Physical activity and cancer: an umbrella review of the literature including 22 major anatomical sites and 770 000 cancer cases
File(s)Manuscript_PA_Cancer_umbrella_v6_BJSM-2.docx (146.65 KB)
Accepted version
Author(s)
Rezende, Leandro Fórnias Machado de
Sá, Thiago Hérick de
Markozannes, Georgios
Rey-López, Juan Pablo
Lee, I-Min
Type
Journal Article
Abstract
OBJECTIVE: To provide an overview of the breadth and validity of claimed associations between physical activity and risk of developing or dying from cancer. DESIGN: Umbrella review. DATA SOURCES: We searched Medline, Embase, Cochrane Database and Web of Science. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews about physical activity and cancer incidence and cancer mortality in different body sites among general population. RESULTS: We included 19 reviews covering 22 cancer sites, 26 exposure-outcome pairs meta-analyses and 541 original studies. Physical activity was associated with lower risk of seven cancer sites (colon, breast, endometrial, lung, oesophageal, pancreas and meningioma). Only colon (a protective association with recreational physical activity) and breast cancer (a protective association with overall physical activity) were supported by strong evidence and highly suggestive evidence, respectively. Evidence from endometrial, lung, oesophageal, pancreas and meningioma presented hints of uncertainty and bias in the literature (eg,not reaching P values<10-6) showing large between-study heterogeneity and/or not demonstrating a definite direction for the effect when 95% prediction intervals were considered. Four of the 26 meta-analyses showed small study effects and 4 showed excess significance. CONCLUSION: Physical activity is associated with a lower risk of several cancers, but only colon and breast cancer associations were supported by strong or highly suggestive evidence, respectively. Evidence from other cancer sites was less consistent, presenting hints of uncertainty and/or bias.
Date Issued
2018-07-01
Date Acceptance
2017-10-31
Citation
British Journal of Sports Medicine, 2018, 52 (13), pp.826-833
ISSN
1473-0480
Publisher
BMJ Publishing Group
Start Page
826
End Page
833
Journal / Book Title
British Journal of Sports Medicine
Volume
52
Issue
13
Copyright Statement
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29146752
PII: bjsports-2017-098391
Subjects
cancer
epidemiology
meta-analysis
oncology
physical activity
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2017-11-16