Christina C. Dahm

Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Krasimira Aleksandrova, Nutrition, Immunity and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany., Germany
  • Mazda Jenab, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Michael Leitzmann, Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany., Germany
  • Bas Bueno-de-Mesquita, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia., National Institute for Public Health and the Environment (RIVM), Bilthoven, Department of Gastroentorology and Hepatology, University Medical Center, Utrecht, Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK., Netherlands
  • Rudolf Kaaks, Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany., Germany
  • Antonia Trichopoulou, WHO Collaborating Center for Nutrition and Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens (NKUA), Athens, Greece., Hellenic Health Foundation, Athens, Greece., Greece
  • Christina Bamia, WHO Collaborating Center for Nutrition and Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens (NKUA), Athens, Greece., Hellenic Health Foundation, Athens, Greece., Greece
  • Pagona Lagiou, Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA., Hellenic Health Foundation, Athens, Greece., Greece
  • Sabina Rinaldi, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Heinz Freisling, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Marion Carayol, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Tobias Pischon, Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine (MDC), Berlin-Buch, Germany., Germany
  • Dagmar Drogan, Quality and Health Services Research Unit, AOK Research Institute, Berlin, Germany., Germany
  • Elisabete Weiderpass, Genetic Epidemiology Group, Folkhalsan Research Center, Helsinki, Finland., Department of Community Medicine, Faculty of Medicine, University of Tromsø, Department of Research, Cancer Registry of Norway, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden, Norway
  • Paula Jakszyn, Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain., Spain
  • Kim Overvad
  • Christina C Dahm
  • Anne Tjønneland, Danish Cancer Society, Denmark
  • Marie-Christine Bouton-Ruault, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France [3] IGR, F-94805 Villejuif, France., France
  • Tilman Kühn, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany., Germany
  • Eleni Peppa, Hellenic Health Foundation, Athens, Greece., Greece
  • Elissavet Valanou, Hellenic Health Foundation, Athens, Greece., Greece
  • Carlo La Vecchia, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy., Hellenic Health Foundation, Athens, Greece., Greece
  • Domenico Palli, Molecular and Nutritional Epidemiology Unit, ISPO, Cancer Prevention and Research Institute, Florence, Italy., Italy
  • Salvatore Panico, Department of Clinical and Experimental Medicine, Federico II University, via Pansini 5, 80131 Naples, Italy., Italy
  • Carlotta Sacerdote, Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy., Italy
  • Claudia Agnoli, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
  • ,
  • Rosario Tumino, Civic-M.P. Arezzo Hospital, Italy
  • Anne May, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands., Netherlands
  • Jonna van Vulpen, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands., Netherlands
  • Kristin Benjaminsen Borch, Department of Community Medicine, University of Tromsø, Tromsø, Norway., Norway
  • Sunday Oluwafemi Oyeyemi, Department of Community Medicine, University of Tromsø, Tromsø, Norway., Norway
  • J Ramón Quirós, Consejería de Sanidad, Public Health Directorate, Oviedo-Asturias, Spain., Spain
  • Catalina Bonet, Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain., Spain
  • María-José Sánchez, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER- CIBERESP), 28029 Madrid, Spain., Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Spain
  • Miren Dorronsoro, 1] Public Health Division of Gipuzkoa-BIODonostia Research Institute, Basque Regional Health Department, 20013 San Sebastian, Spain [2] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain., Spain
  • Carmen Navarro, Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain., CIBERESP, Consortium for Biomedical Research in Epidemiology and Public Health, Spain
  • Aurelio Barricarte, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain., CIBERESP, Consortium for Biomedical Research in Epidemiology and Public Health, Navarre Public Health Institute, Pamplona, Spain., Spain
  • Bethany van Guelpen, Umeå University, Sweden
  • Patrik Wennberg, Department of Public Health and Clinical Medicine, Unit of Family Medicine, Umeå University, Umeå, 90185, Sweden., Sweden
  • Timothy J Key, Nuffield Department of Population Health, University of Oxford, Oxford, UK., United Kingdom
  • Kay-Tee Khaw, University of Cambridge, United Kingdom
  • Nicholas Wareham, MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, PO Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom., United Kingdom
  • Nada Assi, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Heather A Ward, Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK., United Kingdom
  • Dagfinn Aune, Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK., United Kingdom
  • Elio Riboli, Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK., United Kingdom
  • Heiner Boeing, Department of Epidemiology, German Institute of Human Nutrition (DIfE) 14558 Potsdam-Rehbrücke, Nuthetal, Germany., Germany

Background: There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer.

Methods: We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline.

Results: High physical activity was associated with a lower risk of colon cancer: relative risk ≥91 MET-h/week vs <91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively.

Conclusions: Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.

Original languageEnglish
JournalInternational Journal of Epidemiology
Volume46
Issue6
Pages (from-to)1823-1835
Number of pages13
ISSN0300-5771
DOIs
Publication statusPublished - 1 Dec 2017

    Research areas

  • Journal Article, physical activity, adiposity, biomarkers, colon cancer, mediating factors

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