Table 15.
Studies examining the relationship between physical activity and colon cancer.
| Publication Country Study Design Quality Score | Objective | Population | Methods | Outcome | Comments and Conclusions |
|---|---|---|---|---|---|
| Hou et al 2004 [272] | To examine the effect of various forms of PA on colon cancer risk, with particular attention to commuting PA. | • n = 931 case, 1,552 control | PA assessment: Interview for the following variables | • Number of cases: 931 | Regular frequent PA over a long period of time reduces risk of CC. |
| China | • Sex: Men and women | Multivariate OR (95% CI) by OPA, men | |||
| • G1 = 1.00 (referent) | |||||
| Case control | • Age: 30-74 yr | OPA (kJ/min) | • G2 = 1.23 (0.93-1.64) | ||
| D & B score = 14 | • Characteristics: Case: diagnosed with CC. controls: selected randomly from residents of urban Shanghai. | G1 = <8 | • G3 = 0.81 (0.59-1.19) | ||
| G2 = 8-12 | p = 0.10 | ||||
| G3 = >12 | |||||
| Commuting PA (MET hr/wk) | Multivariate OR (95% CI) by OPA, women | ||||
| G1 = <48.3 | • G1 = 1.00 (referent) | ||||
| G2 = 48.3-94.3 | • G2 = 0.96 (0.69-1.16) | ||||
| G3 = >94.3 | • G3 = 0.64 (0.39-1.02) | ||||
| p = 0.009 | |||||
| LTPA (MET hr/wk) | Multivariate OR (95% CI) Commuting PA, men | ||||
| G1 = < 9.2 | • G1 = 1.00 (referent) | ||||
| G2 = 9.2-13.6 | • G2 = 1.11 (0.31-1.23) | ||||
| G3 = >13.6 | • G3 = 0.52 (0.27-0.87) | ||||
| Outcome Measure: incident CC | p<0.001 | ||||
| Multiple logistic regression | Multivariate OR (95% CI) Commuting PA, women | ||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.87 (0.42-1.52) | |||||
| • G3 = 0.56 (0.21-0.91) | |||||
| p = 0.007 | |||||
| Multivariate OR (95% CI) LTPA, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.17 (0.13-1.95) | |||||
| • G3 = 0.72 (0.41-1.07) | |||||
| p = 0.06 | |||||
| Multivariate OR (95% CI) LTPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.03 (0.41-1.59) | |||||
| • G3 = 0.84 (0.13-2.25) | |||||
| p = 0.15 | |||||
| Boutron-Ruault et al 2001 [273] | To determine which step of the adenoma-carcinoma pathway was influenced by OPA and recreational PA. | • n = 480 | PA assessment: Questionnaire and classified into 3 groups | Number of cases: 171 | A sedentary lifestyle was associated with a high risk of CC. |
| France | • Sex: Men and women | G1 = Low | Age and gender adjusted OR (95% CI), OPA | ||
| Case control | • Age: 30-79 years | G2 = Medium | • G1 = 1.00 (referent) | ||
| D & B score = 13 | • Characteristics: Cases had 1stdiagnosis of colorectal adenoma, controls were polyp free. | G3 = High | • G2 = 1.3 (0.8-2.0) | ||
| • G3 = 0.5 (0.3-0.9) | |||||
| p = 0.005 | |||||
| Outcome Measure: Incident CC | |||||
| Multiple logistic regression | Age and gender adjusted OR (95% CI), LTPA | ||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.7 (0.4-1.1) | |||||
| • G3 = 0.3 (0.2-0.5) | |||||
| p = <0.0001 | |||||
| Age and gender adjusted OR (95% CI), Global PA | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.8 (0.5-1.2) | |||||
| • G3 = 0.3 (0.2-0.6) | |||||
| p = 0.0003 | |||||
| Brownson et al 1991 [274] | To investigate the risks of 16 cancer types in relation to OPA. | • n = 17,147 | PA assessment: Medical records and classified into 3 groups: | Number of cases: 1,838 | OPA is inversely related to risk of CC. |
| • Sex: Men | Multivariate OR (95% CI) | ||||
| USA | • Age: ≥ 20 yr | OPA | G1 = 1.00 (referent) | ||
| • Characteristics: White, working | G1 = Low - Activity required <20% of time | G2 = 1.2 (1.0-1.5) | |||
| Case controll | G2 = Moderate - Activity required 20-80% of time | G3 = 1.1 (1.0-1.3) | |||
| D & B score = 15 | G3 = High - Activity required >80% of time | p = 0.05 | |||
| Outcome Measure: CC | |||||
| Maximum likelihood estimates | |||||
| Calton et al 2006 [275] | To examine the relationship between PA and colon cancer risk in women. | • n = 31,783 | 11 year follow up | Number of cases: 243 | Results do not support the hypothesis that PA is related to a lower incidence of CC in women. |
| USA | • Sex: Women | PA Assessment: Questionnaire / Phone interviews for the following variables, divided into 4 or 5 groups | |||
| Prospective cohort | • Age: 61.1 yr | Multivariate RR (95% CI), TPA | |||
| D & B score = 12 | • Characteristics: Free from cancer at baseline | • G1 = 1.00 (referent) | |||
| • G2 = 1.45 (0.98-2.15) | |||||
| • G3 = 1.16 (0.77-1.75) | |||||
| • G4 = 1.27 (0.84-1.91) | |||||
| • G5 = 1.15 (0.76-1.75) | |||||
| p = 0.77 | |||||
| TPA (MET h/d) | |||||
| G1 = 34.0-48.5 | Multivariate RR (95% CI), MPA | ||||
| G2 = 48.51-54.3 | • G1 = 1.00 (referent) | ||||
| G3 = 54.31-59.0 | • G2 = 1.23 (0.82-1.83) | ||||
| G4 = 59.1-64.9 | • G3 = 1.47 (0.99-2.21) | ||||
| G5 = 65.0-98.1 | • G4 = 0.94 (0.61-1.46) | ||||
| • G5 = 1.07 (0.70-1.62) | |||||
| MPA (h/d) | p = 0.80 | ||||
| G1 = 0-3.0 | |||||
| G2 = 3.01-5.0 | |||||
| G3 = 5.01-6.70 | Multivariate RR (95% CI), VPA | ||||
| G4 = 6.71-8.14 | • Q1 = 1.00 (referent) | ||||
| G5 = 8.15-18.0 | • Q2 = 1.19 (0.85-1.66) | ||||
| • Q3 = 0.87 (0.59-1.29) | |||||
| VPA (h/d) | • Q4 = 1.10 (0.78-1.55) | ||||
| Q1 = 0 | p = 0.80 | ||||
| Q2 = 0.1-1.0 | |||||
| Q3 = 1.1-2.0 | |||||
| Q4 = 2.1-14.0 | |||||
| Outcome Measure: Incidence of CC | |||||
| Cox proportional HR | |||||
| Chao et al 2004 [276] | To examine how the characteristics of recreational PA affect its association with colon cancer incidence among older. | • n = 151,174 (70,403 men; 80,771 women) | 7 year follow up | Number of cases: 940 | Increased amounts of time spent in recreational PA is associated with substantially lower risk of CC. |
| USA | • Sex: Men and women | PA assessment: Questionnaire for the following variables | Multivariate RR (95% CI) by recreational PA, men | ||
| Prospective cohort | • Age: mean 63 yr | • G1 = 1.00 (referent) | |||
| D & B score = 12 | • Cancer prevention study II Nutrition Cohort | • G2 = 0.91 (0.69-1.19) | |||
| Recreational PA (h/wk) | • G3 = 0.72 (0.52-1.01) | ||||
| G1 = None | • G4 = 0.86 (0.64-1.15) | ||||
| G2 = <2 | • G5 = 0.77 (0.54-1.08) | ||||
| G3 = 2-3 | • G6 = 0.58 (0.39- 0.87) | ||||
| G4 = 4-6 | p = 0.007 | ||||
| G5 = 7 | |||||
| G6 = ≥ 8 | Multivariate RR (95% CI) by recreational PA, women | ||||
| Recreational (MET h/wk) | • G1 = 1.00 (referent) | ||||
| G1 = None | • G2 = 1.01 (0.70-1.44) | ||||
| G2 = <7, 7-13 | • G3 = 1.01 (0.68-1.49) | ||||
| G3 = 14-23 | • G4 = 0.97 (0.66-1.43) | ||||
| G4 = 24-29 | • G5 = 1.03 (0.65-1.65) | ||||
| G5 = ≥ 30 | • G6 = 0.65 (0.39-1.11) | ||||
| p = 0.14 | |||||
| Walking (h/wk) | |||||
| Q1 = None | |||||
| Q2 = <4 | Multivariate RR (95% CI) by recreational PA, men and women | ||||
| Q3 = 4-6 | • G1 = 1.00 (referent) | ||||
| Q4 = ≥ 7 | • G2 = 0.94 (0.75-1.16) | ||||
| • G3 = 0.83 (0.65-1.07) | |||||
| Walking plus other | • G4 = 0.89 (0.71-1.12) | ||||
| activities (h/wk) | • G5 = 0.85 (0.64-1.12) | ||||
| Q1 = None | • G6 = 0.60 (0.44-0.83) | ||||
| Q2 = <4 | p = 0.002 | ||||
| Q3 = 4-6 | |||||
| Q4 = ≥ 7 | Multivariate RR (95% CI) by MET h/wk men | ||||
| Outcome Measure: Incidence of CC | • G1 = 1.00 (referent) | ||||
| • G2 = 0.90 (0.68-1.18) | |||||
| Cox proportional HR | • G3 = 0.83 (0.59-1.16) | ||||
| • G4 = 0.75 (0.55-1.01) | |||||
| • G5 = 0.86 (0.63-1.19) | |||||
