, Volume 18, Issue 3, pp 243-258

Physical activity and endometrial cancer risk: a review of the current evidence, biologic mechanisms and the quality of physical activity assessment methods

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Abstract

Objectives

To (1) determine the nature of the association between physical activity and endometrial cancer risk; (2) assess the contribution of variation in the quality of physical activity measurement to inconsistencies in study results; and (3) review the biologic mechanisms that might mediate possible effects of physical activity on risk.

Methods

We reviewed and summarized all published epidemiologic studies examining physical activity and endometrial cancer risk, and evidence relating to possible biologic mechanisms. We assigned each study a quality score for physical activity measurement.

Results

Fourteen of the 18 studies showed a convincing or possible protective effect of physical activity on endometrial cancer risk, with an average relative risk reduction of around 30%. A dose–response relation was observed in 7 of 13 studies. The quality score was not related to the observed strength of association or the presence of a dose–response relation. There was epidemiologic and biologic evidence that vigorous activity, as well as light and moderate intensity activities, such as housework, gardening or walking for transportation, may reduce risk.

Conclusions

Physical activity probably has a protective role in endometrial cancer development. More epidemiologic and biologic evidence is needed to make conclusive recommendations on optimal types, characteristics or time periods of physical activity.

Financial support: Anne Cust is supported by a PhD scholarship (UPA) from the University of Sydney and a Research Scholar Award from the Cancer Institute NSW, Australia. Christine Friedenreich is supported by a Canadian Institutes for Health Research New Investigator Award and an Alberta Heritage Foundation for Medical Research Health Scholar Award. Bruce Armstrong’s research is supported by a University of Sydney Medical Foundation Program Grant.