Association of sedentary behaviour with colon and rectal cancer: a meta-analysis of observational studies

Y J Cong, Y Gan, H L Sun, J Deng, S Y Cao, X Xu, Z X Lu, Y J Cong, Y Gan, H L Sun, J Deng, S Y Cao, X Xu, Z X Lu

Abstract

Background: Sedentary behaviour is ubiquitous in modern society. Emerging studies have focused on the health consequences of sedentary behaviour, including colorectal cancer, but whether sedentary behaviour is associated with the risks of colon and rectal cancer remains unclear. No systematic reviews have applied quantitative techniques to independently compute summary risk estimates. We aimed to conduct a meta-analysis to investigate this issue.

Methods: We searched PubMed, Embase, and Google Scholar databases up to May 2013 to identify cohort and case-control studies that evaluated the association between sedentary behaviour and colon or rectal cancer. A random-effect model was used to pool the results of included studies. Publication bias was assessed by using Begg's funnel plot.

Results: Twenty-three studies with 63 reports were included in our meta-analysis. These groups included 4,324,462 participants (27,231 colon cancer cases and 13,813 rectal cancer cases). Sedentary behaviour was significantly associated with colon cancer (relative risk (RR): 1.30, 95% confidence interval (CI): 1.22-1.39) but did not have a statistically significant association with rectal cancer (RR 1.05, 95% CI, 0.98-1.13). Subgroup analyses suggested that the odds ratio (OR) of colon cancer was 1.46 (95% CI: 1.22-1.68) in the case-control studies, and the RR was 1.27 (95% CI: 1.18-1.36) in the cohort studies, the OR of rectal cancer was 1.06 (95% CI: 0.85-1.33) in the case-control studies, and the RR was 1.06 (95% CI, 1.01-1.12) in the cohort studies.

Conclusion: Sedentary behaviour is associated with an increased risk of colon cancer. Subgroup analyses suggest a positive association between sedentary behaviour and risk of rectal cancer in cohort studies. Reducing sedentary behaviour is potentially important for the prevention of colorectal cancer.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Forest plot of sedentary behaviour and risk for colon cancer.
Figure 3
Figure 3
Forest plot of sedentary behaviour and risk for rectal cancer.
Figure 4
Figure 4
Funnel plot of sedentary behaviour and rectal cancer.
Figure 5
Figure 5
Funnel plot of sedentary behaviour and colon cancer.