| • G6 = 0.60 (0.41-0.87) | |||||
| p = 0.005 | |||||
| Multivariate RR (95% CI) by MET h/wk women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.02 (0.71-1.46) | |||||
| • G3 = 0.98 (0.65-1.47) | |||||
| • G4 = 1.0 (0.68-1.47) | |||||
| • G5 = 0.94 (0.60-1.48) | |||||
| • G6 = 0.77 (0.48-1.24) | |||||
| p = 0.15 | |||||
| Multivariate RR (95% CI) by MET h/wk men and women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.93 (0.75-1.16) | |||||
| • G3 = 0.88 (0.68-1.13) | |||||
| • G4 = 0.84 (0.66-1.06) | |||||
| • G5 = 0.89 (0.68-1.15) | |||||
| • G6 = 0.65 (0.49-0.87) | |||||
| p = 0.002 | |||||
| Multivariate RR (95% CI) by walking, Men | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.87 (0.66-1.15) | |||||
| • Q3 = 0.83 (0.60-1.16) | |||||
| • Q4 = 0.88 (0.61-1.25) | |||||
| p = 0.34 | |||||
| Multivariate RR (95% CI) by walking, women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.00 (0.70-1.44) | |||||
| • Q3 = 1.08 (0.71-1.63) | |||||
| • Q4 = 1.18 (0.71-1.95) | |||||
| p = 0.41 | |||||
| Multivariate RR (95% CI) by walking plus other activities, men | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.73 (0.53-1.02) | |||||
| • Q3 = 0.85 (0.58-1.24) | |||||
| • Q4 = 0.53 (0.36-0.78) | |||||
| p = 0.02 | |||||
| Multivariate RR (95% CI) by walking plus other activities, women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.99 (0.67-1.47) | |||||
| • Q3 = 0.72 (0.43-1.19) | |||||
| • Q4 = 0.59 (0.36-0.98) | |||||
| p = 0.07 | |||||
| Colbert et al 2001 [277] | To examine the association between OPA and LTPA and colon cancer in male smokers. | • n = 29,133 | 12 year follow-up | Number of cases: 152 | OPA is protective against CC in a dose-response manner. |
| USA | • Sex: Men | ||||
| Prospective cohort | • Age: 50-69 yr | PA assessment: Interview for OPA and LTPA | Multivariate RR (95% CI) by OPA | ||
| D & B score = 13 | • Characteristics: Smokers | • G1 = 0.61 (0.39-0.98) | |||
| • Alpha- Tocopherol, Beta-Carotene Cancer Prevention Study | • G2 = 1.00 (referent) | ||||
| • G3 = 0.60 (0.34-1.04) | |||||
| OPA | • G4 = 0.45 (0.26-0.78) | ||||
| G1 = Non-worker | p = 0.003 | ||||
| G2 = Sedentary | |||||
| G3 = Light | Multivariate RR (95% CI), by LTPA | ||||
| G4 = Moderate | • G1 = 1.00 (referent) | ||||
| • G2 = 0.82 (0.59-1.13) | |||||
| LTPA | |||||
| G1 = Sedentary | |||||
| G2 = Active | |||||
| Outcome Measure: incident CC | |||||
| Cox proportional HR | |||||
| Dosemeci et al 1993 [278] | To examine associations between PA and cancer sites among workers in Turkey. | • n = 6,236 (3,486 cases in men and 379 cases in women; 2,127 control men and 244 control women) | PA assessment: Stanford Occupational Classification code system. | Number of cases: 93 | Occupational EE is inversely related to risk of CC. |
| Turkey | • 93 cases for CC | Multivariate OR (95% CI) by total occupational EE | |||
| Case control | • Sex: Men and women | • G1 = 1.6 (0.9-2.8) | |||
| • Age: not indicated | Total Occupational EE (kj/min) | • G2 = 1.1 (0.6-2.0) | |||
| D & B score = 13 | • Characteristics: All hospitalized Cases: Diagnosed with CC. Controls: included subjects diagnosed as non-cancers and cancers which there is no suggestion of an association with PA. | G1 = <8 | • G3 = 1.0 (referent) | ||
| G2 = 8-12 | p = 0.04 | ||||
| G3 = >12 | When adjusted for socioeconomic status p = 0.03 | ||||
| Sitting time at work (h/d) Levels: | Multivariate OR (95% CI) by sitting time at work | ||||
| G1 = <2 | • G1 = 1.00 (referent) | ||||
| G2 = 2-6 | • G2 = 1.5 (0.9-2.5) | ||||
| G3 = >6 | • G3 = 1.5 (0.8-3.0) | ||||
| p = 0.03 | |||||
| Outcome Measure: Incident CC | When adjusted for socioeconomic status p = 0.03 | ||||
| Maximum likelihood estimates | |||||
| Friedenreich et al 2006 [279] | To investigate the role of PA in the development of colon cancer. | • n = 413,044 | 4 year follow-up | Multivariate RR (95% CI), TPA | Inverse association between PA and risk of CC, particularly for right sided tumours. |
| • Sex: Men and women | PA assessment: modified Baecke Questionnaire | • Q1 = 1.00 (referent) | |||
| UK | • Age: 35-70 yr | • Q2 = 0.92 (0.76-1.12) | |||
| • Characteristics: Free of cancer at baseline | • Q3 = 0.86 (0.70-1.04) | ||||
| Prospective cohort | • European Prospective Investigation into Nutrition and Cancer. (EPIC) | TPA | • Q4 = 0.78 (0.59-1.03) | ||
| Q1 = Inactive | p = 0.04 | ||||
| D & B score = 14 | Q2 = Moderately inactive | Multivariate RR (95% CI), TPA and right sided CC | |||
| Q3 = Moderately active | • Q1 = 1.00 (referent) | ||||
| Q4 = Active | • Q2 = 1.79 (0.59-1.06) | ||||
| Household PA (MET-h/wk) | • Q3 = 0.64 (0.47-0.86) | ||||
| Q1 = <19.5 | • Q4 = 0.65 (0.43-1.00) | ||||
| Q2 = 19.5-39.6 | p = 0.004 | ||||
| Q3 = 39.6-73.9 | |||||
| Q4 = ≥ 73.9 | Multivariate RR (95% CI), household PA and right sided CC | ||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.97 (0.75-1.27) | |||||
| Outcome Measure: Incident CC | • Q3 = 0.84 (0.64-1.12) | ||||
| • Q4 = 0.74 (0.54-1.02) | |||||
| p = 0.05 | |||||
| Cox proportional HR | |||||
| Giovannucci et al 1995 [280] | To examine the association between PA and colon cancer. | • n = 47,723 | 6 year follow-up | Multivariate RR (95% CI) | A moderate level of PA was related to a substantially lower risk of CC in this cohort of middle age to elderly men. |
| • Sex: Men | • G1 = 1.00 (referent) | ||||
| • Age: 40-75 yr | PA assessment: Questionnaire | • G2 = 0.73 (0.48-1.10) | |||
| USA | • Characteristics: Health professionals | • G3 = 0.94 (0.63-1.39) | |||
| • G4 = 0.78 (0.51-1.20) | |||||
| Prospective cohort | • Health Professionals Follow-up Study | Outcome Measure: Incidence of colon cancer | • G5 = 0.53 (0.32-0.88) | ||
| p = 0.03 | |||||
| D & B score = 12 | |||||
| Mantel-Haeszel estimator and logistic regression | |||||
| Isomura et al 2006 [281] | To examine the relationship of OPA, LTPA, commuting, housework and shopping with colorectal cancer risk. | • n = 1545 (778 cases, 767 controls) | PA assessment: Questionnaire and interview for the following variables | • Number of cases: 778 | Adds to the evidence that PA confers decreased risk of CC, especially of distal CC in both men and women. |
| Japan | • Sex: Men and women | Multivariate OR (95% CI) for all CC by OPA, men | |||
| • G1 = 1.00 (referent) | |||||
| Case control | • Age: 20-74 yr | OPA, men | • G2 = 0.9 (0.6-1.4) | ||
| • Characteristics: Free from cancer at baseline | G1 = Sedentary | • G3 = 0.7 (0.4-1.0) | |||
| D & B score = 12 | G2 = Moderate | p = 0.06 | |||
| . | G3 = Hard | ||||
| • Fukuoka colorectal cancer study | Multivariate OR (95% CI) for proximal | ||||
| OPA, women | CC by OPA, men | ||||
| G1 = Sedentary | • G1 = 1.00 (referent) | ||||
| G2 = Active | • G2 = 1.2 (0.6-2.2) | ||||
| • G3 = 0.7 (0.4-1.4) | |||||
| Total non-OPA, men (MET-h/wk) | p = 0.45 | ||||
| G1 = 0.0 | Multivariate OR (95% CI) for distal CC by OPA, men | ||||
| G2 = 0.1-15.9 | • G1 = 1.00 (referent) | ||||
| G3 = 16.0 | • G2 = 0.8 (0.4-1.4) | ||||
| • G3 = 0.6 (0.4-1.0) | |||||
| p = 0.047 | |||||
| Total non-OPA women (MET hr/wk) | |||||
| G1 = 0.0 | |||||
| G2 = 0.1-15.9 | |||||
| G3 = 16.0 | Multivariate OR (95% CI) for all CC by non-OPA, men | ||||
| Moderate or hard non-OPA, men (MET hr/wk) | • G1 = 1.00 (referent) | ||||
