Sedentary Behavior and Incident Cancer: A Meta-Analysis of Prospective Studies

Background Sedentary behavior is ubiquitous in modern adults' daily lives and it has been suggested to be associated with incident cancer. However, the results have been inconsistent. In this study, we performed a systematic review and meta-analysis of prospective cohort studies to clarify the association between sedentary behavior and incident cancer. Method PubMed and Embase databases were searched up to March 2014. All prospective cohort studies on the association between sedentary behavior and incident cancer were included. The summary relative risks (RRs) with 95% confidence intervals (CIs) were estimated using random effect model. Results A total of 17 prospective studies from 14 articles, including a total of 857,581 participants and 18,553 cases, were included in the analysis for sedentary behavior and risk of incident cancer. The overall meta-analysis suggested that sedentary behavior increased risk of cancer (RR = 1.20, 95%CI = 1.12–1.28), with no evidence of heterogeneity between studies (I 2 = 7.3%, P = 0.368). Subgroup analyses demonstrated that there were statistical associations between sedentary behavior and some cancer types (endometrial cancer: RR = 1.28, 95% CI = 1.08–1.53; colorectal cancer: RR = 1.30, 95%CI = 1.12–1.49; breast cancer: RR = 1.17, 95%CI = 1.03–1.33; lung cancer: RR = 1.27, 95%CI = 1.06–1.52). However, there was no association of sedentary behavior with ovarian cancer (RR = 1.26, 95%CI = 0.87–1.82), renal cell carcinoma (RR = 1.11, 95%CI = 0.87–1.41) or non-Hodgkin lymphoid neoplasms (RR = 1.09, 95%CI = 0.82–1.43). Conclusion The present meta-analysis suggested that prolonged sedentary behavior was independently associated with an increased risk of incident endometrial, colorectal, breast, and lung cancers, but not with ovarian cancer, renal cell carcinoma or non-Hodgkin lymphoid neoplasms.

[1]  Charles E. Matthews,et al.  Physical Activity in Different Periods of Life, Sedentary Behavior, and the Risk of Ovarian Cancer in the NIH-AARP Diet and Health Study , 2013, Cancer Epidemiology, Biomarkers & Prevention.

[2]  Carl J Caspersen,et al.  Sedentary behaviour and cardiovascular disease: a review of prospective studies. , 2012, International journal of epidemiology.

[3]  Y. Gan,et al.  Association of sedentary behaviour with colon and rectal cancer: a meta-analysis of observational studies , 2013, British Journal of Cancer.

[4]  Anette Hjartåker,et al.  Body mass index, physical activity, and colorectal cancer by anatomical subsites: a systematic review and meta-analysis of cohort studies , 2013, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[5]  M. Thun,et al.  The role of body weight in the relationship between physical activity and endometrial cancer: Results from a large cohort of US women , 2008, International journal of cancer.

[6]  M. Thun,et al.  Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women. , 2006, American journal of epidemiology.

[7]  I-Min Lee,et al.  Dose Response Between Physical Activity and Risk of Coronary Heart Disease: A Meta-Analysis , 2011, Circulation.

[8]  F. Visseren,et al.  Obesity and Cancer: The Role of Dysfunctional Adipose Tissue , 2009, Cancer Epidemiology, Biomarkers & Prevention.

[9]  C. Matthews,et al.  Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. , 2011, European heart journal.

[10]  U. Ekelund.  Commentary: Too much sitting--a public health threat? , 2012, International journal of epidemiology.

[11]  W. R. Diver,et al.  Recreational physical activity, leisure sitting time and risk of non‐Hodgkin lymphoid neoplasms in the American Cancer Society Cancer Prevention Study II Cohort , 2012, International journal of cancer.

[12]  N. Owen,et al.  Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior , 2008, Current cardiovascular risk reports.

[13]  F. Hu,et al.  Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. , 2011, JAMA.

[14]  U. Ekelund,et al.  Television viewing time independently predicts all-cause and cardiovascular mortality: the EPIC Norfolk study. , 2011, International journal of epidemiology.

[15]  C. Mantzoros,et al.  Physical Activity and Risk of Endometrial Cancer: A Population-Based Prospective Cohort Study , 2006, Cancer Epidemiology Biomarkers & Prevention.

[16]  K. Khunti,et al.  Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis , 2012, Diabetologia.

[17]  Lucas J Carr,et al.  Letter to the editor: standardized use of the terms "sedentary" and "sedentary behaviours". , 2012, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[18]  R. Goldbohm,et al.  Physical activity, occupational sitting time, and colorectal cancer risk in the Netherlands cohort study. , 2013, American journal of epidemiology.

[19]  Juned Siddique,et al.  Evidence that women meeting physical activity guidelines do not sit less: An observational inclinometry study , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[20]  Gretchen L. Gierach,et al.  Anthropometric Measures and Physical Activity and the Risk of Lung Cancer in Never-Smokers: A Prospective Cohort Study , 2013, PloS one.

[21]  M. Ando,et al.  Prospective cohort study on television viewing time and incidence of lung cancer: findings from the Japan Collaborative Cohort Study , 2013, Cancer Causes & Control.

[22]  Laura J. Gray,et al.  Association of Sedentary Behaviour with Metabolic Syndrome: A Meta-Analysis , 2012, PloS one.

[23]  C. Begg,et al.  Operating characteristics of a rank correlation test for publication bias. , 1994, Biometrics.

[24]  Gretchen L. Gierach,et al.  Physical activity, sedentary behavior, and endometrial cancer risk in the NIH‐AARP Diet and Health Study , 2009, International journal of cancer.

[25]  M. Gail,et al.  Beyond recreational physical activity: examining occupational and household activity, transportation activity, and sedentary behavior in relation to postmenopausal breast cancer risk. , 2010, American journal of public health.

[26]  Brigid M Lynch,et al.  Sedentary Behavior and Cancer: A Systematic Review of the Literature and Proposed Biological Mechanisms , 2010, Cancer Epidemiology, Biomarkers & Prevention.

[27]  A. Schatzkin,et al.  Physical activity, sedentary behavior, and the risk of colon and rectal cancer in the NIH-AARP Diet and Health Study , 2008, Cancer Causes & Control.

[28]  N. Rothman,et al.  Physical activity and breast cancer risk in Chinese women , 2011, British Journal of Cancer.

[29]  C. Matthews,et al.  Sedentary Behavior, Physical Activity, and Likelihood of Breast Cancer among Black and White Women: A Report from the Southern Community Cohort Study , 2013, Cancer Prevention Research.

[30]  H Löllgen,et al.  Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. , 2009, International journal of sports medicine.

[31]  Darren Flynn,et al.  Changing Physical Activity Behavior in Type 2 Diabetes , 2012, Diabetes Care.

[32]  W. Haenszel,et al.  Statistical aspects of the analysis of data from retrospective studies of disease. , 1959, Journal of the National Cancer Institute.

[33]  C. Matthews,et al.  A prospective analysis of prolonged sitting time and risk of renal cell carcinoma among 300,000 older adults. , 2011, Annals of epidemiology.