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J Clin Oncol. 2019 Dec 26:JCO1902407. doi: 10.1200/JCO.19.02407. [Epub ahead of print]

Amount and Intensity of Leisure-Time Physical Activity and Lower Cancer Risk.

Author information

National Cancer Institute, Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, Bethesda, MD.
George Washington University, School of Public Health, Department of Epidemiology, Washington, DC.
Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden.
Uppsala University, Department of Surgical Sciences, Uppsala, Sweden.
American Cancer Society, Behavioral and Epidemiology Research, Atlanta, GA.
Cancer Council Victoria, Cancer Epidemiology Division, and University of Melbourne, School of Population and Global Health, Centre for Epidemiology and Biostatistics, Melbourne, Victoria, Australia.
Baker Heart and Diabetes Institute, Physical Activity Laboratory, Melbourne, Victoria, Australia.
Monash University, School of Clinical Sciences at Monash Health, Precision Medicine, Melbourne, Victoria, Australia.
National Cancer Institute, Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, Bethesda, MD.
National Institute on Aging, Laboratory of Epidemiology and Population Sciences, Baltimore, MD.
Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and Seaver Autism Center for Research and Treatment at Mount Sinai, New York, NY.
Brigham and Women's Hospital and Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA.



To determine whether recommended amounts of leisure-time physical activity (ie, 7.5-15 metabolic equivalent task [MET] hours/week) are associated with lower cancer risk, describe the shape of the dose-response relationship, and explore associations with moderate- and vigorous-intensity physical activity.


Data from 9 prospective cohorts with self-reported leisure-time physical activity and follow-up for cancer incidence were pooled. Multivariable Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% CIs of the relationships between physical activity with incidence of 15 types of cancer. Dose-response relationships were modeled with restricted cubic spline functions that compared 7.5, 15.0, 22.5, and 30.0 MET hours/week to no leisure-time physical activity, and statistically significant associations were determined using tests for trend (P < .05) and 95% CIs (< 1.0).


A total of 755,459 participants (median age, 62 years [range, 32-91 years]; 53% female) were followed for 10.1 years, and 50,620 incident cancers accrued. Engagement in recommended amounts of activity (7.5-15 MET hours/week) was associated with a statistically significant lower risk of 7 of the 15 cancer types studied, including colon (8%-14% lower risk in men), breast (6%-10% lower risk), endometrial (10%-18% lower risk), kidney (11%-17% lower risk), myeloma (14%-19% lower risk), liver (18%-27% lower risk), and non-Hodgkin lymphoma (11%-18% lower risk in women). The dose response was linear in shape for half of the associations and nonlinear for the others. Results for moderate- and vigorous-intensity leisure-time physical activity were mixed. Adjustment for body mass index eliminated the association with endometrial cancer but had limited effect on other cancer types.


Health care providers, fitness professionals, and public health practitioners should encourage adults to adopt and maintain physical activity at recommended levels to lower risks of multiple cancers.


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