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  • Proceedings of the Nutrition Society, Volume 60, Issue 1
  • February 2001, pp. 107-113

Physical activity and cancer risk

  • Adrianne E. Hardman (a1)
  • DOI:
  • Published online: 28 February 2007

Evidence is accumulating that high levels of physical activity are associated with a reduced risk of some cancers. This evidence is most consistent for colon cancer, which is reduced by 40–50 % among the most active individuals, compared with the least active. The effect is evident in men and women, and appears to be independent of important confounding factors. However, there may be important interactions with body fatness; a high BMI has been reported to be associated with an increased risk of colon cancer in sedentary men but not in physically-active men. Whilst the evidence on breast cancer is less consistent, case–control studies typically suggest a reduction of 25–30 % among the most active women, although several studies have found no effect. Potential mechanisms include systemic influences and others relevant only to site-specific cancers. One unifying hypothesis is that physical inactivity reduces insulin sensitivity, leading to a growth-promotional environment which may facilitate neoplasia. The non-specific immune system may be improved by physical activity, possibly through the summative effects of repeated exercise bouts. Regular exercise, even at a recreational level, probably reduces exposure to oestrogen and thus decreases the risk of breast cancer. Increased colonic peristalsis, and thus reduced bowel transit time, might partly explain the lower risk of colon cancer in active people. Physical activity emerges as one of the few modifiable risk factors for some cancers and, as such, justifies further study.

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Corresponding author
Corresponding author: Professor Adrianne Hardman, fax +44 1509 223971, email
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VJ Andaloro , DT Monaghan & TH Rosenquist (1998) Dextromethorphan and other N-methyl D-asparate receptor antagonists are teratogenic in the avian embryo model. Pediatrics Research 43, 17.

BE Ainsworth , B Sternfeld , ML Slattery , V Daguisé & SH Zahm (1998) Physical activity and breast cancer. Evaluation of physical activity assessment methods. Cancer 83, Suppl., 611620.

RC Barber , GM Shaw , EJ Lammer , KA Greer , SW Lacey , CR Wasserman & RH Finnell (1998) Lack of association between mutations in the folate receptor alpha gene and spina bifida. American Journal of Medical Genetics 76, 310317.

L Bernstein , BE Henderson , R Hanisch , J Sullivan-Halley & RK Ross (1994) Physical exercise and reduced risk of breast cancer in young women. Journal of the National Cancer Institute 86, 14031408.

SV Bhave , LD Snell , B Tabakoff & PL Hoffman (1996) Mechanism of ethanol inhibition of NMDA receptor function in primary cultures of cerebral cortical cells. Alcoholism, Clinical and Experimental Research 20, 934941.

L Bernstein & RK Ross (1998) Re: Physical activity and breast cancer risk in a cohort of young women. Journal of the National Cancer Institute 90, 19071908.

DE Bockman , ME Redmond & ML Kirby (1990) Altered development of pharyngeal arch vessels after neural crest ablation. Annals of the New York Academy of Sciences 588, 296304.

BA Bullen , GS Krinar , IZ Beitins , G von Mehring , BA Turnbull & JW McArthur (1985) Induction of menstrual disorders by strenuous exercise in untrained women. New England Journal of Medicine 312, 13491353.

LD Botto & P Mastroiacovo (1998) Exploring gene-gene interactions in the etiology of neural tube defects. Clinical Genetics 53, 456459.

GA Colditz , CC Cannuscio & AL Frazier (1997) Physical activity and reduced risk of colon cancer: implications for prevention. Cancer Causes and Control 8, 649667.

LD Botto & Q Yang (2000) 5,10-Methylenetetrahydrofolate reductase gene variants and congenital anomalies: a HuGE review. American Journal of Epidemiology 151, 862877.

LC Brody , PJ Baker , PS Chines , A Musick , AM Molloy , DA Swanson , PN Kirke , S Ghosh , M Scott & JL Mills (1999) Methionine synthase: high-resolution mapping of the human gene and evaluation as a candidate locus for neural tube defects. Molecular Genetics Metabolism 67, 324333.

J-P Després (1994) Dyslipidaemia and obesity. Baillière's Clinical Endocrinology and Metabolism 8, 629660.

JC Brown , TH Rosenquist , & DT Monaghan (1998) ERK2 activation by homocysteine in vascular smooth muscle cells. Biochemical and Biophysical Research Communications 251, 669676.

M Dosemeci , RB Hayes , R Etter , RN Hoover , M Tucker , K Engin , M Unsal & A Blair (1993) Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey. Cancer Causes and Control 4, 313321.

