DOI QR코드

DOI QR Code

Physical Activity and its Relation to Cancer Risk: Updating the Evidence

  • Kruk, Joanna (Faculty of Physical Culture and Health Promotion, University of Szczecin) ;
  • Czerniak, Urszula (Department of Anthropology and Biometry, Eugeniusz Piasecki University School of Physical Education in Poznan)
  • Published : 2013.07.30

Abstract

Scientific evidence for the primary prevention of cancer caused by physical activity of regular moderate-intensity or greater is rapidly accumulating in this field. About 300 epidemiologic studies on the association between physical activity and cancer risk have been conducted worldwide. The objectives of this paper were three-fold: (i) to describe briefly the components of physical activity and its quantification; (ii) to summarize the most important conclusions available from comprehensive reports, and reviews of the epidemiologic individual and intervention studies on a role physical activity in cancer prevention; (iii) to present proposed biological mechanisms accounting for effects of activity on cancer risk. The evidence of causal linked physical activity and cancer risk is found to be strong for colon cancer - convincing; weaker for postmenopausal breast and endometrium cancers - probable; and limited suggestive for premenopausal breast, lung, prostate, ovary, gastric and pancreatic cancers. The average risk reductions were reported to be 20-30%. The protective effects of physical activity on cancer risk are hypothesized to be through multiple interrelated pathways: decrease in adiposity, decrease in sexual and metabolic hormones, changes in biomarkers and insulin resistance, improvement of immune function, and reduction of inflammation. As there are several gaps in the literature for associations between activity and cancer risk, additional studies are needed. Future research should include studies dealing with limitations in precise estimates of physical activity and of a lack of consensus on what defines sedentary behavior of individuals and those linked with the proposed biomarkers to cancer risk and controlled exercise intervention trials.

Keywords

References

  1. Abrahamson PE, King IB, Ulrich CM, et al (2007). No effect of exercise on colon mucosal prostaglandin concentrations: a 12-month randomized controlled trial. Cancer Epidemiol Biomarkers Prev, 16, 2351-6. https://doi.org/10.1158/1055-9965.EPI-07-0120
  2. AICR (2010). AICR/WCRF, Policy and Action for Cancer Prevention, 2009. Cancer Facts and Figures, 2010, www.aicr.org.
  3. Ainsworth BE, Haskell WL, Leon AS, et al (1993). Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc, 25, 71-80. https://doi.org/10.1249/00005768-199301000-00011
  4. Ainsworth BE, Haskell WL, Whitt WC, et al (2000). Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc, 32, 498-516. https://doi.org/10.1097/00005768-200009001-00009
  5. American Cancer Society (2008). Breast Cancer Facts and Figures 2007-2008, Atlanta, GA: American Cancer Society, Inc.
  6. American Cancer Society (2011). Breast Cancer Facts and Figures 2011-2012. Atlanta: GA American Cancer Society, Inc.
  7. Anderson JP, Ross JA, Folson AR (2004). Anthropometric variables, physical activity, and incidence of ovarian cancer: the Iowa women's health study. Cancer, 100, 1515-21. https://doi.org/10.1002/cncr.20146
  8. Balducci S, Zanuso S, Nicolucci A, et al (2010). Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis, 20, 608-17. https://doi.org/10.1016/j.numecd.2009.04.015
  9. Bao Y, Michaud DS (2008). Physical activity and pancreatic cancer: a systematic review. Cancer Epidemiol Biomarkers Prev, 17, 2671-82. https://doi.org/10.1158/1055-9965.EPI-08-0488
  10. Bernstein L, Lu Y, Henderson KD (2010). Physical activity and cancer. Chap. 7. In : NA Berger (ed.). Cancer and Energy Balance, Epidemiology and Overview. Springer Science Business Media, LLC.
  11. Blair SN (2009). Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med, 43, 1-2.
  12. Bull FC, Groups EW (2010). Physical Activity Guidelines in the UK Review and Recommendations. School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK.