| G1 = 0.0 | • G2 = 0.9 (0.6-1.4) | ||||
| G2 = 0.1-14.9 | • G3 = 0.8 (0.5-1.2) | ||||
| G3 = ≥15.0 | p = 0.22 | ||||
| Multivariate OR (95% CI) for proximal CC by non-OPA, men | |||||
| Moderate or hard non-OPA, women (MET hr/wk) | • G1 = 1.00 (referent) | ||||
| G1 = 0.0 | • G2 = 1.2 (0.6-2.1) | ||||
| G2 = 0.1-14.9 | • G3 = 0.9 (0.5-1.7) | ||||
| G3 = 15.0 | p = 0.69 | ||||
| Outcome Measure: Incident CC | Multivariate OR (95% CI) for distal CC by non-OPA, men | ||||
| • G1 = 1.00 (referent) | |||||
| Multiple logistic regression analysis | • G2 = 0.8 (0.5-1.3) | ||||
| • G3 = 0.7 (0.4-1.1) | |||||
| p = 0.19 | |||||
| Multivariate OR (95% CI) for all CC by non-OPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.9 (0.5-1.5) | |||||
| • G3 = 0.8 (0.5-1.4) | |||||
| p = 0.45 | |||||
| Multivariate OR (95% CI) for proximal CC by non-OPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.5 (0.7-3.3) | |||||
| • G3 = 1.6 (0.7-3.6) | |||||
| p = 0.41 | |||||
| Multivariate OR (95% CI) for distal CC by non-OPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.7 (0.4-1.3) | |||||
| • G3 = 0.6 (0.3-1.1) | |||||
| p = 0.12 | |||||
| Multivariate OR (95% CI) for all CC by moderate or hard non-OPA, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.8 (0.6-1.2) | |||||
| • G3 = 0.8 (0.5-1.1) | |||||
| p = 0.24 | |||||
| Multivariate OR (95% CI) for proximal CC by moderate or hard non-OPA, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.1 (0.6-2.1) | |||||
| • G3 = 1.0 (0.6-1.8) | |||||
| p = 0.99 | |||||
| Multivariate OR (95% CI) for distal CC by moderate or hard non-OPA, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.7 (0.4-1.1) | |||||
| • G3 = 0.7 (0.4-1.0) | |||||
| p = 0.12 | |||||
| Multivariate OR (95% CI) for all CC by moderate or hard non-OPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.0 (0.6-1.6), | |||||
| • G3 = 0.8 (0.5-1.4) | |||||
| p = 0.35 | |||||
| Multivariate OR (95% CI) for proximal CC by moderate or hard non-OPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.3 (0.6-2.5) | |||||
| • G3 = 1.3 (0.6-2.7) | |||||
| p = 0.59 | |||||
| Multivariate OR (95% CI) for distal CC by moderate or hard non-OPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.8 (0.5-1.5) | |||||
| • G3 = 0.5 (0.3-1.1) | |||||
| p = 0.41 | |||||
| Johnsen at el 2006 [282] | To investigate the effects of OPA on colon cancer incidence. | • n = 54,478 (28,356 men, 26,122 women) | 7.6 year follow-up | • Number of cases: 140 women, 157 men | No support for the hypothesis that OPA measured by MET-score may be associated with a lower risk of CC. |
| • Sex: Men and women | PA assessment: Questionnaire for OPA by MET score, 4 groups | • Number of dropouts: <0.8% | |||
| Denmark | • Age: 50-64 yr | Multivariate RR (95% CI), men | |||
| Prospective cohort | • Characteristics: Free of Cancer at baseline | Q1 = Sitting | • Q1 = 1.00 (referent) | ||
| • Diet, Cancer and Health Study | Q2 = Standing | • Q2 = 1.11 (0.69-1.77) | |||
| Q3 = Manual | • Q3 = 1.17 (0.77-1.79) | ||||
| D & B score = 13 | Q4 = Not working | • Q4 = 0.95 (0.58-1.55) | |||
| Outcome Measure: Incidence of colon cancer | Multivariate RR (95% CI), women | ||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.15 (0.68-1.93) | |||||
| • Q3 = 1.34 (0.83-2.16) | |||||
| Cox proportional HR | • Q4 = 0.96 (0.60-1.53) | ||||
| Larsen et al 2006 [283] | To examine the relationship between PA and colorectal cancer. | • n = 6,961 | PA assessment: Questionnaire (scored from 2-12), divided into quartiles: | Number of cases: 108 | Inactivity was not a significant risk factor for advanced colonic neoplasia. |
| • Sex: Men and women | RR (95% CI) | ||||
| Norway | • Age: 50-64 | • Q1 = 1.00 (referent) | |||
| • Characteristics: No history of colorectal surgery, radiotherapy, cardiopulmonary disease, anticoagulant therapy, coronary episode. | Q1 = 2-4 | • Q2 = 0.61 (0.32-1.16) | |||
| Cross-sectional evaluation within a randomized controlled trial | Q2 = 5 | • Q3 = 0.75 (0.45-1.26) | |||
| Q3 = 6 | • Q4 = 0.56 (0.34-0.92) | ||||
| Q4 = 7-12 | p = 0.04 | ||||
| Outcome Measure: Positive test for colonic neoplasia | Multivariate RR (95% CI) | ||||
| D & B score = 13 | • Q1 = 1.00 (referent) | ||||
| • Q2 = 0.64 (0.33-1.25) | |||||
| • Q3 = 0.82 (0.47-1.43) | |||||
| Multivariate logistic regression analysis | • Q4 = 0.67 (0.39-1.16) | ||||
| p = 0.23 | |||||
| Larsson et al 2006 [284] | To investigate the association between PA and colorectal cancer. | • n = 45,906 | 7.1 year follow-up | Number of cases: 309 (133 proximal, 138 distal) | Results support a role of PA in reducing the risk of CC. |
| • Sex: Men | |||||
| • Age: 45-79 yr | PA assessment: Questionnaire for the following variables | ||||
| Sweden | • Characteristics: Free of cancer at baseline | Multivariate HR (95% CI) by LTPA | |||
| • Q1 = 1.00 (referent) | |||||
| Prospective cohort | • Q2 = 0.66 (0.43-1.02) | ||||
| LTPA (min/day) | • Q3 = 0.68 (0.46-1.01) | ||||
| Q1 = <10 | • Q4 = 0.56 (0.37-0.83) | ||||
| D & B score = 14 | Q2 = 10-29 | p = 0.01 | |||
| Q3 = 30-59 | |||||
| Q4 = ≥ 60 | Multivariate HR (95% CI) by home/housework PA | ||||
| Home/housework PA (h/day) | • Q1 = 1.00 (referent) | ||||
| • Q2 = 0.75 (0.58-0.97) | |||||
| Q1 = none | • Q3 = 0.75 (0.58-0.97) | ||||
| Q2 = <1 | • Q4 = 0.68 (0.48-0.96) | ||||
| Q3 = 1-2 | p = 0.01 | ||||
| Q4 = ≥ 3 | |||||
| Incidence of Proximal CC(h/day) | Multivariate HR (95% CI) for distal CC by LTPA | ||||
| G1 = <1 | • Q1 = 1.00 (referent) | ||||
| G2 = 1-2 | |||||
| G3 = ≥ 3 | • Q2 = 0.51 (0.28-0.93) | ||||
| • Q3 = 0.50 (0.29-0.87) | |||||
| • Q4 = 0.40 (0.22-0.70) | |||||
| p = 0.01 | |||||
| Outcome Measure: Incident CC | |||||
| Multivariate HR (95% CI) for proximal CC by home/housework PA | |||||
| Cox proportional HR | • G1 = 1.00 (referent) | ||||
| • G2 = 0.78 (0.53-1.14) | |||||
| • G3 = 0.50 (0.29-0.89) | |||||
| p = 0.02 | |||||
| Lee and Paffenbarger 1994 [285] | To predict cancer risk using prospective assessments of PA. | • n = 17,607 | 26 year follow-up | • Number of cases: 280 | Found a trend, of borderline statistical significance toward decreasing CC risk with increasing PA. |
| • Sex: Men | • Number of dropouts: 14% | ||||
| • Age: 30-79 yr | PA assessment: Questionnaire for PA level (kcal/wk) | ||||
| USA | • Characteristics: Healthy at baseline | Multivariate RR (95% CI), Model A: PA in 1962/1966 and updated in 1977 | |||
| • Harvard College Alumni | • G1 = 1.00 (referent) | ||||
| Prospective cohort | G1 = <1000 | • G2 = 1.07 (0.81-1.42) | |||
| G2 = 1000-2499 | • G3 = 1.08 (0.81-1.46) | ||||
| G3 = ≥ 2500 | p = 0.58 | ||||
| D & B score = 13 | |||||
| Outcome Measure: Incidence of fatal and non fatal CC | Multivariate RR (95% CI), Model B: PA in both 1962/1966 and 1977 | ||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.75 (0.42-1.35) | |||||
| Cox proportional HR | • G3 = 0.94 (0.54-1.64) | ||||
| p = 0.76 | |||||
| Lee et al 1997 [286] | To investigate whether PA alters the risk of developing CC in men. | • n = 20,614 | 10.9 year follow-up | Number of cases: 217 | Data does not support the hypothesis that PA is related inversely to risk of developing CC. |
| • Sex: Men | |||||
| • Age: 40-84 yrs | PA assessment: Questionnaire for the following variables | Multivariate RR (95% CI), frequency of | |||