B Christensen , L Arbour , P Tran , D Leclerc , N Sabbaghian , R Platt , BM Gilfix , DS Rosenblatt , RA Gravel , P Forbes & R Rozen (1999) Genetic polymorphisms in methylenetetrahydrofolate reductase and methionine synthase, folate levels in red blood cells, and risk of neural tube defects. American Journal of Medical Genetics 84, 151157.

SM Enger , MP Longnecker , ER Lee , HD Frankl & RW Haile (1997) Recent and past physical activity and prevalence of colorectal adenomas. British Journal of Cancer 75, 740745.

AH Cornell-Bell , PG Thomas & SJ Smith (1990) The excitatory neurotransmitter glutamate causes filopodia formation in cultured hippocampal astrocytes. Glia 3, 322324.

CM Friedenreich , I Thune , LA Brinton & D Albanes (1998) Epidemiological issues related to the association between physical activity and breast cancer. Cancer 83, Suppl., 600610.

AE Czeizel , M Toth & M Rockenbauer (1996) Population-based case control study of folic acid supplementation during pregnancy. Teratology 53, 345351.

MD Gammon , EM John & JA Britton (1998) Recreational and occupational physical activities and risk of breast cancer. Journal of the National Cancer Institute 90, 100117.

TK Eskes (1998) Open or closed? A world of difference: a history of homocysteine research. Nutrition Reviews 56, 236244.

M Gerharsson , B Floderus & SE Norell (1988) Physical activity and colon cancer risk. International Journal of Epidemiology 17, 743746.

E Giovannucci , A Ascherio , EB Rimm , GA Colditz , MJ Stampfer & WC Willett (1995) Physical activity, obesity, and risk for colon cancer and adenoma in men. Annals of Internal Medicine 122, 327334.

E Giovannucci , GA Colditz , MJ Stampfer & WC Willett (1996) Physical activity, obesity, and risk of colorectal adenoma in women (United States). Cancer Causes and Control 7, 253263.

RH Finnell , GM Shaw , KA Greer , RC Barber & EJ Lammer (1998) Folate receptors and neural tube defects with special emphasis on craniofacial development. Critical Reviews in Oral Biology and Medicine 9, 3853.

RH Finnell , BC Wlordarczyk , JC Craig , JA Piedrahita & GD Bennett (1997) Strain dependent alterations in the expression of folate pathway genes following teratogenic exposure to valproic acid in a mouse model. American Journal of Medical Genetics 70, 303311.

N Haapanen , S Miilunpalo , M Pasanen , P Oja & I Vuori (1997) Assocation between leisure time physical activity and 10-year body mass change among working-aged men and women. International Journal of Obesity 21, 288296.

F Gofflot , G van Maele Fabry & JJ Picard (1996) Cranial nerves and ganglia are altered after in vitro treatment of mouse embryos with valproic acid (VPA) and 4-en-VPA. Developmental Brain Research 93, 6269.

TJ Hartman , D Albanes , M Rautalahti , JA Tangrea , J Virtamo , R Stolzenberg & PR Taylor (1998) Physical activity and prostate cancer in the alpha-tocopherol, beta-carotene (ATBC) cancer prevention study (Finland). Cancer Causes and Control 9, 1118.

A Graham , G Koentges & A Lumsden (1996) Neural crest apoptosis and the establishment of craniofacial pattern: an honorable death. Molecular and Cellular Neuroscience 8, 7683.

MJ Hill (1999) Diet, physical activity and cancer risk. Public Health Nutrition 2, 397401.

I-M Lee , RS Paffenbarger & C-C Hsieh (1991) Physical activity and the risk of developing colorectal cancer among college alumni. Journal of the National Cancer Institute 83, 13241329.

DL Harmon , JV Woodside , JW Yarnell , D McMaster , IS Young , EE McCrum , KF Gey , AS Whitehead & AE Evans (1996) The common 'thermolabile' variant of methylene tetrahydrofolate reductase is a major determinant of mild hyperhomocysteinaemia. Quarterly Journal of Medicine 89, 571577.

F Levi , C Pasche , F Lucchini , A Tavani & C La Vecchia (1999) Occupational and leisure-time physical activity and the risk of colorectal cancer. European Journal of Cancer Prevention 8, 487493.

W Hundt , W Danysz , SM Holter & R Spanagel (1998) Ethanol and N-methyl-D-aspartate receptor complex interactions: a detailed drug discrimination study in the rat. Psychopharmacology (Berlin) 135, 4451.