  13. Byrne NM, Hills AP, Hunter GR, et al (2005). Metabolic equivalent: one size does not fit all. J Appl Physiol, 99, 1112-9. https://doi.org/10.1152/japplphysiol.00023.2004
  14. Campbell PT, Gross MD, Potter JD, et al (2010). Effect of exercise on oxidative stress: a 12-month randomized, controlled trial. Med Sci Sports Exerc, 42, 1448-53. https://doi.org/10.1249/MSS.0b013e3181cfc908
  15. Campbell PT, Wener MH, Sorensen B, et al (2008). Effect of exercise on in vitro immune function: a 12-month randomized, controlled trial among postmenopausal women. Appl Physiol, 104, 1648-55. https://doi.org/10.1152/japplphysiol.01349.2007
  16. Carnide N, Kreiger N, Cotterchio M (2009). Association between frequency and intensity of recreational physical activity and epithelial ovarian cancer risk by age period. Eur J Cancer Prev, 18, 322-30. https://doi.org/10.1097/CEJ.0b013e32832bf3fa
  17. Caspersen CJ, Powell KE, Christensen GM (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep, 100, 126-31.
  18. Coyle YM (2008). Physical activity as a negative modulator of estrogen-induced breast cancer. Cancer Causes Control, 19, 1021-9. https://doi.org/10.1007/s10552-008-9186-x
  19. Cust AE, Armstrong BK, Friedenreich CM, Slimani N, Bauman A (2007). Physical activity and endometrial cancer risk: a review of the current evidence, biologic mechanisms and the quality of physical activity assessment methods. Cancer Causes Control, 18, 243-58. https://doi.org/10.1007/s10552-006-0094-7
  20. Czene K, Lichtenstein P, Hemminki K (2002). Environmental and heritable causes of cancer among 9.6 million individuals in the Swedish family - cancer database. Int J Cancer, 99, 260-6. https://doi.org/10.1002/ijc.10332
  21. FAO (2003). Food energy - methods of analysis and conversion factors. Report of a technical workshop. FAO Food and Nutrition Paper No 77, Rome.
  22. FAO/WHO/UNU (2004). Human energy requirements: Energy requirements for adults. Report of a Joint FAO/WHO/UNU Expert Consultation. Food and Agriculture Organization of the United Nations 2004. http://www.fao.org/docrep/007/y5686e07.htm.
  23. Feig DI, Reid TM, Loeb LA (1994). Reactive oxygen species in tumorigenesis. Cancer Res, 7, 1890-4.
  24. Ferlay J, Shin HR, Bray F, et al (2010). GLOBOCAN 2008 version 2.0. Cancer incidence and mortality worldwide: IARC Cancer Base No 10. Lion, France. International Agency for Research on Cancer, http://globocan.iarc.fr. Accessed May 2011.
  25. Friedenreich CM (2011). Physical activity and breast cancer: review of the epidemiologic evidence and biologic mechanisms. Recent Results Cancer Res, 188, 125-39.
  26. Friedenreich CM, Courneya KS, Bryant HE (1998). The lifetime total physical activity questionnaire: development and reliability. Med Sci Sports Exerc, 30, 266-74.
  27. Friedenreich CM, McGregor SE, Courneya KS, Angyalfi SJ, Elliott PG (2004). Case-control study of lifetime total physical activity and prostate cancer risk. Am J Epidemiol, 159, 740-9. https://doi.org/10.1093/aje/kwh106
  28. Friedenreich CM, Neilson HK, Lynch BM (2010a). State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer, 46, 2593-604. https://doi.org/10.1016/j.ejca.2010.07.028
  29. Friedenreich CM, Neilson HK, Woolcott CG, et al (2011b). Changes in insulin resistance indicators, IGSs and adipokines in a year-long trial of aerobic exercise in postmenopausal women. Endocrine-Related Cancer, 18, 357-69. https://doi.org/10.1530/ERC-10-0303
  30. Friedenreich CM, Orenstein MR (2002). Physical activity and cancer prevention: etiologic evidence and biological mechanisms. J Nutr, 132, 3456-64.