| USA | • Characteristics: Physicians, free of cancer at baseline | PA at baseline | |||
| • G1 = 1.00 (referent) | |||||
| Prospective cohort | • G2 = 1.1 (0.7-1.7) | ||||
| Frequency of PA at baseline (times/week) | • G3 = 1.2 (0.8-1.6) | ||||
| Physicians Health Study | • G4 = 1.1 (0.7-1.6) | ||||
| D & B score = 15 | G1 = <1 | p = 0.6 | |||
| G2 = 1 | |||||
| G3 = 2-4 | RR (95% CI), frequency of PA at baseline and 36 months | ||||
| G4 = 5+ | |||||
| • G1 = 1.00 (referent) | |||||
| Frequency of PA at baseline and 36 months | • G2 = 1.2 (0.5-2.7) | ||||
| G1 = 1/<1 | • G3 = 1.4 (0.9-2.3) | ||||
| G2 = <1/1+ | • G4 = 1.3 (0.9-2.0) | ||||
| G3 = 1+/< 1 | |||||
| G4 = 1+/1+ | |||||
| Outcome Measure: Incidence of fatal and non-fatal CC | |||||
| Cox proportional HR | |||||
| Lee et al 2007 [287] | To examine the association between PA and the risk of developing CRC in Japanese men and women. | • n = 65,022 | 6 year follow-up | Number of cases: 154 proximal CC, 166 distal CC | PA may prevent CC among Japanese men. |
| • Sex: Men and women | |||||
| Japan | • Age: 40-69 yr | Multivariate RR (95% CI) for CC men | |||
| • Characteristics | PA assessment: Questionnaire for PA level (median MET hr/d) | • Q1 = 1.00 (referent) | |||
| Prospective cohort | • Ethnicity: Japanese | Q1 = 28.25 | • Q2 = 0.87 (0.61-1.26) | ||
| Q2 = 33.25 | • Q3 = 0.62 (0.41-0.95) | ||||
| Q3 = 35.25 | • Q4 = 0.58 (0.39-0.87) | ||||
| D & B score = 13 | Q4 = 43.75 | p = 0.006 | |||
| Outcome Measure: Incidence of CC | Multivariate RR (95% CI) for proximal CC men | ||||
| Cox proportional HR | • Q1 = 1.00 (referent) | ||||
| • Q2 = 0.89 (0.52-1.51) | |||||
| • Q3 = 0.44 (0.22-0.86) | |||||
| • Q4 = 0.29 (0.14-0.60) | |||||
| p < 0.001 | |||||
| Multivariate RR (95% CI) for distal CC Men | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.92 (0.54-1.54) | |||||
| • Q3 = 0.75 (0.42-1.33) | |||||
| • Q4 = 0.89 (0.53-1.51) | |||||
| p = 0.685 | |||||
| PA level and incidence of CC women | |||||
| Total CC | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.03 (0.65-1.64) | |||||
| • Q3 = 0.91 (0.57-1.47) | |||||
| • Q4 = 0.89 (0.54-1.49) | |||||
| p = 0.610 | |||||
| Proximal CC women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.14 (0.61-2.12) | |||||
| • Q3 = 1.01 (0.53-1.89) | |||||
| • Q4 = 0.55 (0.24-1.26) | |||||
| p = 0.151 | |||||
| Distal CC women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.09 (0.52-2.29) | |||||
| • Q3 = 0.77 (0.34-1.74) | |||||
| • Q4 = 1.37 (0.66-2.85) | |||||
| p = 0.401 | |||||
| Longnecker et al 1995 [288] | To examine the relationship between OPA and vigorous LTPA and the risk of cancer of the right colon and rectum. | • n = 242 rectal cancer and 703 controls | PA assessment: Interview for vigorous LTPA and OPA (coded and self-reported), divided into groups: | Number of cases: 163 | The amount of time spent at vigorous LTPA was associated with a decreased risk of cancer of the right colon. |
| • Sex: Men | RR (95% CI) by vigorous LTPA | ||||
| USA | • Age: ≥ 31 yr | • G1 = 1.00 (referent) | |||
| • Characteristics: Case: Diagnosed with adenocarcinoma of the right colon or rectum. Controls: Both community and hospital. No history of large bowel cancer. | • G2 = 0.73 (0.23-2.29) | ||||
| Case control | • G3 = 0.47 (0.16-1.36) | ||||
| Vigorous LTPA (h/wk) | • G4 = 0.60 (0.35-1.00) | ||||
| D & B score = 14 | G1 = 0 | p = 0.03 | |||
| G2 = ≤ 0.5 | |||||
| G3 = 1 | Multivariate OR (95% CI) by vigorous | ||||
| G4 = >1 | LTPA | ||||
| • G1 = 1.00 (referent) | |||||
| Coded lifetime OPA | • G2 = 0.81 (0.26-2.54) | ||||
| G1 = Sedentary | • G3 = 0.36 (0.11-1.14) | ||||
| G2 = light work | • G4 = 0.57 (0.33-0.97) | ||||
| G3 = moderate | p = 0.06 | ||||
| G4 = heavy | |||||
| Self reported lifetime | Multivariate OR (95% CI) by coded lifetime OPA | ||||
| OPA | |||||
| G1 = Sedentary | • G1 = 1.00 (referent) | ||||
| G2 = light work | • G2 = 0.79 (0.39-1.61) | ||||
| G3 = more than light work | • G3 = 0.79 (0.36-1.74) | ||||
| • G4 = 0.99 (0.30-3.22) | |||||
| p = 0.42 | |||||
| Outcome Measure: Diagnosed with CC | |||||
| Multivariate OR (95% CI) by self reported lifetime OPA | |||||
| Conditional Logistic Regression | • G1 = 1.00 (referent) | ||||
| • G2 = 0.85 (0.41-1.76) | |||||
| • G3 = 0.68 (0.31-1.52) | |||||
| p = 0.15 | |||||
| Mai et al 2007 [289] | To examine in detail the relationship between recreational PA and invasive CC among women. | • n = 120,147 | 7 year follow-up | Number of cases: 395 | Modest inverse association between recreational PA and CC. |
| • Sex: Women | |||||
| • Age: 22-84 yr | PA assessment: Questionnaire | RR (95% CI) by MPA over past 3 years | |||
| USA | • Characteristics: no prior history of CC | • G1 = 1.00 (referent) | |||
| • G2 = 0.95 (0.72-1.24) | |||||
| Prospective cohort | MPA over past 3 yrs (h/wk/yr) | • G3 = 0.78 (0.62-0.97) | |||
| • California Teachers Study | p = 0.02 | ||||
| G1 = 0-0.50 | |||||
| D & B score = 15 | G2 = 0.51-1.99 | RR (95% CI) by strenuous + moderate (lifetime) PA: | |||
| G3 = ≥ 2.00 | • G1 = 1.00 (referent) | ||||
| • G2 = 0.79 (0.56-1.11) | |||||
| Strenuous + Moderate (lifetime) PA (h/wk/yr) | • G3 = 0.64 (0.44-0.93) | ||||
| p = 0.04 | |||||
| G1 = 0.0-0.50 | |||||
| G2 = 0.51-3.99 | |||||
| G3 = ≥ 4.00 | |||||
| Outcome Measure: Incidence of invasive adenocarcinoma of the colon | |||||
| Cox proportional HR | |||||
| Martinez et al 1997 [290] | To examine whether LTPA could significantly influence the risk of CC in women. | • n = 89,448 | 6 year follow-up | Number of cases: 212 | Significant inverse association between LTPA and incidence of CC in women. |
| • Sex: Women | |||||
| • Age: 30-55 yr | PA assessment: Questionnaire for LTPA | Multivariate RR (95% CI) for all CC | |||
| USA | • Characteristics: Nurses, free from cancer at baseline | • G1 = 1.00 (referent) | |||
| G1 = <2 | • G2 = 0.71 (0.44-1.15) | ||||
| Prospective | G2 = 2-4 | • G3 = 0.78 (0.50-1.20) | |||
| cohort | G3 = 5-10 | • G4 = 0.67 (0.42-1.07) | |||
| G4 = 11-21 | • G5 = 0.54 (0.33-0.90) | ||||
| D & B score = 14 | G5 = >21 | p = 0.03 | |||
| Outcome Measure: Incidence of CC | Multivariate RR (95% CI) for distal CC | ||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.92 (0.48-1.79) | |||||
| Mantel-Haenszel Estimator and logistic regression models | • G3 = 0.81 (0.43-1.55) | ||||
| • G4 = 0.71 (0.36-1.41) | |||||
| • G5 = 0.31 (0.12-0.77) | |||||
| p = 0.01 | |||||
| Multivariate RR (95% CI) for proximal | |||||
| CC | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.54 (0.23-1.22) | |||||
| • G3 = 0.79 (0.40-1.56) | |||||
| • G4 = 0.62 (0.30-1.32) | |||||
| • G5 = 0.77 (0.38-1.58) | |||||
| p = 0.67 | |||||
| Nilsen et al 2008 [291] | To study the separate associations of recreational PA with the incidence of, and mortality from cancer in the ascending, transverse, descending and sigmoid segments of the colon. | • n = 59,369 | 17 year follow-up | Number of cases: 736 | Strong inverse associations between recreational PA and risk of cancer morbidity and mortality of the transverse and sigmoid colon but no association for cancer in the ascending and descending colon. |
| • Sex: Men and women | PA assessment: Questionnaire for frequency and duration of recreational PA | HR (95% CI) by frequency of recreational PA, men | |||
