J Korean Med Sci.  2022 May;37(19):e158. 10.3346/jkms.2022.37.e158.

Association of Physical Activity and Sedentary Behavior With the Risk of Colorectal Cancer

Affiliations
  • 1Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 2Department of Occupational and Environmental Medicine, Incheon Nasaret International Hospital, Incheon, Korea

Abstract

Background
Although recent evidence supports that prolonged sedentary behavior and reduced physical activity are associated with colorectal cancer risk, there are few studies analyzing the colorectal cancer risk according to different types of physical activity and combined effects of sedentary behavior and physical activity on colorectal cancer. This study aimed to investigate the association of sedentary behavior and physical activity with colorectal cancer.
Methods
A cross-sectional study included a total of 33,403 participants from the Korea National Health and Nutrition Examination Survey from 2014 to 2019. Sedentary behavior was dichotomized into < 10 hr/day and ≥ 10 hr/day, and three types of physical activity were investigated, including leisure-time, occupational, and transportation physical activity. Multiple logistic regression analyses were performed to assess the risk of colorectal cancer in relation to sedentary behavior and physical activity.
Results
Sedentary behavior was associated with an increased risk of colorectal cancer (odds ratio [OR] 1.64; 95% confidence interval [CI], 1.22–2.21), while the different domains of physical activity were not significantly associated with colorectal cancer risk. In a combined analysis, those with sedentary behavior and without physical activity showed an increased risk of colorectal cancer compared to that of the reference category without sedentary behavior and with physical activity (OR, 1.49; 95% CI, 1.02–2.16).
Conclusion
This study found that sedentary behavior was significantly associated with the increased risk of colorectal cancer. Moreover, sedentary behavior without physical activity increased the risk of colorectal cancer. Reducing sedentary behavior and recommending any type of physical activity may reduce the risk of colorectal cancer.

Keyword

Colorectal Neoplasm; Risk Factors; Sedentary Behavior; Physical Activity; Exercise

Figure

  • Fig. 1 Fully adjusted odds ratios and 95% confidence intervals for colorectal cancer associated with SB and PA, performing at least one of three types of PA, including occupational PA, leisure-time PA, or transportation PA.SB = sedentary behavior, PA = physical activity.