  31. Friedenreich CM, Woolcott CG, McTiernan A, et al (2010c). Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obesity, 35, 427-35.
  32. Friedenreich CM, Woolcott CG, McTiernan A, et al (2011). Alberta physical activity and breast cancer prevention trial: sex hormone changes in a year-long exercise intervention among postmenopausal women. J Clin Oncol, 28, 1458-66.
  33. Garofalo C, Surmacz E (2006) Leptin and cancer. J Cell Physiol, 207, 12-22. https://doi.org/10.1002/jcp.20472
  34. Gierach GL, Chang SC, Brinton LA, et al (2009). Physical activity, sedentary behavior, and endometrial cancer risk in the NIH-AARP diet and health study. Int J Cancer, 124, 2139-47. https://doi.org/10.1002/ijc.24059
  35. Giovannucci EL, Liu Y, Leitzman MF, Stampfer MJ, Willett WC (2005). A prospective study of physical activity and incident and fatal prostate risk. Arch Int Med, 165, 1005-10. https://doi.org/10.1001/archinte.165.9.1005
  36. Gomez-Cabrera MC, Domenech E, Vina J (2008). Moderate exercise is an antioxidant: upregulation of antioxidant genes by training. Free Radic Biol Med, 44, 126-31. https://doi.org/10.1016/j.freeradbiomed.2007.02.001
  37. Harriss DJ, Atkinson G, Batterham A, et al (2009). Lifestyle factors and colorectal cancer risk (2): a systematic review and meta-analysis of associations with leisure-time physical activity. Colorectal Dis, 11, 689-701. https://doi.org/10.1111/j.1463-1318.2009.01767.x
  38. Hawkins VN, Foster-Schubert K, Chubak J, et al (2008). Effect of exercise on serum sex hormones in men: a 12-month randomized clinical trial. Med Sci Sports Exerc, 40, 223-33. https://doi.org/10.1249/mss.0b013e31815bbba9
  39. Heikkila K, Nyberg ST, Theorell T, et al (2013). Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European man and women. BMJ, 346, 165. https://doi.org/10.1136/bmj.f165
  40. Hoffman-Goetz L, Apter D, Denmark-Wahnefried W, et al (1998). Possible mechanisms mediating an association between physical activity and breast cancer. Cancer, 83, 621-8. https://doi.org/10.1002/(SICI)1097-0142(19980801)83:3+<621::AID-CNCR4>3.0.CO;2-A
  41. Howard RA, Freedman DM, Park Y, et al (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, 939-53. https://doi.org/10.1007/s10552-008-9159-0
  42. IARC working group (2002). Weight control and physical activity. Vol. 6 IARC Handbook of Cancer Prevention. IARC Press, Lyon, France.
  43. Inoue M, Yamamoto S, Kurahashi N, et al (2008). Daily total physical activity level and total cancer risk in men and women: results from a large-scale population-based cohort study in Japan. Am J Epidemiol, 168, 391-403. https://doi.org/10.1093/aje/kwn146
  44. Jakobisiak M, Lasek W, Golab J (2003). Natural mechanisms protecting against cancer. Immunol Lett, 90, 103-22. https://doi.org/10.1016/j.imlet.2003.08.005
  45. Janssen I, Ross R (2012). Vigorous intensity physical activity is related to the metabolic syndrome independent of the physical activity dose. Int J Epidemiol, 41, 1132-40. https://doi.org/10.1093/ije/dys038
  46. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistic. CA Cancer Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  47. Jemal A, Siegel R, Ward, et al (2009). Cancer statistics, 2009. CA Cancer J Clin, 59, 225-49. https://doi.org/10.3322/caac.20006
  48. Jiao L, Mitrou PN, Reedy J, et al (2009). A combined healthy lifestyle score and risk of pancreatic cancer in a large cohort study. Arch Intern Med, 169, 764-70. https://doi.org/10.1001/archinternmed.2009.46
  49. Kaaks R, Lukanowa A, Kurzer MS (2002). Obesity, endogenous hormones, and endometrial cancer: a synthetic review. Cancer Epidemiol Biomarkers Prev, 11, 1531-43.