| Norway | • Age: not indicated | • G1 = 1.00 (referent) | |||
| Prospective cohort | • Characteristics: Free from cancer at baseline | • G2 = 0.84 (0.60-1.19) | |||
| • Nord-Trondelag Health Study | • G3 = 0.82 (0.58-1.17) | ||||
| • G4 = 0.81 (0.57-1.15) | |||||
| D & B score = 14 | Frequency of Recreational PA (times per week) | • G5 = 0.77 (0.54-1.09) | |||
| G1 = none | p = 0.18 | ||||
| G2 = <1 | HR (95% CI) by frequency of | ||||
| G3 = 1 | recreational PA, women | ||||
| G4 = 2-3 | • G1 = 1.00 (referent) | ||||
| G5 = ≥ 4 | • G2 = 0.91 (0.66-1.25) | ||||
| • G3 = 0.79 (0.57-1.09) | |||||
| Duration of recreational PA (min per exercise) | • G4 = 0.66 (0.47-0.92) | ||||
| • G5 = 0.99 (0.72-1.36) | |||||
| G1 = none | p = 0.35 | ||||
| G2 = <15 | |||||
| G3 = 15-30 | HR (95% CI) by duration of recreational | ||||
| G4 = 31-60 | PA, men | ||||
| G5 = >60 | • G1 = 1.00 (referent) | ||||
| • G2 = 1.07 (0.71-1.60) | |||||
| Intensity of recreational PA | • G3 = 0.80 (0.57-1.12) | ||||
| • G4 = 0.68 (0.48-0.97) | |||||
| G1 = none | • G5 = 0.74 (0.50-1.08) | ||||
| G2 = Low | p = 0.02 | ||||
| G3 = Moderate/High | HR (95% CI) by duration of recreational PA, women | ||||
| Summary score for recreational PA | • G1 = 1.00 (referent) | ||||
| G1 = None | • G2 = 0.85 (0.59-1.23) | ||||
| G2 = Low | • G3 = 0.81 (0.60-1.09) | ||||
| G3 = High | • G4 = 0.73 (0.53-1.01) | ||||
| By subsite-specific (transverse colon, decending colon, sigmoid colon) CC | • G5 = 0.84 (0.53-1.34) | ||||
| p = 0.10 | |||||
| HR (95% CI) by intensity of recreational PA, men | |||||
| Levels of REC PA: | |||||
| G1 = None | • G1 = 1.00 (referent) | ||||
| G2 = < 1 x/wk | • G2 = 0.83 (0.62-1.12) | ||||
| G3 = low score | • G3 = 0.74 (0.52-1.06) | ||||
| G4 = high score | p = 0.11 | ||||
| Outcome Measure: incidence of fatal and non fatal CC | HR (95% CI) by intensity of recreational PA, women | ||||
| Cox proportional HR | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.77 (0.59-1.01) | |||||
| • G3 = 0.89 (0.60-1.32) | |||||
| p = 0.33 | |||||
| HR (95% CI) by summary score for recreational PA, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.85 (0.62-1.16) | |||||
| • G3 = 0.69 (0.48-0.98) | |||||
| p = 0.06 | |||||
| HR (95% CI) by summary score for recreational PA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.86 (0.64-1.01) | |||||
| • G3 = 0.72 (0.53-0.98) | |||||
| p = 0.03 | |||||
| HR (95% CI) by total CC and recreational PA, incidence | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.88 (0.70-1.12) | |||||
| • G3 = 0.87 (0.70-*1.08) | |||||
| • G4 = 0.73 (0.58-0.92) | |||||
| p = 0.009 | |||||
| HR (95% CI) by subsite specific CC and recreational PA, death | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.87 (0.64-1.18) | |||||
| • G3 = 0.79 (0.59-1.04) | |||||
| • G4 = 0.56 (0.41-0.78) | |||||
| p <0.001 | |||||
| HR (95% CI) for transverse CC incidence and recreational PA | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.75 (0.44-1.28) | |||||
| • G3 = 0.66 (0.41-1.08) | |||||
| • G4 = 0.44 (0.25-0.78) | |||||
| p = 0.004 | |||||
| HR (95% CI) for transverse CC death and recreational PA | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.73 (0.36-1.49) | |||||
| • G3 = 0.40 (0.19-0.82) | |||||
| • G4 = 0.33 (0.14-0.76) | |||||
| p = 0.002 | |||||
| HR (95% CI) for sigmoid CC incidence and recreational PA | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.88 (0.59-1.32) | |||||
| • G3 = 0.68 (0.46-1.01) | |||||
| • G4 = 0.48 (0.31-0.75) | |||||
| p <0.001 | |||||
| HR (95% CI) for sigmoid CC death and recreational PA | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.78 (0.45-1.35) | |||||
| • G3 = 0.51 (0.30-0.87) | |||||
| • G4 = 0.29 (0.15-0.56) | |||||
| p <0.001 | |||||
| Schnohr et al 2005 [292] | To assess the association between LTPA and incidence of cancer in the general population. | • n = 28,259 (15,043 men,13,216 women) | 14 year follow-up | • Number of cases: 215 men, 108 women | For the most active men, VPA was associated with a non-significant lower risk of CC. |
| Denmark | PA assessment: Questionnaire for LTPA | Multivariate RR (95% CI), men | |||
| • Sex: Men and women | G1 = Low | • G1 = 1.00 (referent) | |||
| Prospective cohort | G2 = Moderate | • G2 = 1.08 (0.74-1.57) | |||
| • Age: 20-93 yr | G3 = Vigorous | • G3 = 0.72 (0.47-1.11) | |||
| D & B score = 13 | • Characteristics: Free from cancer at baseline | Outcome Measure: Incidence of CC | p =0.06 | ||
| Multivariate RR (95% CI), women | |||||
| • Copenhagen Heart Study, The Copenhagen County Centre of Preventive Medicine and the Copenhagen Male Study | • G1 = 1.00 (referent) | ||||
| Cox proportional HR | • G2 = 1.02 (0.70-1.50) | ||||
| • G3 = 0.90 (0.56-1.46) | |||||
| p = 0.68 | |||||
| Slattery et al 1988 [293] | To assess the relationship of PA and diet with the development of CC in Utah. | • n = 229 cases, 384 controls | PA assessment: Interview for the following variables | • Number of cases: 229 | PA shows an inverse relationship with incidence of CC. |
| USA | • Sex: Men and women | Multivariate OR (95% CI) by TPA, men | |||
| Case control | • Age: 40-79 yr | • Q1 = 1.00 (referent) | |||
| • Characteristics: Case: Diagnosed with CC Controls: no history of cancer | TPA | • Q2 = 1.19 (0.67-2.13) | |||
| Q1 = Low | • Q3 = 0.88 (0.48-1.69) | ||||
| Q2 | • Q4 = .70 (0.38-1.29) | ||||
| D & B score = 13 | Q3 | ||||
| Q4 = high | Multivariate OR (95% CI) by TPA, women | ||||
| Intense PA | • Q1 = 1.00 (referent) | ||||
| G1 = none | • Q2 = 0.97 (0.56-1.69) | ||||
| G2 = low | • Q3 = 0.91 (0.52-1.60) | ||||
| G3 = high | • Q4 = 0.48 (0.27-0.87) | ||||
| Non-intense PA | Multivariate OR (95% CI) by intense PA, men | ||||
| Q1 = Low | |||||
| Q2 | • G1 = 1.00 (referent) | ||||
| Q3 | • G2 = 0.83 (0.40-1.75) | ||||
| Q4 = high | • G3 = 0.27 (0.11-0.65) | ||||
| Outcome Measure: Diagnosed with CC | Multivariate OR (95% CI) by intense PA, women | ||||
| Multiple logistic regression analysis | • G1 = 1.00 (referent) | ||||
| • G2 = 0.55 (0.23-1.34) | |||||
| Multivariate OR (95% CI) by non-intense PA, men | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.40 (0.76-2.57) | |||||
| • Q3 = 0.93 (0.51-1.72) | |||||
| • Q4 = 1.25 (0.68-2.29) | |||||
| Multivariate OR (95% CI) by non-intense PA, women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.09 (0.62-1.90) | |||||
| • Q3 = 0.94 (0.53-1.66) | |||||
| • Q4 = 0.53 (0.29-0.95) | |||||
| Slattery et al 1997 [294] | To examine the relationship between weekly PA patterns (source, duration and frequency) and CC. | • n = 1,993 cases, 2,410 controls | PA Assessment: Interview, adapted CARDIA PA history | Number of cases: 1,993 | High level of leisure time VPA during the past 20 yrs was associated with a reduced risk of CC in both men and women. The same associations were not observed with leisure time MPA. |
| USA | • Sex: Men and women | Multivariate OR (95% CI) by recent leisure time VPA, men | |||
| Case control | • Age: 30-79 yr | Recent leisure time | • Q1 = 1.00 (referent) | ||
| • Characteristics: Cases: diagnosed with first primary CC. Controls: no history of CC | VPA | • Q2 = 0.80 (0.64-1.01) | |||
| Q1 = None | • Q3 = 0.84 (0.66-1.05) | ||||