VP Johnson , VW Swayze II, Y Sato & NC Andreasen (1996) Fetal alcohol syndrome: craniofacial and central nervous system manifestations. American Journal of Medical Genetics 61, 329339.

S Liu , I-M Lee , P Linson , U Ajani , JE Buring & CH Hennekens (2000) A prospective study of physical activity and risk of prostate cancer in US physicians. International Journal of Epidemiology 29, 2935.

L Kapusta , ML Haagmans , EA Steegers , MH Cuypers , HJ Blom & TK Eskes (1999) Congenital heart defects and maternal derangement of homocysteine metabolism. Journal of Pediatrics 135, 773774.

ML Kirby , TF Gale & DE Stewart (1983) Neural crest cells contribute to normal aorticopulmonary septation. Science 220, 10591061.

ML Kirby & KL Waldo (1990) Role of neural crest in congenital heart disease. Circulation 82, 332340.

A McTiernan , C Ulrich , S Slate & J Potter (1998) Physical activity and cancer etiology: associations and mechanisms. Cancer Causes and Control 9, 487509.

ML Kirby & KL Waldo (1995) Neural crest and cardiovascular patterning. Circulation Research 77, 211215.

ME Martínez , E Giovannucci , D Spiegelman , DJ Hunter , WC Willett & GA Colditz (1997) Leisure-time physical activity, body size, and colon cancer in women. Journal of the National Cancer Institute 89, 948955.

H Komuro & P Rakic (1993) Modulation of neuronal migration by NMDA receptors. Science 260, 9597.

ME Martínez , D Heddens , DL Earnest , CL Bogert , D Roe , J Einspahr , JR Marshall & DS Alberts (1999) Physical activity, body mass index, and prostaglandin E2 levels in rectal mucosa. Journal of the National Cancer Institute 91, 950953.

SA Lipton , WK Kim , YB Choi , S Kumar , DM D'Emilia , PV Rayudu , DR Arnelle & JS Stamler (1997) Neurotoxicity associated with dual actions of homocysteine at the N-methyl-D-aspartate receptor. Proceedings of the National Academy of Sciences USA 94, 59235928.

T Moradi , H-O Adami , R Bergström , G Gridley , A Wolk , M Gerhardsson , M Dosemeci & O Nyrén (1999) Occupational physical activity and risk for breast cancer in a nationwide cohort study in Sweden. Cancer Causes and Control 10, 423430.

JL Mills , PN Kirke , AM Molloy , H Burke , MR Conley , YJ Lee , PD Mayne , DG Weir & JM Scott (1999) Methylenetetrahydrofolate reductase thermolabile variant and oral clefts. American Journal of Medical Genetics 86, 7174.

AI Neugut , MB Terry , G Hocking , L Mosca , GC Garbowski , KA Forde , MR Treat & J Waye (1996) Leisure and occupational physical activity and risk of colorectal adenomatous polyps. International Journal of Cancer 68, 744748.

DT Monaghan , VJ Andaloro & DA Skifter (1998) Molecular determinants of NMDA receptor pharmacological diversity. Progress in Brain Research 116, 171190.

K Morrison , C Papapetrou , FA Hol , EC Mariman , SA Lynch , J Burn & YH Edwards (1998) Susceptibility to spina bifida; an association study of five candidate genes. Annals of Human Genetics 62, 379396.

DC Nieman , SL Nehlsen-Cannarella , PA Markoff , AJ Balk-Lamberton , H Yang , DBW Chritton , JW Lee & K Arabatzis (1990) The effects of moderate exercise training on natural killer cells and acute respiratory tract infections. International Journal of Sports Medicine 11, 467473.

RG Munger , PA Romitti , S Daack Hirsch , TL Burns , JC Murray & J Hanson (1996) Maternal alcohol use and risk of orofacial cleft birth defects. Teratology 54, 2733.

DC Nieman & BK Pedersen (1999) Exercise and immune function: recent developments. Sports Medicine 27, 7380.

H Nau (1985) Teratogenic valproic acid concentrations: infusion by implanted minipumps vs conventional injection regimen in the mouse. Toxicology and Applied Pharmacology 80, 243250.

RR Pate , M Pratt , SN Blair , WL Haskell , CA Macera , C Bouchard , D Buchner , W Ettinger , GW Heath , AC King , A Kriska , AS Leon , BH Marcus , J Morris , RS Paffenbarger , K Patrick , ML Pollock , JM Rippe , J Sallis & JH Wilmore (1995) Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of the American Medical Association 273, 402407.

