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Researcher: Adair Minihan, MPH
Institution: American Cancer Society
Area of Focus: Risk Factors & Screening Surveillance and Health Equity Science
“Our results show that if adults met recommended levels of physical activity, many cancer cases could potentially be prevented in the United States. State and local health departments may need to partner with a multitude of organizations to raise awareness, provide social support, and develop safe spaces to walk, bike, and play.”
The Challenge: Many countries have conducted studies to estimate the proportion of all cases of cancer that may be attributed to lack of physical activity. Global proportions range from 0.1% in Egypt to 4.9% in Canada.
In 2014, the estimate for the United States was 2.9% of all cancer cases. At that time, the risks of physical inactivity were only studied for breast, colon, and endometrial cancer.
Since then, physical inactivity has been strongly linked with a higher risk of developing 7 types of cancer:
So, we don’t know how many cancers are linked with physical inactivity based on this updated list. Nor do we know how the number of cancers linked with physical inactivity varies by each US state.
Plus, scientists wanted to better understand how varying recommended levels of physical activity, as defined in the ACS Nutrition and Physical Activity Guidelines for Cancer Prevention, affect the number of linked cancers
The Research: The American Cancer Society’s Associate Scientist II, in Risk Factors & Screening Surveillance Research, Adair Minihan, MPH, led the first study to estimate the number of cancer cases for these 7 cancers by state. She and other ACS researchers published results of their study, which looked at inactivity levels for people age 20 and older in 2003 through 2006 and cancer cases for people age 30 and older in 2013 through 2016 for all 50 states and the District of Columbia.
They used data from self-reported surveys about physical activity that didn’t occur at work, which included being physically active to get back and forth from work or school, complete household chores, as well as for fun, recreation, and sports.
Minihan and her colleagues sorted activity habits into 8 categories depending on intensity of the activity or the energy used. The lowest category was being completely inactive and the highest was the equivalent of 5 hours of moderate-intensity activity a week (45 minutes a day). That’s the upper limit, ideal recommendation of weekly exercise for adults by the US Physical Activity Guidelines and the ACS Nutrition and Physical Activity Guidelines for Cancer Prevention.
Moderate intensity exercise is any activity that makes you breathe hard and increase your heart rate a bit. You may or may not sweat. Examples of moderate-intensity exercise include brisk walking, leisurely bicycling, and ice or roller skating.
The researchers found that 3% of all cancer cases (excluding non-melanoma skin cancer) were attributable to physical inactivity when the optimal level of physical activity was defined as 5 or more hours of moderate-intensity activity a week. That’s equal to about 46,400 people a year whose inactivity was linked to the development of cancer.
They also found that:
The link between certain cancers and too little physical activity was about:
The authors note that the maximum prevention may occur at higher activity levels, which, they say, many people are unlikely to achieve.
Why Does It Matter? Having state-level data can help inform the level of cancer prevention and control programs that are needed in that region.
The authors discuss several actions with promising evidence of behavior change that states can support at an individual or community level:
The authors note several groups that may need extra support to increase daily physical activity:
More research is needed to help improve long-term behavior change.