Physical Activity and Cancer (Fact Sheet)
A nurse and patient discuss an exercise regimen.
Physical activity is defined as any movement that uses skeletal muscles and requires more energy than does resting. Physical activity can include working, exercising, performing household chores, and leisure-time activities such as walking, tennis, hiking, bicycling, and swimming.
Physical activity is essential for people to maintain a balance between the number of calories consumed and the number of calories used. Consistently expending fewer calories than are consumed leads to obesity, which scientists have convincingly linked to increased risks of 13 different cancers.1 Additionally, evidence indicates that physical activity may reduce the risks of several cancers through other mechanisms, independent of its effect on obesity.
What is known about the relationship between physical activity and cancer risk?
There is substantial evidence that higher levels of physical activity are linked to lower risks of several cancers.2
Colon cancer: Colon cancer is one of the most extensively studied cancers in relation to physical activity.3 A 2009 meta-analysis of 52 epidemiologic studies that examined the association between physical activity and colon cancer risk found that the most physically active individuals had a 24% lower risk of colon cancer than those who were the least physically active.4 A pooled analysis of data on leisure-time physical activity (activities done at an individual's discretion generally to improve or maintain fitness or health) from 12 prospective U.S. and European cohort studies reported a risk reduction of 16%, when comparing individuals who were most active to those where least active.5 Incidence of both distal colon and proximal colon cancers is lower in people who are more physically active than in those who are less physically active.6,7 Physical activity is also associated with a decreased risk of colon adenomas (polyps), a type of colon polyp that may develop into colon cancer.8However, it is less clear whether physical activity is associated with lower risks that polyps that have been removed will come back.9-11
Breast cancer: Many studies show that physically active women have a lower risk of breast cancer than inactive women; in a 2013 meta-analysis of 31 prospective studies, the average breast cancer risk reduction associated with physical activity was 12%.12 Physical activity has been associated with a reduced risk of breast cancer in both premenopausal and postmenopausal women; however, the evidence for an association is stronger for postmenopausal breast cancer.12-15 Women who increase their physical activity after menopause may also have a lower risk of breast cancer than women who do not.13,15
Endometrial cancer: Many studies have examined the relationship between physical activity and the risk of endometrial cancer (cancer of the lining of the uterus). In a meta-analysis of 33 studies, the average endometrial cancer risk reduction associated with high versus low physical activity was 20%.16 There is some evidence that the association between physical activity and endometrial cancer risk may reflect the effect of physical activity on obesity, a known risk factor for endometrial cancer. 16-18
For a number of other cancers, there is more limited evidence of a relationship with physical activity. In a study of over 1 million individuals, leisure-time physical activity was linked to reduced risks of esophageal adenocarcinoma, liver cancer, gastric cardia cancer (a type of stomach cancer), kidney cancer, myeloid leukemia, myeloma, and cancers of the head and neck, rectum, and bladder.5 These results are generally corroborated by large cohort studies19 or meta-analyses.20-22
Nearly all of the evidence linking physical activity to cancer risk comes from observational studies, in which individuals report on their physical activity and are followed for years for diagnoses of cancer. Data from observational studies can give researchers clues about the relationship between physical activity and cancer risk, but such studies cannot definitively establish that being physically inactive causes cancer (or that being physically active protects against cancer). That is because people who are not physically active may differ from active people in ways other than their level of physical activity. These other differences, rather than the differences in physical activity, could explain their different cancer risk. For example, if someone does not feel well, they may not exercise much, and sometimes people do not feel well because they have undiagnosed cancer.