| D & B score = 14 | Q2 | • Q4 = 0.69 (0.55-0.87) | |||
| Q3 | |||||
| Q4 = High | Multivariate OR (95% CI) by recent leisure time VPA, women | The greatest inverse association was observed when activities were performed for longer periods of time per session. | |||
| The Three Centered Diet, Activity and Lifestyle Colon Cancer Study | Leisure time VPA | • Q1 = 1.00 (referent) | |||
| Q1 = Low | • Q2 = 0.79 (0.61-1.02) | ||||
| Q2 | • Q3 = 0.83 (0.64-1.07) | ||||
| Q3 | • Q4 = 0.86 (0.67-1.10) | ||||
| Q4 = High | |||||
| Current PA (min) | Multivariate OR (95% CI) by leisure time VPA, men | ||||
| G1 = <30 | |||||
| G2 = 30-60 | • Q1 = 1.00 (referent) | ||||
| G3 = ≥ 60 | • Q2 = 0.97 (0.76-1.25) | ||||
| • Q3 = 0.86 (0.67-1.09) | |||||
| LTPA (ranked by time per session) | • Q4 = 0.61 (0.47-0.79) | ||||
| Q1 = None | Multivariate OR (95% CI) by leisure time VPA, women | ||||
| Q2 = Low - <30 min | |||||
| Q3 = moderate - 30-60 min | • Q1 = 1.00 (referent) | ||||
| Q4 = high ->60 min | • Q2 = 0.75 (0.59-0.95) | ||||
| • Q3 = 0.68 (0.53-0.87) | |||||
| Number of activity session per week | • Q4 = 0.63 (0.48-0.83) | ||||
| G1 = None | Multivariate OR (95% CI) by current MPA time per week | ||||
| G2 = 1 | |||||
| G3 = 2-4 | • Q1 = 1.00 (referent) | ||||
| G4 = 5-7 | • Q2 = 1.00 (0.83-1.21) | ||||
| G5 = >7 | • Q3 = 0.90 (0.76-1.07) | ||||
| • Q4 = 0.92 (0.77-1.10) | |||||
| Outcome Measure: Diagnosed with CC | Multivariate OR (95% CI) by current VPA time per week | ||||
| Unconditional regression models | • Q1 = 1.00 (referent) | ||||
| • Q2 = 0.90 (0.73-1.12) | |||||
| • Q3 = 0.89 (0.71-1.10) | |||||
| • Q4 = 0.83 (0.69-0.98) | |||||
| Multivariate OR (95% CI) by leisure time MPA time per session | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.20 (0.91-1.59) | |||||
| • Q3 = 1.09 (0.83-1.42) | |||||
| • Q4 = 1.08 (0.82-1.42) | |||||
| Multivariate OR (95% CI) by leisure time VPA time per session | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.86 (0.74-0.99) | |||||
| • Q3 = 0.76 (0.64-0.90) | |||||
| • Q4 = 0.68 (0.52-0.87) | |||||
| Multivariate OR (95% CI) by number of MPA sessions/wk | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.02 (0.79-1.30) | |||||
| • G3 = 0.86 (0.72-1.02) | |||||
| • G4 = 0.91 (0.81-1.14) | |||||
| • G5 = 1.02 (0.82-1.27) | |||||
| Multivariate OR (95% CI) by number of VPA sessions/wk | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.72 (0.56-0.92) | |||||
| • G3 = 0.87 (0.73-1.03) | |||||
| • G4 = 1.00 (0.81-1.25) | |||||
| • G5 = 0.84 (0.61-1.15) | |||||
| Slattery et al 1997 [295] | To determine how physical inactivity interacts with other components of energy balance in determining risk of CC. | • n = 1,993 cases, 2,410 controls | PA Assessment: Interview for lifetime VPA (PA index) | Number of cases: 1,993 | These results support previous findings that physical inactiity is associated with an increased risk of developing CC. |
| USA | • Sex: Men and women | Q1 = 10-12 | Multivariate OR (95% CI), men | ||
| • Age: 30-79 yr | Q2 = 7-9 | • Q1 = 1.00 (referent) | |||
| • Characteristics: Cases: diagnosed with first primary CC. Controls: no history of CC | Q3 = 4-6 | • Q2 = 1.60 (1.11-1.75) | |||
| Case control | • The Three Centered Diet, Activity and Lifestyle Colon Cancer Study | Q4 = <4 | • Q3 = 1.59 (1.26-2.01) | ||
| D & B score = 14 | • Q4 = 1.63 (1.26-2.12) | ||||
| Outcome Measure: Diagnosed with CC | Multivariate OR (95% CI), women | ||||
| • Q1 = 1.00 | |||||
| • Q2 = 1.14 (0.86-1.52) | |||||
| Unconditional regression models | • Q3 = 1.13 (0.85-1.49 | ||||
| • Q4 = 1.59 (1.21-2.10) | |||||
| Takahashi et al 2007 [296] | To investigate the association between time spent walking each day and the risk of CRC. | • n = 20,519 men, 21,469 women | 7 year follow-up | • Number of cases: 101 | Time spent walking per day was associated with a lower risk of colon cancer in men but not in women. |
| • Sex: Men and women | PA assessment: Questionnaire for time spent walking (h/day) | • Number of dropouts: 3.5% | |||
| Japan | • Age: 40-64 yr | Multivariate RR (95% CI), men | |||
| • Characteristics: Free from cancer at baseline | • G1 = 1.00 (referent) | ||||
| Prospective cohort | G1 = <0.5 | • G2 = 0.72 (0.43-1.21) | |||
| G2 = 0.5-1 | • G3 = 0.38 (0.22-0.64) | ||||
| G3 = >1 | p < 0.001 | ||||
| D & B score = 12 | Outcome Measure: Incidence of CC | Time spent walking and incidence of CC | |||
| Multivariate RR (95% CI), women | |||||
| Cox proportional HR | • G1 = 1.00 | ||||
| • G2 = 2.68 (0.94-7.68) | |||||
| • G3 = 1.79 (0.64-4.96) | |||||
| p = 0.42 | |||||
| Tang et al 1999 [297] | To investigate the association between PA, water intake and risk of CRC in a hospital based case controlled study. | • n = 163 cases, 163 controls | PA assessment: Interview | • Number of cases: 163 | Found a negative association between LTPA and the risk of CC among men. |
| • Sex: Men and women | Multivariate RR (95% CI), men | ||||
| Taiwan | LTPA METs | • G1 = 1.00 (referent) | |||
| • Age: 33-80 yr | G1 = Sedentary | • G2 = 2.22 (0.68-7.21) | |||
| Case control | • Characteristics: Cases: Hospital patients diagnosed with colorectal cancer Controls: Hospital patients in hospital for other reasons, free of CRC. | G2 = Moderate (< 20 MET) | • G3 = 0.19 (0.05-0.77) | ||
| D & B score = 14 | G3 = Active (≥20 MET) | p = 0.03 | |||
| Multivariate RR (95% CI), women | |||||
| Outcome Measure: Diagnosis of CC | • G1 = 1.00 (referent) | ||||
| • G2 = 0.52 (0.13-2.03) | |||||
| • G3 = 0.63 (0.18-2.18) | |||||
| Conditional logistic regression analysis | p = 0.48 | ||||
| Tavani et al 1999 [298] | To investigate the relationship between PA and risk of CC in both sexes at different ages. | • n = 5,379 (1,225 cases and 4,154 controls) | PA assessment: Questionnaire on activity at work and during leisure time | • Number of cases: 537 women, 688 men | The study confirms that OPA is protective against CC. |
| Italy | • Sex: Men and women | Multivariate OR (95% CI) for CC by OPA at age 15-19 yr, men | |||
| Case control | • Age: 19-74 yr | G1 = Highest | • G1 = 1.00 (referent) | ||
| G2 | • G2 = 0.89 (0.64-1.23) | ||||
| D & B score = 13 | G3 | • G3 = 0.72 (0.54-0.97) | |||
| G4 | • G4 = 0.54 (0.40-0.74) | ||||
| G5 = Lowest | • G5 = 0.47 (0.31-0.71) | ||||
| p < 0.01 | |||||
| OPA at 30-39 yrs old | |||||
| Q1 = Highest | Multivariate OR (95% CI) for CC by OPA at age 15-19 yr, women | ||||
| Q2 | • G1 = 1.00 (referent) | ||||
| Q3 | • G2 = 0.73 (0.55-0.96) | ||||
| Q4 = Lowest | • G3 = 0.91 (0.69-1.21) | ||||
| Outcome Measure: Diagnosis of CC | • G4 = 0.62 (0.44-0.89) | ||||
| Unconditional multiple Logistic Regression | p < 0.05 | ||||
| Multivariate OR (95% CI) for CC by OPA at age 30-39 yr, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.01 (0.75-1.37) | |||||
| • G3 = 0.79 (0.59-1.06) | |||||
| • G4 = 0.71 (0.52-0.97) | |||||
| • G5 = 0.64 (0.44-0.93) | |||||
| p < 0.01 | |||||
| Multivariate OR (95% CI) for CC by OPA at age 30-39 yr, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.65 (0.46-0.93) | |||||
| • G3 = 0.57 (0.41-0.79) | |||||
| • G4 = 0.49 (0.33-0.72) | |||||
| p < 0.01 | |||||
| Multivariate OR (95% CI) for CC by OPA at age 50-59 yr, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.06 (0.78-1.43) | |||||
| • G3 = 0.85 (0.63-1.14) | |||||