  50. Kay SJ, Sing MA (2006). The influence of physical activity on abdominal fat: a systematic review of the literature. Obes Rev, 7, 183-200. https://doi.org/10.1111/j.1467-789X.2006.00250.x
  51. Kelesidis I, Kelesidis T, Mantzoros CS (2006). Adiponectin and cancer: a systematic review. Br J Cancer, 94, 1221-5. https://doi.org/10.1038/sj.bjc.6603051
  52. Key TJ, Schatzkin A, Willett W, et al (2004). Diet, nutrition and the prevention of cancer. Public Health Nutrition, 7, 187-200.
  53. Kruk J (2011). Physical exercise and oxidative stress. Med Sport, 15, 30-40. https://doi.org/10.2478/v10036-011-0004-2
  54. Kruk J, Aboul-Enein HY (2006). Environmental, and other behavioral risk factors in breast cancer. Curr Cancer Ther Rev, 2, 3-21.
  55. Kruk J, Aboul-Enein HY (2007). Physical activity and cancer prevention: updating the evidence. The role of oxidative stress in carcinogenesis. Curr Cancer Ther Rev, 3, 81-95. https://doi.org/10.2174/157339407780618443
  56. Kushi L, Byers T, Doyle C, et al (2006). American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin, 56, 254-81. https://doi.org/10.3322/canjclin.56.5.254
  57. Lagiou A, Samoli E, Georgila C, et al (2008). Occupational physical activity in relation with prostate cancer and benign prostatic hyperplasia. Eur J Cancer Prev, 17, 336-9. https://doi.org/10.1097/CEJ.0b013e3282f5221e
  58. Lee IM, Oguma Y (2006). Physical activity. In: Schottenfeld D and Fraumeni JF (eds). Cancer Epidemiology and Prevention, 3rd ed. New York, NY, Oxford University Press, 449-67.
  59. Leitzmann MF, Koebnick C, Abnet CC, et al (2009a). Prospective study of physical activity and lung cancer by histologic type in current, former and never smokers. Am J Epidemiol, 169, 542-53.
  60. Leitzmann MF, Koebnick C, Freedman ND, et al (2009c). Physical activity and esophageal and gastric carcinoma in a large prospective study. Am J Prev Med, 36, 112-9. https://doi.org/10.1016/j.amepre.2008.09.033
  61. Leitzmann MF, Koebnick C, Moore SC, et al (2009b). Prospective study of physical activity and the risk of ovarian cancer. Cancer Causes Control, 20, 765-73. https://doi.org/10.1007/s10552-008-9291-x
  62. Lichr JG, Jones JS (2001). Role of iron in estrogen-induced cancer. Curr Med Chem, 8, 839-49. https://doi.org/10.2174/0929867013372931
  63. Littman AJ, Kristal AR, White E (2006). Recreational physical activity and prostate cancer risk. Cancer Causes Control, 17, 831-41. https://doi.org/10.1007/s10552-006-0024-8
  64. Loprinzi PD, Cardinal BJ, Smit E, Winters-Stone K (2012). Physical activity and breast cancer risk. J Exerc Sci Fitness, 10, 1-7. https://doi.org/10.1016/j.jesf.2012.04.004
  65. Lynch BM, Neilson HK, Friedenreich CM (2011). Physical activity and breast cancer prevention. In: Courneya KS, Friedenreich (eds) Physical Activity and Cancer, Recent Results in Cancer Research, Chap. 2. Springer Verlag, Berlin Heidenberg, 186, 13-42.