DM Noden (1975) An analysis of migratory behavior of avian cephalic neural crest cells. Developmental Biology 42, 106130.

DM Noden (1978 a) The control of avian cephalic neural crest cytodifferentiation. I. Skeletal and connective tissues. Developmental Biology 67, 296312.

JD Potter (1999) Colorectal cancer: molecules and populations. Journal of the National Cancer Institute 91, 916932.

KE Powell , PD Thompson , CJ Casperson & JS Kendrick (1987) Physical activity and the incidence of coronary heart disease. Annual Review of Public Health 8, 253287.

B Rockhill , WC Willett , DJ Hunter , JE Manson , SE Hankinson , GA Colditz (1999) A prospective study of recreational physical activity and breast cancer risk. Archives of Internal Medicine 159, 22902296.

CY Ou , RE Stevenson , VK Brown , CE Schwartz , WP Allen , MJ Khoury , R Rozen , GP Oakley Jr & MJ Adams Jr (1996) 5,10 Methylenetetrahydrofolate reductase genetic polymorphism as a risk factor for neural tube defects. American Journal of Medical Genetics 63, 610614.

B Rockhill , WC Willett , DJ Hunter , JE Manson , SE Hankinson , D Spiegelman & GA Colditz (1998) Physical activity and breast cancer risk in a cohort of young women. Journal of the National Cancer Institute 90, 11551160.

CB Scanga , TJ Verde , AM Paolone , RE Andersen & TA Wadden (1998) Effects of weight loss and exercise training on natural killer cell activity in obese women. Medicine and Science in Sports and Exercise 30, 16661671.

D Ramsbottom , JM Scott , A Molloy , DG Weir , PN Kirke , JL Mills , PM Gallagher & AS Whitehead (1997) Are common mutations of cystathionine beta-synthase involved in the aetiology of neural tube defects? Clinical Genetics 51, 3942.

NA Rashid & MA Cambray-Deakin (1992) N-methyl-D-aspartate effects on the growth, morphology and cytoskeleton of individual neurons in vitro. Brain Research 67, 301308.

TH Rosenquist & AC Beall (1990 a) Elastogenic cells in the developing cardiovascular system: smooth muscle, non-muscle and cardiac neural crest. Annals of the New York Academy of Sciences 588, 106119.

I Thune , T Brenn , E Lund & M Gaard (1997) Physical activity and the risk of breast cancer. New England Journal of Medicine 336, 12691275.

I Thune & E Lund (1996) Physical activity and risk of colorectal cancer in men and women. British Journal of Cancer 73, 11341140.

TH Rosenquist , AC Beall , L Modis & R Fishman (1990 b) Impaired elastic matrix development in the great arteries after ablation of the cardiac neural crest. Anatomical Record 226, 347359.

J Verloop , MA Rookus , K van der Kooy & FE Van Leeuwen (2000) Physical activity and breast cancer risk in women aged 20–54 years. Journal of the National Cancer Institute 92, 128135.

TH Rosenquist , JR McCoy , K Waldo & ML Kirby (1988) Origin and propagation of elastogenesis in the cardiovascular system. Anatomical Record 221, 860871.

JA Woods , JM Davis , JA Smith & DC Nieman (1999) Exercise and innate immune function. Medicine and Science in Sports and Exercise 31, 5766.

TH Rosenquist , SA Ratashak & J Selhub (1996) Homocysteine induces congenital heart and neural tube defects. Effect of folic acid. Proceedings of the National Academy of Sciences USA 93, 1522715232.

MJ Seller & NC Nevin (1984) Periconceptional vitamin supplementation and the prevention of neural tube defects in South-East England and Northern Ireland. Journal of Medical Genetics 21, 325330.

GM Shaw , CD O'Malley , CR Wasserman , MM Tolarova & EJ Lammer (1995) Maternal periconceptional use of multivitamins and reduced risk for conotruncal heart defects and limb deficiencies among offspring. American Journal of Medical Genetics 59, 536545.

GM Shaw , R Rozen , RH Finnell , K Todoroff & EJ Lammer (1998) Infant C677T mutation in MTHFR, maternal periconceptional vitamin use, and cleft lip. American Journal of Medical Genetics 80, 196198.

GM Shaw , K Todoroff , RH Finnell , R Rozen & EJ Lammer (1999) Maternal vitamin use, infant C677T mutation in MTHFR, and isolated cleft palate risk (letter). American Journal of Medical Genetics 85, 8485.