References

    1. Arbman G, Axelson O, Fredriksson M, Nilsson E, Sjodahl R. Do occupational factors influence the risk of colon and rectal cancer in different ways. Cancer. 1993;72:2543–2549.
    1. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–1101.
    1. Blanck HM, Mccullough ML, Patel AV, Gillespie C, Calle EE, Cokkinides VE, Galuska DA, Khan LK, Serdula MK. Sedentary behavior, recreational physical activity, and 7-year weight gain among postmenopausal U.S. women. Obesity. 2007;15:1578–1588.
    1. Boyle T. Physical Activity and Colon Cancer: Timing, Intensity, and Sedentary Behavior. Am J Lifestyle Med. 2012;6:204–215.
    1. Boyle T, Fritschi L, Heyworth J, Bull F. Long-Term Sedentary Work and the Risk of Subsite-specific Colorectal Cancer. Am J Epidemiol. 2011;173:1183–1191.
    1. Boyle T, Keegel T, Bull F, Heyworth J, Fritschi L. Physical activity and risks of proximal and distal colon cancers: a systematic review and meta-analysis. J Natl Cancer Inst. 2012;104:1548–1561.
    1. Brown WJ, Bauman AE, Owen N. Stand up, sit down, keep moving: turning circles in physical activity research. Br J Sports Med. 2009;43:86–88.
    1. Campbell PT, Patel AV, Newton CC, Jacobs EJ, Gapstur SM. Associations of recreational physical activity and leisure time spent sitting with colorectal cancer survival. J Clin Oncol. 2013;31:876–885.
    1. Colbert LH, Hartman TJ, Malila N, Limburg PJ, Pietinen P, Virtamo J, Taylor PR, Albanes D. Physical activity in relation to cancer of the colon and rectum in a cohort of male smokers. Cancer Epidemiol Biomarkers Prev. 2001;10:265–268.
    1. Dosemeci M, Hayes RB, Vetter R, Hoover RN, Tucker M, Engin K, Unsal M, Blair A. Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey. Cancer Causes Control. 1993;4:313–321.
    1. Dunstan DW, Barr EL, Healy GN, SalmoN J, Shaw JE, Balkau B, Magliano DJ, CameroN AJ, Zimmet PZ, Owen N. Television viewing time and mortality: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) Circulation. 2010;121:384–391.
    1. Edwardson CL, Gorely T, Davies MJ, Gray LJ, Khunti K, Wilmot EG, Yates T, Biddle SJ. Association of sedentary behaviour with metabolic syndrome: a meta-analysis. PLoS One. 2012;7:e34916.
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–634.
    1. Feskanich D, Ma J, Fuchs CS, Kirkner GJ, Hankinson SE, Hollis BW, Giovannucci EL. Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev. 2004;13:1502–1508.
    1. Fraser G, Pearce N. Occupational physical activity and risk of cancer of the colon and rectum in New Zealand males. Cancer Causes Control. 1993;4:45–50.
    1. Fredriksson M, Bengtsson NO, Hardell L, Axelson O. Colon cancer, physical activity, and occupational exposures. A case-control study. Cancer. 1989;63:1838–1842.
    1. Friedenreich C, Norat T, Steindorf K, Boutron-Ruault MC, Pischon T, Mazuir M, Clavel-Chapelon F, Linseisen J, Boeing H, Bergman M, Johnsen NF, Tjonneland A, Overvad K, Mendez M, Quiros JR, Martinez C, Dorronsoro M, Navarro C, Gurrea AB, Bingham S, Khaw KT, Allen N, Key T, Trichopoulou A, Trichopoulos D, Orfanou N, Krogh V, Palli D, Tumino R, Panico S, Vineis P, Bueno-De-Mesquita HB, Peeters PH, Monninkhof E, Berglund G, Manjer J, Ferrari P, Slimani N, Kaaks R, Riboli E. Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev. 2006;15:2398–2407.
    1. Garabrant DH, Peters JM, Mack TM, Bernstein L. Job activity and colon cancer risk. Am J Epidemiol. 1984;119:1005–1014.
    1. George SM, Irwin ML, Matthews CE, Mayne ST, Gail MH, Moore SC, AlbaneS D, Ballard-Barbash R, Hollenbeck AR, Schatzkin A, LeitzmanN MF. Beyond recreational physical activity: examining occupational and household activity, transportation activity, and sedentary behavior in relation to postmenopausal breast cancer risk. Am J Public Health. 2010;100:2288–2295.
    1. Gerhardsson M, Norell SE, Kiviranta H, Pedersen NL, Ahlbom A. Sedentary jobs and colon cancer. Am J Epidemiol. 1986;123:775–780.
    1. Giovannucci E. Insulin and colon cancer. Cancer Causes Control. 1995;6:164–179.
    1. Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr. 2001;131:3109S–3120SS.
    1. Giovannucci E. Metabolic syndrome, hyperinsulinemia, and colon cancer: a review. Am J Clin Nutr. 2007;86:s836–s842.
    1. Greenland S. Quantitative methods in the review of epidemiologic literature. Epidemiol Rev. 1987;9:1–30.
    1. Grontved A, Hu FB. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. JAMA. 2011;305:2448–2455.
    1. Healy GN, Dunstan DW, Salmon J, Cerin E, Shaw JE, Zimmet PZ, Owen N. Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care. 2007;30:1384–1389.
    1. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–1558.
    1. Howard RA, Freedman DM, Park Y, Hollenbeck A, Schatzkin A, LeitzmanN MF. Physical activity, sedentary behavior, and the risk of colon and rectal cancer in the NIH-AARP Diet and Health Study. Cancer Causes Control. 2008;19:939–953.
    1. Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA. 2003;289:1785–1791.
