Home LiteratureArticle Details
PMID: 8740738 Published · ppublish English Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Physical activity, obesity, and risk of colorectal adenoma in women (United States).

Cancer causes & control : CCC ·Vol. 7 ·No. 2 ·1996-03-00 ·Pages 253-63

Giovannucci E, Colditz GA, Stampfer MJ, Willett WC

Abstract

The relationship between physical inactivity, body mass index (BMI) (wt[kg]/ht[m]2), and pattern of adipose distribution with risk of colorectal adenomas (precursors of cancer) was examined in 13,057 female nurses in the United States, 40 to 65 years of age in 1986, who had an endoscopy between 1986 and 1992. From 1986 to 1992, 439 participants were newly diagnosed with adenomas of the distal colorectum. After controlling for age, prior endoscopy, parental history of colorectal cancer, smoking, aspirin, and intakes of animal fat, dietary fiber, folate, methionine, and alcohol, physical activity was associated inversely with risk of large (> or = 1 cm) adenomas in the distal colon (relative risk [RR] = 0.57, 95 percent confidence interval [CI] = 0.30-1.08, comparing high and low quintiles of average weekly energy expenditure from leisure-time activities; P trend = 0.05). Much of the benefit came from activities of moderate intensity such as brisk walking. In addition, BMI was associated directly with risk of large adenomas in the distal colon (multivariate RR = 2.21 [CI = 1.18-4.16], P trend = 0.0001, for BMI > or = 29 cf < 21 kg/m2). Waist circumference and the waist-to-hip ratio (WHR) were not related significantly to adenoma independently of BMI, but women with both a high BMI and high WHR were at greater risk of large colon adenoma (multivariate RR = 1.99, CI = 0.98-4.05) than women with high BMI but relatively low WHR (multivariate RR = 1.35, CI = 0.61-2.97). BMI was not related to small (< 1 cm) adenoma risk but physical activity had an inverse association with small adenomas in the distal colon (multivariate RR = 0.68, CI = 0.40-1.15, P trend = 0.03). The relationships between BMI or physical activity were considerably weaker and inconsistent for rectal adenomas. These results, in women, support an inverse association between physical activity and occurrence or progression of adenomas in the distal colon; obesity is associated with an elevated risk of large adenomas.

