Associations between Physical Activity and Incidence of Cancer among Overweight Adults in Korea: Results from the Health Examinees-G Study

Abstract

Although the protective effects of physical activity against several cancers are well established, evidence is inconsistent concerning Asian populations. Therefore, we assessed the association between the characteristics of physical activity and overall and type-specific cancer incidence in Koreans and examined the differences in association according to obesity status. Using prospective data from 112,108 parti-cipants in the Health Examinees study-G from 2004 to 2013, we evaluated the association between leisure-time physical activity (LTPA) and the incidence of overall and type -specific cancers using the Cox proportional hazards model. Self-reported LTPA participation, duration per week, inten-sity, type, and diversity were assessed. The incidence of overall and type-specific cancers, including colorectal, gas-tric, lung, breast, and prostate cancer and 13 obesity-related cancers, was identified using the Korea Central Cancer Registry from 1999 to 2018. Analyses were also stratified according to obesity status. In overweight males, participa-tion in vigorous LTPA [HR, 0.84; 95% confidence interval (CI), 0.72-0.97] and walking (HR, 0.84; 95% CI, 0.72-0.98) were associated with a lower risk of cancer overall. Regarding cancer types, climbing was marginally associated with a lower risk of colorectal cancer in overweight males (HR, 0.61; 95% CI, 0.37-1.00). In normal-weight females, although there was an increased risk in those performing recreational activities, this risk was attenuated when those diagnosed with thyroid cancer were excluded. In the analysis for 13 obesity-related cancers, consistent associations were found. These findings suggest the need for greater public awareness regarding physical activity among overweight individuals within the Asian population. Prevention Relevance: Overall cancer risk is associated with leisure-time physical activity such as duration, intensity, type, and diversity in overweight males, but not in the general population. The decreased risk was most noticeable for colorectal cancer. Our results suggest that physical activity may reduce the risk of cancer among overweight Asian males.