    1. Johnsen NF, Christensen J, Thomsen BL, Olsen A, Loft S, Overvad K, Tjonneland A. Physical activity and risk of colon cancer in a cohort of Danish middle-aged men and women. Eur J Epidemiol. 2006;21:877–884.
    1. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009;41:998–1005.
    1. Levi F, Pasche C, Lucchini F, Tavani A, La Vecchia C. Occupational and leisure-time physical activity and the risk of colorectal cancer. Eur J Cancer Prev. 1999;8:487–493.
    1. Lynch BM. Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer Epidemiol Biomarkers Prev. 2010;19:2691–2709.
    1. Mathew A, Gajalakshmi V, Rajan B, Kanimozhi VC, Brennan P, Binukumar BP, Boffetta P. Physical activity levels among urban and rural women in south India and the risk of breast cancer: a case-control study. Eur J Cancer Prev. 2009;18:368–376.
    1. Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008;167:875–881.
    1. McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk. Cancer Epidemiol Biomarkers Prev. 1994;3:687–695.
    1. Moradi T, Gridley G, Bjork J, Dosemeci M, Ji BT, Berkel HJ, Lemeshow S. Occupational physical activity and risk for cancer of the colon and rectum in Sweden among men and women by anatomic subsite. Eur J Cancer Prev. 2008;17:201–208.
    1. Neilson HK, Friedenreich CM, Brockton NT, Millikan RC. Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev. 2009;18:11–27.
    1. Organization WH.2011. Globocan2008: Cancer incidence and mortality worldwide in 2008:.
    1. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev. 2010;38:105–113.
    1. Parent ME, Rousseau MC, El-Zein M, Latreille B, Desy M, Siemiatycki J. Occupational and recreational physical activity during adult life and the risk of cancer among men. Cancer Epidemiol. 2011;35:151–159.
    1. Pate RR, O'Neill JR, Lobelo F. The evolving definition of ‘sedentary'. Exerc Sport Sci Rev. 2008;36:173–178.
    1. Peters RK, Garabrant DH, Yu MC, Mack TM. A case-control study of occupational and dietary factors in colorectal cancer in young men by subsite. Cancer Res. 1989;49:5459–5468.
    1. Pukkala E, Martinsen JI, Lynge E, Gunnarsdottir HK, Sparen P, Tryggvadottir L, Weiderpass E, Kjaerheim K. Occupation and cancer - follow-up of 15 million people in five Nordic countries. Acta Oncol. 2009;48:646–790.
    1. Simons CC, Hughes LA, Van Engeland M, Goldbohm RA, Van Den Brandt PA, Weijenberg MP. Physical activity, occupational sitting time, and colorectal cancer risk in the Netherlands cohort study. Am J Epidemiol. 2013;177:514–530.
    1. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008–2012.
    1. Tang R, Wang JY, Lo SK, Hsieh LL. Physical activity, water intake and risk of colorectal cancer in Taiwan: a hospital-based case-control study. Int J Cancer. 1999;82:484–489.
    1. Tavani A, Braga C, La Vecchia C, Conti E, Filiberti R, Montella M, Amadori D, Russo A, Franceschi S. Physical activity and risk of cancers of the colon and rectum: an Italian case-control study. Br J Cancer. 1999;79:1912–1916.
    1. Thune I, Lund E. Physical activity and risk of colorectal cancer in men and women. Br J Cancer. 1996;73:1134–1140.
    1. Vetter R, Dosemeci M, Blair A, Wacholder S, Unsal M, Engin K, Fraumeni JF., Jr Occupational physical activity and colon cancer risk in Turkey. Eur J Epidemiol. 1992;8:845–850.
    1. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ. 2007;85:867–872.
    1. Wallace BC, Schmid CH, Lau J, Trikalinos TA. Meta-Analyst: software for meta-analysis of binary, continuous and diagnostic data. BMC Med Res Methodol. 2009;9:80.
    1. Weiderpass E, Vainio H, Kauppinen T, Vasama-Neuvonen K, Partanen T, Pukkala E. Occupational Exposures and Gastrointestinal Cancers Among Finnish Women. J Occup Environ Med. 2003;45:305–315.
    1. Whittemore AS, Wu-Williams AH, Lee M, Zheng S, Gallagher RP, Jiao DA, Zhou L, Wang XH, Chen K, Jung D, Chong-Ze T, Ling CD, Xu JY, Paffenbarger RS, Henderson BE. Diet, physical activity, and colorectal cancer among Chinese in North America and China. J Natl Cancer Inst. 1990;82:915–926.
    1. Wijndaele K, Brage S, Besson H, Khaw KT, Sharp SJ, Luben R, Wareham NJ, Ekelund U. Television viewing time independently predicts all-cause and cardiovascular mortality: the EPIC Norfolk study. Int J Epidemiol. 2011;40:150–159.
    1. Wijndaele K, Healy GN, Dunstan DW, Barnett AG, Salmon J, Shaw JE, Zimmet PZ, Owen N. Increased cardiometabolic risk is associated with increased TV viewing time. Med Sci Sports Exerc. 2010;42:1511–1518.
    1. Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, Khunti K, Yates T, Biddle SJ. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012;55:2895–2905.
    1. Wolin KY, Yan Y, Colditz GA, Lee IM. Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer. 2009;100:611–616.
    1. Wong WC, Cheung CS, Hart GJ. Development of a quality assessment tool for systematic reviews of observational studies (QATSO) of HIV prevalence in men having sex with men and associated risk behaviours. Emerg Themes Epidemiol. 2008;5:23.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe