A prospective study of physical activity and cardiometabolic diseases in association with cancer risk

Background: Most physical activity research focuses on general populations, and its cancer-preventive benefits in adults with cardiometabolic diseases remain poorly understood. This study investigated associations between non-occupational physical activity and cancer risk in adults with and without cardiometabolic diseases (cardiovascular disease and/or type 2 diabetes). Methods: We conducted a meta-analysis of individual participant data of 598,890 men and women, aged 35–70 years at recruitment, across six European countries from the European Prospective Investigation into Cancer and Nutrition (EPIC) and UK Biobank. Participants with cancer at baseline were excluded. Physical activity was assessed at baseline using self-reported validated questionnaires. We used multivariable-adjusted Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between non-occupational physical activity and the risk of physical activity-related cancers (a composite of 15 cancers), with a multiplicative interaction between non-occupational physical activity and time-varying cardiometabolic disease status. Results: We show that after a median follow-up of 11 years, 37,182 participants developed a first primary physical activity-related cancer (EPIC and UK Biobank combined). In the meta-analysis of both cohorts, a 1 standard deviation increment of non-occupational physical activity is associated with a lower risk of physical activity-related cancer, with HRs of 0.96 (95% CI: 0.93, 0.98) and 0.93 (95% CI: 0.91, 0.96) in adults without and in those with a cardiometabolic disease, respectively (all p-interaction ≥ 0.17). Conclusions: The findings of this study suggest that higher non-occupational physical activity is equally beneficial for cancer prevention in adults with and without cardiometabolic diseases.