MeSH Terms
Adenoma/epidemiology Adult Body Mass Index Cohort Studies Colorectal Neoplasms/epidemiology Exercise Female Humans Middle Aged Obesity Precancerous Conditions/epidemiology Prospective Studies Risk Factors Surveys and Questionnaires United States/epidemiology
Authors & Affiliations
4 authors, click to expand affiliations / ORCID
Giovannucci E
Department of Medicine, Harvard Medical School, Boston, MA, USA.
Colditz G A
Stampfer M J
Willett W C
References (82)
82 references, click to expand
  1. Are cell number and cell proliferation risk factors for cancer?
    J Natl Cancer Inst. 1988 Jul 20;80(10):772-4 PMID: 3385783
  2. Risk factors for fatal colon cancer in a large prospective study.
    J Natl Cancer Inst. 1992 Oct 7;84(19):1491-500 PMID: 1433333
  3. Diet, physical activity, and colorectal cancer among Chinese in North America and China.
    J Natl Cancer Inst. 1990 Jun 6;82(11):915-26 PMID: 2342126
  4. Increased risk of 'high-risk' colorectal adenomas in overweight men.
    Gastroenterology. 1993 Jan;104(1):137-44 PMID: 8419236
  5. Validity of self-reported waist and hip circumferences in men and women.
    Epidemiology. 1990 Nov;1(6):466-73 PMID: 2090285
  6. The association of body size and large bowel cancer risk in Wisconsin (United States) women.
    Cancer Causes Control. 1995 Jan;6(1):30-6 PMID: 7718733
  7. Sex differences in colonic function: a randomised trial.
    Gut. 1993 Apr;34(4):531-6 PMID: 8387940
  8. Validation of the physical activity instrument for the Life in New Zealand national survey.
    Am J Epidemiol. 1991 Jan;133(1):73-82 PMID: 1983901
  9. Relation of body fat distribution to metabolic complications of obesity.
    J Clin Endocrinol Metab. 1982 Feb;54(2):254-60 PMID: 7033275
  10. Dietary epidemiology of cancer of the colon in western New York.
    Am J Epidemiol. 1988 Sep;128(3):490-503 PMID: 2843038
  11. Relationship between habitual physical activity and insulin levels among nondiabetic men and women. San Luis Valley Diabetes Study.
    Diabetes Care. 1991 Nov;14(11):1066-74 PMID: 1797488
  12. Sedentary jobs and colon cancer.
    Am J Epidemiol. 1986 May;123(5):775-80 PMID: 3962961
  13. Occupational physical activity and risk of cancer of the colon and rectum in New Zealand males.
    Cancer Causes Control. 1993 Jan;4(1):45-50 PMID: 8431530
  14. Reproducibility and validity of a self-administered physical activity questionnaire.
    Int J Epidemiol. 1994 Oct;23(5):991-9 PMID: 7860180
  15. Dietary fat and the risk of breast cancer.
    N Engl J Med. 1987 Jan 1;316(1):22-8 PMID: 3785347
  16. Does physical exercise influence bowel transit time in healthy young men?
    Am J Gastroenterol. 1992 Mar;87(3):292-5 PMID: 1539562
  17. A case-control study of physical activity in relation to risk of cancer of the right colon and rectum in men.
    Int J Epidemiol. 1995 Feb;24(1):42-50 PMID: 7797355
  18. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935.
    N Engl J Med. 1992 Nov 5;327(19):1350-5 PMID: 1406836
  19. Colon cancer, physical activity, and occupational exposures. A case-control study.
    Cancer. 1989 May 1;63(9):1838-42 PMID: 2702592
  20. Height, weight and mortality. The Norwegian experience.
    Acta Med Scand Suppl. 1984;679:1-56 PMID: 6585126
  21. Physical activity, diet, and risk of colon cancer in Utah.
    Am J Epidemiol. 1988 Nov;128(5):989-99 PMID: 3189298
  22. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men.
    Lancet. 1985 Feb 9;1(8424):307-9 PMID: 2857364
  23. Body mass index as a predictor of cancer in men.
    J Natl Cancer Inst. 1985 Feb;74(2):319-23 PMID: 3856045
  24. Obesity and adenomatous polyps of the sigmoid colon.
    Jpn J Cancer Res. 1994 May;85(5):479-84 PMID: 8014105
  25. Obesity and colorectal adenomatous polyps.
    J Natl Cancer Inst. 1991 Mar 6;83(5):359-61 PMID: 1995919
  26. Compendium of physical activities: classification of energy costs of human physical activities.
    Med Sci Sports Exerc. 1993 Jan;25(1):71-80 PMID: 8292105
  27. Effect of exercise and physical fitness on large intestinal function.
    Gastroenterology. 1989 Dec;97(6):1389-99 PMID: 2583406
  28. The relations of alcoholic beverage use to colon and rectal cancer.