  66. Mai PL, Sullivan-Halley J, Ursin G, et al (2007). Physical activity and colon cancer risk among women in the California Teachers Study. Cancer Epidemiol Biomarkers Prev, 16, 517-25. https://doi.org/10.1158/1055-9965.EPI-06-0747
  67. Mates JM, Sanchez-Jimenez FM (2000). Role of reactive oxygen species in apoptosis: implications for cancer therapy. Int J Biochem Cell Biol, 32, 152-70.
  68. McTiernan A (2008). Mechanisms linking physical activity with cancer. Nat Rev Cancer, 8, 205-11. https://doi.org/10.1038/nrc2325
  69. McTiernan A, Sorensen B, Yasui Y, et al (2005). No effect of exercise on insulin-like growth factor and insulin-like growth factor binding protein 3 in postmenopausal women: a 12-month randomized clinical trial. Cancer Epidemiol Biomarkers Prev, 14, 1020-1. https://doi.org/10.1158/1055-9965.EPI-04-0834
  70. McTiernan A, Tworoger SS, Ulrich CM, et al (2004). Effect of exercise on serum estrogens in postmenopausal women: a 12-month randomized clinical trial. Cancer Res, 64, 2923-8. https://doi.org/10.1158/0008-5472.CAN-03-3393
  71. McTiernan A, Wu LL, Chen C, et al (2006). Women's Health Initiative Investigators, Relation of BMI and physical activity to sex hormones in postmenopausal women. Obesity, 14, 1662-77. https://doi.org/10.1038/oby.2006.191
  72. Miles L (2007). Physical activity and the prevention of cancer: a review of recent findings. Nutr Bull, 32, 250-2. https://doi.org/10.1111/j.1467-3010.2007.00653.x
  73. Miles L (2008). The new WCRF/AICR report-food, nutrition, physical activity and the prevention of cancer: a global perspective. Nutrition Bulletin, 33, 26-32. https://doi.org/10.1111/j.1467-3010.2007.00681.x
  74. Monninkhof EM, Elias SG, Vlems FA, et al (2007). Physical activity and breast cancer: a systematic review. Epidemiol, 18, 137-57. https://doi.org/10.1097/01.ede.0000251167.75581.98
  75. Monninkhof EM, Velthuis MJ, Peeters PH, et al (2009). Effect of exercise on postmenopausal sex hormone levels and role of body fat: a randomized controlled trial. J Clin Oncol, 27, 4492-9. https://doi.org/10.1200/JCO.2008.19.7459
  76. Moore MA, Sobue T (2010). Strategies for cancer control on an organ-site basis. Asian Pac J Cancer Prev, 11, 149-64.
  77. Moore SC, Peters TM, Ahn J, et al (2008). Physical activity in relation to total, advanced, and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev, 17, 2458-66. https://doi.org/10.1158/1055-9965.EPI-08-0403
  78. Neilson HK, Friedenreich CM, Brockton NT, et al (2009). Physical activity and postmenopausal breast cancer: Proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomark Prev, 18, 11-27. https://doi.org/10.1158/1055-9965.EPI-08-0756
  79. Nilsen TI, Romundstad PR, Vatten LJ (2006). Recreational physical activity and risk of prostate cancer: a prospective population-based study in Norway (the HUNT study). Int J Cancer, 119, 2943-7. https://doi.org/10.1002/ijc.22184
  80. Norton K, Norton L, Sadgrove D (2010). Position statement on physical activity and exercise intensity terminology. J Sci Med Sport, 13, 496-502. https://doi.org/10.1016/j.jsams.2009.09.008
  81. Olsen CM, Bain CJ, Jordan SJ, et al (2007). Recreational physical activity and epithelial ovarian cancer: a case-control study, systematic review, and meta-analysis. Cancer Epidemiol Biomarkers Prev, 16, 2321-30. https://doi.org/10.1158/1055-9965.EPI-07-0566
  82. Patel AV, Rodriguez C, Pavluck AL, Thun MJ, Calle EE (2006). Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women. Am J Epidemiol, 163, 709-16. https://doi.org/10.1093/aje/kwj098
  83. Reding KW, Lampe JW, Wang CY et al (2011). A 12-month moderate-intensity exercise intervention does not alter serum prolactin concentrations. Cancer Epidemiol, 35, 569-73. https://doi.org/10.1016/j.canep.2011.01.006
