Exercise and Cancer Prevention: Current Evidence and Future Directions
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REVIEW ARTICLE
Exercise and Cancer Prevention: Current Evidence and Future Directions Lee W. Jones1,2 Received: 5 February 2020 / Accepted: 26 March 2020 © Beijing Sport University 2020
Abstract Establishment of the strong putative relationship between exercise and risk of virtually all non-communicable diseases prompted several research groups over the past two decades to investigate a question of significant public health concern: whether exercise lowers the risk of certain forms of cancer. In this Opinion review I first overview studies of exercise in cancer prevention summarizing evidence from observational studies and available clinical trials. In the final section, I consider the next steps in the continued development of exercise as a cancer prevention strategy. Keywords Cancer · Exercise · Oncology · Physical activity · Primary prevention
Introduction Cancer is now the leading cause of death and the single most important barrier to increasing life expectancy globally [17]. The global burden of cancer according to the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer (IARC) reports that a total of 18.1 million new cases of cancer and 9.6 million deaths from cancer occurred in 2018 [17]. Specific cancers dominate the global burden of cancer: lung, female breast, and colorectal cancer are responsible for one-third of all cancer diagnoses and mortality burden worldwide [17]. Of importance, recent estimates suggest that close to half of all new cancer diagnoses and over half of cancer deaths could be prevented or delayed in developed countries by eliminating or reducing exposure to ’genotoxic’ lifestyle and environmental exposures [2–6]. Indeed, using population-based historical estimates of (lifestyle) exposure prevalence, Canadian Population Attributable Risk of Cancer (ComPARe) project findings indicated that between 33 and 37% (up to 70,000 cases) of incident cancer cases among
* Lee W. Jones [email protected] 1
Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
Weill Cornell Medical College, New York, NY, USA
2
adults aged 30 years and over in 2015 were attributable to preventable risk factors in Canada [55]. This is most clearly illustrated by the profound deleterious consequences of tobacco smoking, alcohol consumption, and exposure to ultraviolet light. For instance, tobacco smoking is associated with at least 17 types of human cancer, responsible for an estimated six million deaths every year [1]. Tobacco smoke is a complex mixture of chemicals among which at least 60 are carcinogens. Reducing exposure to tobacco smoke has been the centerpiece of cancer prevention efforts for more than two decades however several recent reports indicate that obesity, the consequence of chronic excess energy consumption (i.e., excess nutrient intake) in the context of low energy expenditure (i.e., insufficient exercise), is expected to overtake smoking as the number one preventable cau
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