| • G4 = 0.68 (0.49-0.95) | |||||
| • G5 = 0.69 (0.45-1.05) | |||||
| p < 0.01 | |||||
| Multivariate OR (95% CI) for CC by OPA at age 50-59 yr, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.69 (0.47-1.00) | |||||
| • G3 = 0.68 (0.46-1.00) | |||||
| • G4 = 0.75 (0.47-1.20) | |||||
| p = > 0.05 | |||||
| Multivariate OR (95% CI) for ascending CC by OPA at age 30-39 yr No significant associations for men or women | |||||
| Multivariate OR (95% CI) for transverse and descending CC by OPA at age 30-39 yr, men | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.92 (0.51-1.67) | |||||
| • Q3 = 0.76 (0.43-1.37) | |||||
| • Q4 = 0.46 (0.24-0.87) | |||||
| p < 0.05 | |||||
| Multivariate OR (95% CI) for transverse and descending CC by OPA at age 30-39 yr, women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.51 (0.23-1.10) | |||||
| • Q3 = 0.39 (0.19-0.80) | |||||
| • Q4 = 0.29 (0.12-0.71) | |||||
| p < 0.01 | |||||
| Multivariate OR (95% CI) for sigmoid CC by OPA at age 30-39 yr, men | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 1.02 (0.65-1.57) | |||||
| • Q3 = 0.78 (0.51-1.20) | |||||
| • Q4 = 0.54 (0.34-0.85) | |||||
| p < 0.01 | |||||
| Multivariate OR (95% CI) for sigmoid CC by OPA at age 30-39 yr, women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.62 (0.36-1.05) | |||||
| • Q3 = 0.71 (0.44-1.15) | |||||
| • Q4 = 0.58 (0.32-1.03) | |||||
| p > 0.05 | |||||
| Thune et al 1996 [299] | To examine the association between self-reported OPA and LTPA and the subsequent risk of CC. | • n = 81,516 (53,242 men, 28,274 women) | 16.3 year follow up | Number of cases: 236 men, 99 women | An inverse dose-response relationship between TPA and risk of CC was observed in women. In men this inverse dose-response was found only for those 45 yrs or older at study entry. |
| PA assessment: Questionnaire for TPA (OPA plus recreational PA (combined) | Multivariate RR (95% CI) for total CC, men | ||||
| Norway | • Sex: Men and women | G1 = Sedentary | • G1 = 1.00 (referent) | ||
| Prospective cohort | • Age: 20-49 yr | G2 = Moderate | • G2 = 1.18 (0.76-1.82) | ||
| • Characteristics: Free from cancer at baseline | G3 = Active | • G3 = 0.97 (0.63-1.50) | |||
| D & B score = 14 | p = 0.49 | ||||
| Multivariate RR (95% CI) for total CC, women | |||||
| Outcome Measure: Incidence of CC | • G1 = 1.00 (referent) | ||||
| Cox proportional HR | • G2 = 0.97 (0.33-2.77) | ||||
| • G3 = 0.63 (0.39-1.04) | |||||
| p = 0.04 | |||||
| Multivariate RR (95% CI) for proximal CC, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.16 (0.57-2.34) | |||||
| • G3 = 0.96 (0.47-1.93) | |||||
| p = 0.64 | |||||
| Multivariate RR (95% CI) for proximal CC, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.22 (0.51-2.94) | |||||
| • G3 = 0.62 (0.30-1.28) | |||||
| p = 0.10 | |||||
| Multivariate RR (95% CI) for distal CC, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.29 (0.72-2.33) | |||||
| • G3 = 0.99 (0.55-1.80) | |||||
| p = 0.53 | |||||
| Multivariate RR (95% CI) for distal CC, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.84 (0.32-2.17) | |||||
| • G3 = 0.61 (0.30-1.23) | |||||
| p = 0.15 | |||||
| Multivariate RR (95% CI) for total CC, men < 45 yrs at entry | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 2.02 (0.78-5.21) | |||||
| • G3 = 2.23 (0.88-5.66) | |||||
| p = 0.13 | |||||
| Multivariate RR (95% CI) for total CC, women < 45 yrs at entry | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.96 (0.39-2.40) | |||||
| • G3 = 0.62 (0.31-1.23) | |||||
| p = 0.13 | |||||
| Multivariate RR (95% CI) for total CC, men ≥ 45 yrs at entry | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.96 (0.59-1.58) | |||||
| • G3 = 0.66 (0.40-1.10) | |||||
| p = 0.04 | |||||
| Multivariate RR (95% CI) for total CC, women ≥ 45 yrs at entry | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.99 (0.41-2.39) | |||||
| • G3 = 0.66 (0.33-1.33) | |||||
| p = 0.19 | |||||
| Vena et al 1985 [300] | To assess the relationship between lifetime OPA and the risk of CC. | • n = 1,641 (210 cases, 1,431 control) | PA assessment: Questionnaire | • Number of cases: 210 | CC risk increased with increasing amount and proportion of time in jobs involving only sedentary or light work. |
| USA | • Sex: Men | Number of work years in jobs with sedentary or light work (yr) | OR (95% CI) by number of work years in jobs with sedentary or light work | ||
| Case control | • Age: 30-79 yr | G1 = None | • G1 = 1.00 (referent) | ||
| • Characteristics: Cases: admitted to hospital. Diagnosis of CC Controls: Admitted to hospital. Diagnosed with non-neoplastic non-digestive diseases | G2 = 1-20 | • G2 = 1.49 | |||
| D & B score = 15 | G3 = >20 | • G3 = 1.97 | |||
| OR (95% CI) by proportion of years in jobs with sedentary or light work | |||||
| Proportion of years in jobs with sedentary or light work | • G1 = 1.00 (referent) | ||||
| • G2 = 1.53 | |||||
| • G3 = 1.58 | |||||
| G1 = None | • G4 = 2.10 | ||||
| G2 = 0.01-0.50 | |||||
| G3 = 0.41-0.99 | OR (95% CI) by proportion of life in jobs with sedentary or light work | ||||
| G4 = 1.00 (referent) | |||||
| • G1 = 1.00 (referent) | |||||
| Proportion of life in jobs with sedentary or light work | • G2 = 1.66 | ||||
| • G3 = 1.83 | |||||
| G1 = None | |||||
| G2 = 0.01-0.40 | |||||
| G3 = 0.41-1.00 | |||||
| Outcome Measure: diagnosed with CC | |||||
| Multiple logistic regression | |||||
| Vetter et al 1992 [301] | To investigate the influence of OPA on the risk of CC in a developing country. | • n = 87 men cases, 13 women cases, 371 controls | PA assessment: Questionnaire Job title and industry names | Number of cases: 87 men, 13 women | This study presents a weak inverse association between CC and PA. |
| USA | • Sex: Men and women | OR (95% CI) Sitting time and CC | Only 2 of the 4 measures of activity showed evidence of an increased CC risk for sedentary jobs (time spent sitting and occupational EE) though neither was statistically significant. | ||
| Case control | • Age: 14-97 yr | Levels (Sitting time, energy expenditure | • G1 = 1.00 (referent) | ||
| D & B score = 11 | • Characteristics: Cases: Diagnosed with CC Controls: cancer cases other then colon, rectum and lung cancer. | G1 = High | • G2 = 1.0 (0.5-2.0) | ||
| G2 = Moderate | • G3 = 1.5 (0.7-2.9) | ||||
| G3 = Sedentary | p = 0.145 | ||||
| Outcome Measure: Diagnosed with CC | OR (95% CI) Energy Expenditure and CC | ||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.5 (0.7-3.3) | |||||
| • G3 = 1.6 (0.8-3.6) | |||||
| p = 0.143 | |||||
| White et al 1996 [302] | To assess the relationship between PA and CC among men and women. | • n = 871 (251 men, 193 women cases. 233 men & 194 women controls) | PA assessment: Phone interview | • Number of cases: 251 men & 193 women | The results of this study show modest support that recreational PA is associated with a reduced risk of CC. |
| USA | Total PA (episodes/wk) | RR (95% CI) by total PA, men | |||
| G1 = 0 | • G1 = 1.00 (referent) | ||||
| Case control | • Sex: Men and women | G2 = <1 | • G2 = 0.81 (0.45-1.44) | ||
| G3 = 1-<2 | • G3 = 0.53 (0.30-0.94) | ||||
| D & B score = 14 | • Age: 30-62 yr | G4 = 2-< 4 | • G4 = 0.57 (0.33-1.00) | ||
| • Characteristics: Cases: Diagnosed with CC, no previous history or CC or inflammatory bowel | G5 = ≥ 4 | • G5 = 0.57 (0.40-1.11) | |||
