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Physical Activity in Relation to Cancer of the Colon and Rectum in a Cohort of Male Smokers¹

Division of Clinical Sciences, National Cancer Institute, NIH, Bethesda, Maryland 20892 [L. H. C., T. J. H., P. J. L., P. R. T., D. A.]; National Public Health Institute, FIN-00300 Helsinki, Finland [N. M., P. P., J. V.]

We examined the association between occupational and leisure physical activity and colorectal cancer in a cohort of male smokers. Among the 29,133 men aged 50–69 years in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention study, 152 colon and 104 rectal cancers were documented during up to 12 years of follow-up. For colon cancer, compared with sedentary workers, men in light occupational activity had a relative risk (RR) of 0.60 [95% confidence interval (CI), 0.34–1.04], whereas those in moderate/heavy activity had an RR of 0.45 (CI, 0.26–0.78; P for trend, 0.003). Subsite analysis revealed a significant association for moderate/heavy occupational activity in the distal colon (RR, 0.21; CI, 0.09–0.51) but not in the proximal colon (RR, 0.87; CI, 0.40–1.92). There was no significant association between leisure activity and colon cancer (active versus sedentary; RR, 0.82; CI, 0.59–1.13); however, the strongest inverse association was found among those most active in both work and leisure (RR, 0.33; CI, 0.16–0.71). For rectal cancer, there were risk reductions for those in light (RR, 0.71; CI, 0.36–1.37) and moderate/heavy occupational activity (RR, 0.50; CI, 0.26–0.97; P for trend, 0.04), and no association for leisure activity. These data provide evidence for a protective role of physical activity in colon and rectal cancer.

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