MC Speer , J Nye , D McLone , G Worley , EC Melvin , KD Viles , A Franklin , C Drake , J Mackey , & TM George (1999) Possible interaction of genotypes at cystathionine beta-synthase and methylenetetrahydrofolate reductase (MTHFR) in neural tube defects. NTD Collaborative Group. Clinical Genetics 56, 142144.

MC Speer , G Worley , JF Mackey , E Melvin , WJ Oakes & TM George (1997) The NTD Collaborative Group. The thermolabile variant of methylenetetrahydrofolate reductase (MTHFR) is not a major risk factor for neural tube defect in American Caucasians. Neurogenetics 1, 149150.

RP Steegers-Theunissen , GH Boers , HJ Blom , JG Nijhuis , CM Thomas , GF Borm & TK Eskes (1995) Neural tube defects and elevated homocysteine levels in amniotic fluid. American Journal of Obstetrics and Gynecology 172, 14361441.

RP Steegers-Theunissen , GH Boers , FJ Trijbels , JD Finkelstein , HJ Blom , CM Thomas , GF Borm , MG Wouters & TK Eskes (1994) Maternal hyperhomocysteinemia: a risk factor for neural-tube defects? Metabolism: Clinical and Experimental 43, 14751480.

MT Steen , AM Boddie , AJ Fisher , W Macmahon , D Saxe , KM Sullivan , PP Dembure & LJ Elsas (1998) Neural-tube defects are associated with low concentrations of cobalamin (vitamin B12) in amniotic fluid. Prenatal Diagnosis 18, 545555.

SL Thieszen , M Dalton , PF Gadson , E Patterson & TH Rosenquist (1996) Embryonic lineage of vascular smooth muscle cells determines responses to collagen matrices and integrin receptor expression. Experimental Cell Research 227, 135145.

SL Thieszen & TH Rosenquist (1995) Developmental regulation of decorin and collagen: implications for matrix pattern formation. Matrix Biology 14, 573582.

D Uberti , M Belloni , M Grilli , P Spano & M Memo (1998) Induction of tumour-suppressor phosphoprotein p53 in the apoptosis of cultured rat cerebellar neurones triggered by excitatory amino acids. European Journal of Neuroscience 10, 246254.

NM van der Put , RP Steegers-Theunissen , P Frosst , FJ Trijbels , TK Eskes , LP van den Heuvel , EC Mariman , M den Heyer , R Rozen & HJ Blom (1995) Mutated methylenetetrahydrofolate reductase as a risk factor for spina bifida. Lancet 346, 10701071.

NM van der Put , CM Thomas , TK Eskes , FJ Trijbels , RP Steegers-Theunissen , EC Mariman , A de Graaf Hess , JA Smeitink & HJ Blom (1997) Altered folate and vitamin B12 metabolism in families with spina bifida offspring. Quarterly Journal of Medicine 90, 505510.

NJ Wald , AD Hackshaw , R Stone & NA Sourial (1996) Blood folic acid and vitamin B12 in relation to neural tube defects. British Journal of Obstetric Gynecology 103, 319324.

C Wang , WF Pralong , MF Schulz , G Rougon , JM Aubry , S Pagliusi , A Robert & JZ Kiss (1996) Functional N-methyl-D-asparate receptors in O-2A glial precursor cells: a critical role in regulating polysialic acid-neural cell adhesion molecule expression and cell migration. Journal of Cell Biology 135, 15651581.

M Weil , MD Jacobson & MC Ratt (1997) Is programmed cell death required for neural tube closure? Current Biology 7, 281284.

A Wenzel , JM Fritschy , H Mohler & D Benke (1997) NMDA receptor heterogeneity during postnatal development of the rat brain: differential expression of the NR2A, NR2B, and NR2C subunit proteins. Journal of Neurochemistry 68, 469478.

A Wilson , R Platt , Q Wu , D Leclerc , B Christensen , H Yang , RA Gravel & RA Rozen (1999) Common variant in methionine synthase reductase combined with low cobalamin (vitamin B12) increases risk for spina bifida. Molecular Genetics Metabolism 67, 317323.

A Winkler , B Mahal , K Kiianmaa , W Zieglgansberger & R Spanagel (1999) Effects of chronic alcohol consumption on the expression of different NR1 splice variants in the brain of AA and ANA lines of rats. Brain Research 72, 166175.

MW Wood , HM VanDongen & AM VanDongen (1999) A mutation in the glycine binding pocket of the N-methyl-d-aspartate receptor NR1 subunit alters agonist efficacy. Brain Research 73, 189192.

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