Timing and intensity of recreational physical activity and the risk of subsite-specific colorectal cancer
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Although there is convincing evidence that physical activity reduces colon cancer risk, there are important questions that remain unanswered about the association. These include the timing and intensity of activity required to optimally reduce risk, and whether physical activity has a different effect on cancers at different sites within the colon. We conducted a case–control study to investigate these issues.
A case–control study of colorectal cancer was conducted in Western Australia in 2005–2007. Data were collected on various risk factors. The estimated effects of recreational physical activity on the risk of cancers of the distal colon, proximal colon, and rectum were analyzed using multinomial logistic regression. This analysis included 870 cases and 996 controls.
The risk of distal colon cancer was reduced by performing a high level of vigorous-intensity activity between the ages 19 and 34 years (women), 35 and 50 years (men), after the age of 51 years (men and women), and consistently over the adult lifetime (men and women). The risk of rectal cancer was reduced by performing a high level of vigorous activity between the ages 35 and 50 years (men), and consistently over the adult lifetime (men). Proximal colon cancer risk was not associated with physical activity in any of the age periods or over the adult lifetime. Moderate intensity activity did not reduce the risk of colorectal cancer.
Physical activity may have a greater effect on the risk of distal colon cancer than proximal colon cancer. Vigorous physical activity is required to reduce colorectal cancer risk.
KeywordsColon cancer Rectal cancer Physical activity Case control studies
Adjusted odds ratio
The authors thank Barry Iacopetta, Kieran McCaul, David Crawford, Cassandra Clayforth, Jenny Landrigan, Jen Girschik, Clare Tran and Beatriz Cuesta-Briand for their contributions to the Western Australian Bowel Health Study. This work was supported by the Australian National Health and Medical Research Council (Project Grant Number 353568 and Fellowship Number 37614900 to LF), the University of Western Australia (PhD scholarship to TB) and the Lions Cancer Institute of Western Australia (PhD scholarship to TB).
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