    Am J Epidemiol. 1988 Nov;128(5):1007-15 PMID: 3189277
  29. Dietary intake and colon cancer: sex- and anatomic site-specific associations.
    Am J Epidemiol. 1989 Nov;130(5):883-94 PMID: 2554725
  30. Body weight and physical activity as predictors of colorectal cancer risk.
    Nutr Cancer. 1990;13(1-2):9-17 PMID: 2300499
  31. Dietary relationships with fatal colorectal cancer among Seventh-Day Adventists.
    J Natl Cancer Inst. 1985 Feb;74(2):307-17 PMID: 3856044
  32. Physical activity, obesity, and risk for colon cancer and adenoma in men.
    Ann Intern Med. 1995 Mar 1;122(5):327-34 PMID: 7847643
  33. Lifetime occupational exercise and colon cancer.
    Am J Epidemiol. 1985 Sep;122(3):357-65 PMID: 4025286
  34. Obesity in youth and middle age and risk of colorectal cancer in men.
    Cancer Causes Control. 1992 Jul;3(4):349-54 PMID: 1617122
  35. Colorectal adenomas and diet: a case-control study of subjects participating in the Nottingham faecal occult blood screening programme.
    Br J Cancer. 1993 Jan;67(1):177-84 PMID: 8381298
  36. Influence of caloric restriction and exercise on tumorigenesis in rats.
    Proc Soc Exp Biol Med. 1990 Jan;193(1):35-8 PMID: 2104673
  37. Growth-regulatory effects of sensory neuropeptides, epidermal growth factor, insulin, and somatostatin on the non-transformed intestinal epithelial cell line IEC-6 and the colon cancer cell line HT 29.
    Scand J Gastroenterol. 1993 Oct;28(10):879-84 PMID: 7505479
  38. A prospective analysis of physical activity and cancer.
    Am J Epidemiol. 1989 Sep;130(3):522-9 PMID: 2763997
  39. Physical activity and incidence of cancer in diverse populations: a preliminary report.
    Am J Clin Nutr. 1987 Jan;45(1 Suppl):312-7 PMID: 3799521
  40. Physical activity and colon cancer: a case-referent study in Stockholm.
    Int J Cancer. 1990 Dec 15;46(6):985-9 PMID: 2249904
  41. Test of the National Death Index.
    Am J Epidemiol. 1984 May;119(5):837-9 PMID: 6720679
  42. Physical activity and risk of developing colorectal cancer among college alumni.
    J Natl Cancer Inst. 1991 Sep 18;83(18):1324-9 PMID: 1886158
  43. Use of surveillance systems for occupational cancer: data from the Danish National system.
    Int J Epidemiol. 1988 Sep;17(3):493-500 PMID: 3209325
  44. Gastrointestinal problems in the old. I.
    Br Med J. 1974 Jan 19;1(5898):107-10 PMID: 4520577
  45. A prospective study of body mass, height, and smoking on the risk of colorectal cancer in women.
    Cancer Causes Control. 1991 Mar;2(2):117-24 PMID: 1873436
  46. Occupational exercise and risk of cancer.
    Am J Clin Nutr. 1987 Jan;45(1 Suppl):318-27 PMID: 3799522
  47. The evolution of cancer of the colon and rectum.
    Cancer. 1975 Dec;36(6):2251-70 PMID: 1203876
  48. Folate, methionine, and alcohol intake and risk of colorectal adenoma.
    J Natl Cancer Inst. 1993 Jun 2;85(11):875-84 PMID: 8492316
  49. Physical activity, dietary habits and adenomatous polyps of the sigmoid colon: a study of self-defense officials in Japan.
    J Clin Epidemiol. 1991;44(11):1255-61 PMID: 1941019
  50. Bowel habit in older people.
    Gerontol Clin (Basel). 1972;14(1):56-60 PMID: 5018707
  51. Caloric restriction and 7,12-dimethylbenz(a)anthracene-induced mammary tumor growth in rats: alterations in circulating insulin, insulin-like growth factors I and II, and epidermal growth factor.
    Cancer Res. 1989 Aug 1;49(15):4130-4 PMID: 2501021
  52. Cigarette smoking, alcohol, and the risk of colorectal adenomas.
    Gastroenterology. 1993 May;104(5):1445-51 PMID: 8482454
  53. Reduction of enhanced mammary carcinogenesis in LA/N-cp (corpulent) rats by energy restriction.
    Proc Soc Exp Biol Med. 1991 Apr;196(4):381-4 PMID: 1901169
  54. Physical activity and risk of cancer in the NHANES I population.
    Am J Public Health. 1989 Jun;79(6):744-50 PMID: 2729471
  55. Central obesity and coronary heart disease in men.
    Lancet. 1987 Apr 11;1(8537):821-4 PMID: 2882231
  56. Association of diet and other factors with adenomatous polyps of the large bowel: a prospective autopsy study.
    Am J Clin Nutr. 1988 Feb;47(2):312-7 PMID: 3341261
  57. Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study.
    Br J Cancer. 1987 Jun;55(6):687-94 PMID: 3620314