| Moderate-high intensity PA (epsiodes/wk) | p = 0.03 | ||||
| RR (95% CI) by total PA, women | |||||
| G1 = 0 | • G1 = 1.00 (referent) | ||||
| G2 = <1 | • G2 = 1.17 (0.57-2.40) | ||||
| G3 = 1-<2 | • G3 = 1.27 (0.65-2.45) | ||||
| Controls: No history of CC or inflammatory bowel | G4 = ≥ 2 | • G4 = 0.59 (0.34-1.04) | |||
| • G5 = 1.09 (0.61-1.97) | |||||
| High intensity PA (episodes/wk) | p = 0.52 | ||||
| G1 = 0 | RR (95% CI) by total PA, men and women | ||||
| G2 = <1 | • G1 = 1.00 (referent) | ||||
| G3 = ≥ 1 | • G2 = 0.94 (0.60-1.47) | ||||
| METS/wk | • G3 = 0.77 (0.50-1.19) | ||||
| Q1 = 0 | • G4 = 0.57 (0.39-0.85) | ||||
| Q2 = <7.30 | |||||
| Q3 = 7.30-17.88 | • G5 = 0.83 (0.57-1.22) | ||||
| Q4 = ≥ 17.88 | p = 0.04 | ||||
| Outcome Measure: Diagnosed with CC | RR (95% CI) by moderate-high intensity PA, men | ||||
| • G1 = 1.00 (referent) | |||||
| Unconditional logistic regression | • G2 = 0.84 (0.49-1.43) | ||||
| • Q3 = 0.75 (0.42-1.36) | |||||
| • Q4 = 0.66 (0.41-1.05) | |||||
| p = 0.07 | |||||
| RR (95% CI) by moderate-high intensity PA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.07 (0.58-1.97) | |||||
| • G3 = 1.00 (0.51-1.98) | |||||
| • G4 = 0.74 (0.42-1.29) | |||||
| p = 0.37 | |||||
| RR (95% CI) by moderate-high intensity PA, men and women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.93 (0.62-1.39) | |||||
| • Q3 = 0.86 (0.55-1.34) | |||||
| • Q4 = 0.70 (0.49-1.00) | |||||
| p = 0.05 | |||||
| RR (95% CI) by high intensity PA, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.85 (0.48-1.52) | |||||
| • G3 = 0.57 (0.35-0.92) | |||||
| p = 0.02 | |||||
| RR (95% CI) by high intensity PA, Women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.02 (0.51-2.04) | |||||
| • G3 = 0.74 (0.43-1.28) | |||||
| p = 0.31 | |||||
| RR (95% CI) by high intensity PA, men and women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.93 (0.59-1.44) | |||||
| • G3 = 0.64 (0.45-0.92) | |||||
| p = 0.02 | |||||
| RR (95% CI) by METs/wk, men | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.64 (0.38-1.07) | |||||
| • Q3 = 0.59 (0.37-0.96) | |||||
| • Q4 = 0.69 (0.42-1.13) | |||||
| p = 0.05 | |||||
| RR (95% CI) by METs/wk, women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.87 (0.51-1.49) | |||||
| • Q3 = 1.20 (0.69-2.08) | |||||
| • Q4 = 0.74 (0.41-1.34) | |||||
| p = 0.62 | |||||
| RR (95% CI) by METs/wk, women | |||||
| • Q1 = 1.00 (referent) | |||||
| • Q2 = 0.73 (0.50-1.06) | |||||
| • Q3 = 0.80 (0.56-1.16) | |||||
| • Q4 = 0.73 (0.50-1.06) | |||||
| p = 0.08 | |||||
| Wolin et al 2007 [303] | To assess the relationship between PA and risk of CC in women. | • n = 79,295 | 16 year follow-up | Number of cases: 547 (245 distal, 302 proximal) Number of dropouts: 10% | A significant inverse association exists between PA, including moderate intensity, such as walking, and risk of CC in women that is more pronounced for distal tumours. |
| • Sex: Women | |||||
| • Age: 40-65 yr | PA assessment: Questionnaire | ||||
| USA | • Characteristics: Nurses, no history of CC, ulcerative colitis and Crohn's disease | ||||
| Prospective cohort | Level of PA | Multivariate RR (95% CI) for distal CC by level of PA | |||
| G1 = <2 | • G1 = 1.00 (referent) | ||||
| G2 = 2.1-4.5 | • G2 = 0.93 (0.64-1.36) | ||||
| D & B score = 14 | G3 = 4.6-10.3 | • G3 = 0.99 (0.68-1.44) | |||
| Nurses' Health Study | G4 = 10.4 - 21.4 | • G4 = 0.87 (0.59-1.29 | |||
| G5 = ≥ 21.5 | • G5 = 0.54 (0.34-0.84) | ||||
| MPA or VPA (hr/wk) | p = 0.004 | ||||
| G1 = 0 | Multivariate RR (95% CI) for proximal CC by level of PA not significant p = 0.77 | ||||
| G2 = <1 | |||||
| G3 = 1-1.9 | |||||
| G4 = 2-3.9 | |||||
| G5 = ≥ 4 | Multivariate RR (95% CI) for all CC by MPA or VPA | ||||
| Outcome Measure: Fatal and non fatal CC | • G1 = 1.00 (referent) | ||||
| • G2 = 0.85, (0.64-1.14) | |||||
| Cox proportional HR | • G3 = 0.74 (0.53-1.04) | ||||
| • G4 = 0.56 (0.33-0.94) | |||||
| p = 0.01 | |||||
| Multivariate RR (95% CI) for distal CC by MPA or VPA | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 1.10 (0.73-1.66) | |||||
| • G3 = 0.63 (0.36-1.10) | |||||
| • G4 = 0.51 (0.22-1.17) | |||||
| p = 0.04 | |||||
| Multivariate RR (95% CI) for proximal CC by MPA or VPA not significant p = 0.12 | |||||
| Zhang et al 2006 [304] | To examine the relationship between LTPA and OPA and the risk of CC by anatomic site and to evaluate their joint effect on the risk of CC. | • n = 585 cases 2,172 controls | PA assessment: Questionnaire for the following variables | Number of cases: 585 | Found a significant inverse association between reported LTPA and risk of CC with a slightly stronger association for the right colon than the left in both men and women. |
| USA | • Sex: Men and women | Multivariate OR (95% CI) by moderate- strenuous LTPA, men and women | |||
| • Age: 40-85 yr | Moderate-Strenuous LTPA | • G1 = 1.00 (referent) | |||
| Case control | • Characteristics: Case: diagnosed with CC Control: no history of CC. | G1 = <1 month | • G2 = 0.7 (0.5-1.1) | ||
| G2 = 1-4 months | • G3 = 0.6 (0.4-0.8) | ||||
| D & B score = 15 | G3 = ≥ 2 weeks | p = 0.003 | |||
| Multivariate OR (95% CI) by moderate- strenuous LTPA, men | The joint effect of OPA and LTPA suggested that the risk was lowest for those with high OPA and non-OPA. | ||||
| • G1 = 1.00 (referent) | |||||
| Outcome Measure: CC | • G2 = 0.9 (0.5-1.7) | ||||
| • G3 = 0.5 (0.3-0.9) | |||||
| Unconditional logistic regression models | p = 0.02 | ||||
| Multivariate OR (95% CI) by moderate-strenuous LTPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G3 = 0.5 (0.3-1.0) | |||||
| • G3 = 0.6 (0.4-0.9) | |||||
| p = 0.02 | |||||
| Multivariate OR (95% CI) by moderate-strenuous LTPA, men and women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.7 (0.5-1.1) | |||||
| • G3 = 0.8 (0.6-1.1) | |||||
| p = 0.53 | |||||
| Multivariate OR (95% CI) by moderate-strenuous LTPA, men | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.9 (0.5-1.5) | |||||
| • G3 = 0.8 (0.6-1.2) | |||||
| p = 0.55 | |||||
| Multivariate OR (95% CI) by moderate- strenuous LTPA, women | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.6 (0.3-1.1) | |||||
| • G3 = 0.8 (0.5-1.2) | |||||
| p = 0.62 | |||||
| Multivariate OR (95% CI) by moderate- strenuous LTPA and OPA, OPA-Low | |||||
| • G1 = 1.00 (referent) | |||||
| • G2 = 0.5 (0.3-0.9) | |||||
| • G3 = 0.8 (0.5-1.2) | |||||
| p = 0.41 | |||||
| Multivariate OR (95% CI) by moderate-strenuous LTPA and OPA, OPA-Medium | |||||
| • G1 = 0.7 (0.5-1.1) | |||||
| • G2 = 0.7 (0.4-1.3) | |||||
| • G3 = 0.5 (0.3-0.8) | |||||
| p = 0.04 | |||||
| Multivariate OR (95% CI) by moderate-strenuous LTPA and OPA, OPA-High | |||||
| • G1 = 0.9 (0.5-1.6) | |||||
| • G2 = 0.6 (0.3-1.3) | |||||
| • G3 = 0.5 (0.3-0.8) | |||||
D & B score, Downs and Black quality score; YR, years; PA, physical activity; OPA, occupational physical activity; kJ/min, kilojoules per minute; G, groups; MET, metabolic equivalent; HR, hazard ratio; RR, risk ratio; OR, odds ratio; 95% CI, confidence interval; LTPA, leisure-time physical activity; CC, colon cancer; TPA, total physical activity; MDA, moderate physical activity; h/d, hours per day; VPA, vigorous physical activity; h/wk, hours per week.