  84. Renehan AG, Tyson M, Egger M, et al (2008). Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet, 371, 569-78. https://doi.org/10.1016/S0140-6736(08)60269-X
  85. Rodriguez C, Freedland SJ, Deka A, et al (2007). Body mass index, weight change, and risk of prostate in the cancer prevention study II nutrition cohort. Cancer Epidemiol Biomarkers Prev, 16, 63-9. https://doi.org/10.1158/1055-9965.EPI-06-0754
  86. Rossing MA, Cushing-Haugen KL, Wicklund KG, Doherty JA, Weiss NS (2010). Recreational physical activity and risk of epithelial ovarian cancer. Cancer Causes Control, 21, 485-91. https://doi.org/10.1007/s10552-009-9479-8
  87. Rundle A (2005) Molecular epidemiology of physical activity and cancer. Cancer Epidem Biomark Prev, 14, 227-36.
  88. Shephard RJ, Shek PN (1998). Associations between physical activity and susceptibility to cancer: possible mechanisms. Sports Med, 26, 293-315. https://doi.org/10.2165/00007256-199826050-00002
  89. Siegel R, Naishadham D, Jemal A (2012). Cancer statistics. CA Cancer J Clin, 62, 10-29. https://doi.org/10.3322/caac.20138
  90. Speck RM, Schmitz KH, Lee I-M, McTiernan A (2011). Epidemiology of physical activity and cancer risk. In: Physical Activity, Dietary Calorie Restriction, and Cancer Mc Tiernan A (ed) 25-53. Springer Science + Business Media, LLC.
  91. Spence RR, Heesch KC, Brown WJ (2009). A systematic review of the association between physical activity and colorectal cancer risk. Scand J Med Sci Sports, 19, 764-81. https://doi.org/10.1111/j.1600-0838.2009.00992.x
  92. Steindorf K, Ritte R, Eomois PP, et al (2012). Physical activity and risk of breast cancer overall and by hormone receptor status: the European prospective investigation into cancer and nutrition. Int J Cancer, 132, 1667-78.
  93. Stevens RJ, Roddam AW, Spencer EA, et al (2009). Factors associated with incident and fatal pancreatic cancer in a cohort of middle-aged women. Int J Cancer, 124, 2400-5. https://doi.org/10.1002/ijc.24196
  94. Subramanian J, Gowindan R (2007). Lung cancer in never smokers: a review. J Clin Oncol, 25, 561-70. https://doi.org/10.1200/JCO.2006.06.8015
  95. Szlosarek P, Charles KA, Balkwill FR (2006). Tumour necrosis factor-alpha as a tumour promoter. Eur J Cancer, 42, 745-50. https://doi.org/10.1016/j.ejca.2006.01.012
  96. Tardon A, Lee WJ, Delgado-Rodriguez M, et al (2005). Leisuretime physical activity and lung cancer: a meta-analysis. Cancer Causes Control, 16, 389-97. https://doi.org/10.1007/s10552-004-5026-9
  97. Thompson HJ, Jiang W, Zhu Z (2009). Candidate mechanisms accounting for effects of physical activity on breast carcinogenesis. IUBMB Life, 61, 895-901. https://doi.org/10.1002/iub.233
  98. Toyokuni S, Okamoto K, Yodoi J, Hiai H (1995). Persistent oxidative stress in cancer. FEBS Letters, 358, 1-3. https://doi.org/10.1016/0014-5793(94)01368-B
  99. Tworoger SS, Missmer SA, Eliassen AH, et al (2007a). Physical activity and inactivity in relation to sex hormone, prolactin, and insulin-like growth factor concentrations in premenopausal women-exercise and premenopausal hormones. Cancer Causes Control, 18, 743-52. https://doi.org/10.1007/s10552-007-9017-5
  100. Tworoger SS, Sorensen B, Chubak J et al (2007b). Effect of a 12-month randomized clinical trial of exercise on serum prolactin concentrations in postmenopausal women. Cancer Epidemiol Biomarkers Prev, 16, 895-9. https://doi.org/10.1158/1055-9965.EPI-06-0701
  101. Verna AM, Montgomery K (2009). Energy balance, physical activity, and breast cancer. In: Verna M (ed) Methods of Molecular Biology, Cancer Epidemiology, 472, 57-88.