  58. Physical activity and risk of large bowel cancer in the Framingham Study.
    Cancer Res. 1990 Jun 15;50(12):3610-3 PMID: 2340509
  59. Insulin and colon cancer.
    Cancer Causes Control. 1995 Mar;6(2):164-79 PMID: 7749056
  60. Measurement of the human intestinal length in vivo and some causes of variation.
    Gastroenterology. 1956 Sep;31(3):274-84 PMID: 13365837
  61. Diet, body mass and colorectal cancer: a case-referent study in Stockholm.
    Int J Cancer. 1990 Nov 15;46(5):832-8 PMID: 2172171
  62. A case-control study of occupational and dietary factors in colorectal cancer in young men by subsite.
    Cancer Res. 1989 Oct 1;49(19):5459-68 PMID: 2766308
  63. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution.
    J Clin Invest. 1983 Sep;72(3):1150-62 PMID: 6350364
  64. Physical activity and colon cancer risk.
    Int J Epidemiol. 1988 Dec;17(4):743-6 PMID: 3272134
  65. Insulin and insulin-like growth factor 1 stimulate proliferation of metastatic variants of colon carcinoma 26.
    Jpn J Cancer Res. 1989 Jan;80(1):51-8 PMID: 2540132
  66. Metabolic implications of body fat distribution.
    Diabetes Care. 1991 Dec;14(12):1132-43 PMID: 1773700
  67. Self-reported physical activity compared with maximal oxygen uptake.
    Am J Epidemiol. 1985 Jul;122(1):101-5 PMID: 4014188
  68. Influence of insulin on growth and metabolism of 7,12-dimethylbenz(alpha)anthracene-induced mammary tumors.
    Cancer Res. 1974 Dec;34(12):3245-52 PMID: 4279139
  69. Relationship between insulin and estrogen binding to growth response in 7,12-dimethylbenz(a)anthracene-induced rat mammary tumors.
    Cancer Res. 1978 Mar;38(3):759-64 PMID: 414834
  70. Effect of moderate exercise on bowel habit.
    Gut. 1991 Aug;32(8):941-4 PMID: 1885077
  71. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States).
    Cancer Causes Control. 1994 Jan;5(1):38-52 PMID: 8123778
  72. Colorectal cancer: the role of dietary fat and caloric restriction.
    Mutat Res. 1993 Nov;290(1):63-70 PMID: 7694100
  73. Relationship of body fat topography to insulin sensitivity and metabolic profiles in premenopausal women.
    Metabolism. 1984 Jan;33(1):68-75 PMID: 6361449
  74. Physical training and insulin sensitivity.
    Diabetes Metab Rev. 1986;1(4):445-81 PMID: 3522140
  75. Validation and comparison of eight physical activity questionnaires.
    Epidemiology. 1990 Jan;1(1):65-71 PMID: 2081242
  76. Characterization of the synergistic effect of insulin and transferrin and the regulation of their receptors on a human colon carcinoma cell line.
    Int J Cancer. 1990 Feb 15;45(2):372-5 PMID: 2406206
  77. A comparative case-control study of colorectal cancer and adenoma.
    Jpn J Cancer Res. 1990 Nov;81(11):1101-8 PMID: 2125036
  78. Diet, alcohol, and smoking and the occurrence of hyperplastic polyps of the colon and rectum (United States).
    Cancer Causes Control. 1995 Jan;6(1):45-56 PMID: 7718735
  79. Occupational risk of colon cancer. An analysis by anatomic subsite.
    Am J Epidemiol. 1989 Oct;130(4):675-87 PMID: 2773916
  80. College athletics, body size, and cancer mortality.
    Cancer. 1976 Jul;38(1):382-7 PMID: 947530
  81. Variations in mortality by weight among 750,000 men and women.
    J Chronic Dis. 1979;32(8):563-76 PMID: 468958
  82. Job activity and colon cancer risk.
    Am J Epidemiol. 1984 Jun;119(6):1005-14 PMID: 6731427
Article Info
Journal
Cancer causes & control : CCC
Abbr.
Cancer Causes Control
ISSN
0957-5243
DOI
10.1007/BF00051301
Published
1996-03-00
Pages
253-63
Language
English
Region
Netherlands
NLM ID
9100846
Subset
IM
Grants
NCI NIH HHS · CA 40935 · United States
NCI NIH HHS · CA 55075 · United States
External Links
PubMed source DOI: 10.1007/BF00051301 View journal details
Analysis Services
Analysis Services

Contact

No. 2 Wenbo Road, Zhangqiu District, Jinan, Shandong

Qilu Normal University · Genelibs Bioinformatics Lab

750 Shunhua Rd, Jinan

2F, Bldg F, University Science Park

Tel: 0531-88819269

WeChat Official Account

Follow our WeChat subscription account for real-time updates and the latest in medical and biological research.


Business Email

E-mail: product@genelibs.com

Copyright © 2026.Genelibs Jinan Honghui Biotechnology Co., Ltd. 鲁ICP备20007159号-2