Association of physical activity with cancer incidence, mortality, and survival: a population-based study of men

Within a population-based cohort study, 40 708 men aged 45-79 years followed from 1998 to 2004. After adjusting for potential confounders, we observed a strong inverse linear association between total daily physical activity (PA) and death from cancer (n = 1153). For each increment of 4 metabolic equivalent (MET)-h day(-1) of total PA (approximately 1 h daily of moderate effort) cancer incidence (n = 3714) tended to be decreased by 2% and cancer mortality decreased significantly by 12% (95% confidence interval 6-18%). The 5-year survival after cancer among those men in the top quartile of total PA (77%) was significantly higher compared to the lowest quartile (69%). Compared to those men who hardly ever walked or biked, walking or bicycling an average of 30 min day(-1) was associated with a 34% (18-47%) lower rate of cancer death and with improved cancer survival by 33% (14-47%). Incidence of cancer was 16% (2-28%) lower among those who walked or biked at least 60 min day(-1). Our results suggest that higher levels of PA and the main component of active living, walking or bicycling are associated with reduced cancer incidence and mortality, as well as higher cancer survival.