  102. Voskuil DW, Monninkhof EM, Elias SG, Vlems FA, van Leeuwen FE (2007). Physical activity and endometrial cancer risk, a systematic review of current evidence. Cancer Epidemiol Biomarkers Prev, 16, 639-48. https://doi.org/10.1158/1055-9965.EPI-06-0742
  103. Warburton DE, Katzmarzyk PT, Rhodes RE, Shephard RJ (2007). Evidence - informed physical activity guidelines for Canadian adults. Appl Physiol Nutr Metab, 32, 16-68. https://doi.org/10.1139/H07-123
  104. Warburton DE, Nicol C, Bredin SS (2006). Health benefits of physical activity: the evidence, Can Med Assoc J, 174, 801-9. https://doi.org/10.1503/cmaj.051351
  105. Warburton DER, Charlesworth S, Ivey A, Nettlefold L, Bredin SSD (2010). A systematic review of the evidence for Canada's Physical Activity Guidelines. Int J Behav Nutr Phys Activity, 7, 39. https://doi.org/10.1186/1479-5868-7-39
  106. Wetmore CM, Ulrich CM (2006). Mechanisms associating physical activity with cancer incidence. Exercise and immune function. In: McTiernan A (ed) Cancer Prevention and Management Through Exercise and Weight Control. CRC Press Taylor & Francis, Boca Raton, FL.
  107. WHO (2010). Global Recommendations on Physical Activity for Health. Geneva. http://www.who.int/dietphysicalactivity/factsheet_recommendations/en/index.html.
  108. Wolin KY, Yan Y, Colditz GA, Lee IM (2009). Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer, 100, 611-6. https://doi.org/10.1038/sj.bjc.6604917
  109. World Cancer Research Fund and the American Institute for Cancer Research (2007). Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. The Panel's judgements Washington, DC: AICR, 1-506.
  110. World Health Organization (2002). The World Health Report 2002, Reducing risks, promoting healthy life, WHO, Geneva.
  111. World Health Organization (2008). 2008-2013 action plan for global strategy for the prevention and control of noncommunicable diseases, WHO, Geneva.
