank is an open access resource. Bona fide researchers can apply to use the UK Biobank data set by registering and applying at http://www.ukbiobank.ac.uk/register-apply/. KEB was supported by a Girdlers’ New Zealand Health Research Council Fellowship.

Author information

Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK

    • Jessica S Morris
    •  & Amanda J Cross
  2. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK

    • Kathryn E Bradbury
  3. Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France

    • Marc J Gunter
    •  & Neil Murphy

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to Neil Murphy.

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DOI

https://doi.org/10.1038/bjc.2017.496

This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License.

Supplementary Information accompanies this paper on British Journal of Cancer website (http://www.nature.com/bjc)