Physical activity, cardiometabolic diseases, and cancer risk: a prospective analysis

Purpose Whether physical activity is associated with the risk of cancer among adults with a cardiometabolic disease is not well understood. This study investigated associations between physical activity and cancer risk in adults with and without a history of cardiometabolic diseases (cardiovascular disease and/or type 2 diabetes). Methods We conducted a meta-analysis of individual participant data of 564,622 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. We excluded participants from these cohorts who had cancer, cardiovascular disease, or type 2 diabetes at baseline. Data on physical activity were assessed at baseline with self-reported validated questionnaires and modelled as metabolic equivalent task hours per week (MET-h/week). We used multivariable-adjusted Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between physical activity and the risk of physical activity-related cancers, with a multiplicative interaction between physical activity and time-varying cardiometabolic disease status. Results After a median of 11 years of follow-up, 28,345 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 (SD) increment of physical activity was associated with a lower risk of physical activity-related cancer, with HRs of 0.96 (95% CI: 0.95, 0.97) and 0.94 (95% CI: 0.90, 0.99) in adults without and in those with a cardiometabolic disease, respectively (p-interaction > 0.3). Conclusions The findings of this study among European adults suggest that higher physical activity is equally beneficial for cancer prevention in adults with and without underlying cardiometabolic diseases.