  112. Zhang M, Xie X, Lee AH, Binns CW (2004). Sedentary behaviours and epithelial ovarian cancer risk. Cancer Causes Control, 15, 83-9. https://doi.org/10.1023/B:CACO.0000016633.47025.2a

Cited by

  1. Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group? vol.15, pp.1, 2014, https://doi.org/10.7314/APJCP.2014.15.1.195
  2. Clinical, Laboratory Biomarkers and Imaging Findings of Pancreatic Adenocarcinoma in Iran vol.15, pp.10, 2014, https://doi.org/10.7314/APJCP.2014.15.10.4349
  3. Health and Economic Costs of Physical Inactivity vol.15, pp.18, 2014, https://doi.org/10.7314/APJCP.2014.15.18.7499
  4. Exercise Barriers in Korean Colorectal Cancer Patients vol.15, pp.18, 2014, https://doi.org/10.7314/APJCP.2014.15.18.7539
  5. The Kuala Lumpur Qigong Trial for Women in the Cancer Survivorship Phase-Efficacy of a Three-Arm RCT to Improve QOL vol.15, pp.19, 2014, https://doi.org/10.7314/APJCP.2014.15.19.8127
  6. Physical Activity and Cancer Prevention: Awareness and Meeting the Recommendations among Adult Saudis vol.15, pp.6, 2014, https://doi.org/10.7314/APJCP.2014.15.6.2597
  7. Insulin Resistance Reduces Sensitivity to Cis-Platinum and Promotes Adhesion, Migration and Invasion in HepG2 Cells vol.15, pp.7, 2014, https://doi.org/10.7314/APJCP.2014.15.7.3123
  8. Nonoccupational physical activity and risk of ovarian cancer: a meta-analysis vol.35, pp.11, 2014, https://doi.org/10.1007/s13277-014-2385-z
  9. Chemoprevention of Prostate Cancer vol.65, pp.1, 2014, https://doi.org/10.1146/annurev-med-121211-091759
  10. Integrative Therapies in Cancer vol.14, pp.2, 2015, https://doi.org/10.1177/1534735414567473
  11. Intensity-specific effect of physical activity on urinary levels of 8-hydroxydeoxyguanosine in middle-aged Japanese vol.107, pp.11, 2016, https://doi.org/10.1111/cas.13070
  12. The Role of Physical Activity in Harm Reduction among Betel Quid Chewers from a Prospective Cohort of 419,378 Individuals vol.11, pp.4, 2016, https://doi.org/10.1371/journal.pone.0152246
  13. Exercise Activates p53 and Negatively Regulates IGF-1 Pathway in Epidermis within a Skin Cancer Model vol.11, pp.8, 2016, https://doi.org/10.1371/journal.pone.0160939
  14. Hair dye use, regular exercise, and the risk and prognosis of prostate cancer: multicenter case–control and case-only studies vol.16, pp.1, 2016, https://doi.org/10.1186/s12885-016-2280-7
  15. Impact of Physical Inactivity on Risk of Developing Cancer of the Uterine Cervix vol.20, pp.3, 2016, https://doi.org/10.1097/LGT.0000000000000210
  16. Physical Activity and Risk of Lung Cancer vol.26, pp.3, 2016, https://doi.org/10.1097/JSM.0000000000000219
  17. Physical Activity and Gastric Cancer Risk vol.26, pp.6, 2016, https://doi.org/10.1097/JSM.0000000000000316
  18. Proportion of cancer in a Middle eastern country attributable to established risk factors vol.17, pp.1, 2017, https://doi.org/10.1186/s12885-017-3304-7
  19. Regular recreational physical activity and risk of head and neck cancer vol.17, pp.1, 2017, https://doi.org/10.1186/s12885-017-3223-7
  20. Dietary alkylresorcinols and cancer prevention: a systematic review vol.243, pp.10, 2017, https://doi.org/10.1007/s00217-017-2890-6
  21. The association of lifetime physical inactivity with head and neck cancer: a hospital-based case–control analysis vol.274, pp.10, 2017, https://doi.org/10.1007/s00405-017-4688-3
  22. Polymorphisms in RETN gene and susceptibility to colon cancer in Saudi patients vol.34, pp.4, 2014, https://doi.org/10.5144/0256-4947.2014.334
  23. Inhibition of Human Lung Cancer Cell Proliferation and Survival by Post-Exercise Serum Is Associated with the Inhibition of Akt, mTOR, p70 S6K, and Erk1/2 vol.9, pp.5, 2017, https://doi.org/10.3390/cancers9050046
  24. Microbiota, Inflammation and Colorectal Cancer vol.18, pp.6, 2017, https://doi.org/10.3390/ijms18061310
  25. Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms vol.97, pp.4, 2017, https://doi.org/10.1152/physrev.00019.2016
  26. Glucose impairments and insulin resistance in prostate cancer: the role of obesity, nutrition and exercise vol.19, pp.7, 2018, https://doi.org/10.1111/obr.12674