Reference

1. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol. 2019; 14(2):89–103. PMID: 31616522.
2. Khil H, Kim SM, Hong S, Gil HM, Cheon E, Lee DH, et al. Time trends of colorectal cancer incidence and associated lifestyle factors in South Korea. Sci Rep. 2021; 11(1):2413. PMID: 33510236.
3. Sierra MS, Forman D. Burden of colorectal cancer in Central and South America. Cancer Epidemiol. 2016; 44(Suppl 1):S74–S81. PMID: 27678325.
4. Nam S, Choi YJ, Kim DW, Park EC, Kang JG. Risk factors for colorectal cancer in Korea: a population-based retrospective cohort study. Ann Coloproctol. 2019; 35(6):347–356. PMID: 31937075.
5. Friedenreich CM, Ryder-Burbidge C, McNeil J. Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Mol Oncol. 2021; 15(3):790–800. PMID: 32741068.
6. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, et al. Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act. 2017; 14(1):75. PMID: 28599680.
7. Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary lifestyle: overview of updated evidence of potential health risks. Korean J Fam Med. 2020; 41(6):365–373. PMID: 33242381.
8. Byun W, Dowda M, Pate RR. Associations between screen-based sedentary behavior and cardiovascular disease risk factors in Korean youth. J Korean Med Sci. 2012; 27(4):388–394. PMID: 22468102.
9. Park MS, Chung SY, Chang Y, Kim K. Physical activity and physical fitness as predictors of all-cause mortality in Korean men. J Korean Med Sci. 2009; 24(1):13–19. PMID: 19270807.
10. Kerr J, Anderson C, Lippman SM. Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence. Lancet Oncol. 2017; 18(8):e457–e471. PMID: 28759385.
11. Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, et al. Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American Heart Association. Circulation. 2013; 128(20):2259–2279. PMID: 24126387.
12. Holtermann A, Hansen JV, Burr H, Søgaard K, Sjøgaard G. The health paradox of occupational and leisure-time physical activity. Br J Sports Med. 2012; 46(4):291–295. PMID: 21459873.
13. Park CS, Ha KH, Kim HC, Park S, Ihm SH, Lee HY. The association between parameters of socioeconomic status and hypertension in Korea: the Korean genome and epidemiology study. J Korean Med Sci. 2016; 31(12):1922–1928. PMID: 27822930.
14. Armstrong T, Bull F. Development of the world health organization global physical activity questionnaire (GPAQ). J Public Health. 2006; 14(2):66–70.
15. Jeon JY. Development of the KOREAN Version of Global Physical Activity Questionnaire and Assessment of Reliability and Validity. Osong, Korea: Korea Center for Disease Control and Prevention;2013.
16. An SY, Kang HE, Kim SM, Sok SA, Yang HJ, Lee GN. Association between sitting time and diabetes mellitus, cardiovascular disease and metabolic syndrome in Korean: the sixth Korean National Health and Nutrition Examination Survey 2013 and 2014. Korean J Fam Pract. 2017; 7(4):588–595.
17. Lee Y, Son JS, Eum YH, Kang OL. Association of sedentary time and physical activity with the 10-year risk of cardiovascular disease: Korea National Health and Nutrition Examination Survey 2014–2017. Korean J Fam Med. 2020; 41(6):374–380. PMID: 32008313.
18. Lee SY, Son DH, Lee YJ. Relationship between sedentary time and handgrip strength in healthy Korean women: Korea National Health and Nutrition Examination Survey 2014–2016. Korean J Fam Med. 2020; 41(6):422–426. PMID: 31902197.
19. Patel AV, Hildebrand JS, Campbell PT, Teras LR, Craft LL, McCullough ML, et al. Leisure-time spent sitting and site-specific cancer incidence in a large US cohort. Cancer Epidemiol Biomarkers Prev. 2015; 24(9):1350–1359. PMID: 26126627.
20. Li Y, Eshak ES, Cui R, Shirai K, Liu K, Iso H, et al. Television viewing time and the risk of colorectal cancer mortality among Japanese population: the JACC study. Cancer Res Treat. 2021; 53(2):497–505. PMID: 33138348.
21. Ma P, Yao Y, Sun W, Dai S, Zhou C. Daily sedentary time and its association with risk for colorectal cancer in adults: a dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore). 2017; 96(22):e7049. PMID: 28562564.
22. Eaglehouse YL, Koh WP, Wang R, Aizhen J, Yuan JM, Butler LM. Physical activity, sedentary time, and risk of colorectal cancer: the Singapore Chinese Health Study. Eur J Cancer Prev. 2017; 26(6):469–475. PMID: 28542077.
23. Gorczyca AM, Eaton CB, LaMonte MJ, Garcia DO, Johnston JD, He K, et al. Association of physical activity and sitting time with incident colorectal cancer in postmenopausal women. Eur J Cancer Prev. 2018; 27(4):331–338. PMID: 28538039.
24. 2018 Physical activity guidelines advisory committee scientific report. Updated 2018. Accessed February 2, 2022. https://health.gov/sites/default/files/2019-09/PAG_Advisory_Committee_Report.pdf .
25. Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, et al. American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Med Sci Sports Exerc. 2019; 51(11):2391–2402. PMID: 31626056.
26. Helmerhorst HJ, Wijndaele K, Brage S, Wareham NJ, Ekelund U. Objectively measured sedentary time may predict insulin resistance independent of moderate- and vigorous-intensity physical activity. Diabetes. 2009; 58(8):1776–1779. PMID: 19470610.
27. Ryu TY, Park J, Scherer PE. Hyperglycemia as a risk factor for cancer progression. Diabetes Metab J. 2014; 38(5):330–336. PMID: 25349819.
28. Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr. 2001; 131(11):Suppl. 3109S–3120S. PMID: 11694656.
29. Howard BJ, Balkau B, Thorp AA, Magliano DJ, Shaw JE, Owen N, et al. Associations of overall sitting time and TV viewing time with fibrinogen and C reactive protein: the AusDiab study. Br J Sports Med. 2015; 49(4):255–258. PMID: 24550208.
30. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002; 420(6917):860–867. PMID: 12490959.
31. Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011; 11(9):607–615. PMID: 21818123.
32. Hojman P, Gehl J, Christensen JF, Pedersen BK. Molecular mechanisms linking exercise to cancer prevention and treatment. Cell Metab. 2018; 27(1):10–21. PMID: 29056514.
33. Holtermann A, Burr H, Hansen JV, Krause N, Søgaard K, Mortensen OS. Occupational physical activity and mortality among Danish workers. Int Arch Occup Environ Health. 2012; 85(3):305–310. PMID: 21695437.
34. Päivärinne V, Kautiainen H, Heinonen A, Kiviranta I. Relations between subdomains of physical activity, sedentary lifestyle, and quality of life in young adult men. Scand J Med Sci Sports. 2018; 28(4):1389–1396. PMID: 29095553.
35. Omorou AY, Vuillemin A, Menai M, Latarche C, Kesse-Guyot E, Galan P, et al. 10-year cumulative and bidirectional associations of domain-specific physical activity and sedentary behaviour with health-related quality of life in French adults: Results from the SU.VI.MAX studies. Prev Med. 2016; 88:66–72. PMID: 27058941.
36. Arem H, Moore SC, Patel A, Hartge P, Berrington de Gonzalez A, Visvanathan K, et al. Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med. 2015; 175(6):959–967. PMID: 25844730.
37. Mahmood S, MacInnis RJ, English DR, Karahalios A, Lynch BM. Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis. Int J Epidemiol. 2017; 46(6):1797–1813. PMID: 29025130.
38. Morris JS, Bradbury KE, Cross AJ, Gunter MJ, Murphy N. Physical activity, sedentary behaviour and colorectal cancer risk in the UK Biobank. Br J Cancer. 2018; 118(6):920–929. PMID: 29520109.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr