Combating cancer with physical activity

16 November 2018 | Cancer research

Dr Brigid Lynch is a Principal Fellow in the Cancer Epidemiology and Intelligence Division at Cancer Council Victoria. Here, she shares her thoughts on the 2018 International Society for Physical Activity and Health (ISPAH) Congress, which was held in London last month.

The biennial ISPAH Congress is always an exciting opportunity for physical activity researchers, practitioners and policymakers to share latest findings, best practice models and policy developments with peers from around the world. This year’s congress, which was co-hosted by Public Health England (PHE) and Sport England, and delivered with partner organisation the European Network for the promotion of Health-Enhancing Physical Activity (HEPA Europe), brought together more than 1,000 experts from over 60 countries. 

Having the World Health Organization (WHO) as the official congress co-sponsor reinforced the vital role that physical activity plays in combating non-communicable diseases (NCDs). The congress was the perfect forum to disseminate the recently launched WHO plan, More active people for a healthier world: the global action plan on physical activity 2018-2030This plan calls on all countries to scale up the promotion of physical activity, and provides updated guidance on effective and feasible policy actions to increase physical activity around a framework of four objectives: Active Societies; Active Environments; Active People; and Active Systems. This recommended ‘whole of system’ approach to increasing levels of physical activity across all ages and abilities requires bold leadership combined with cross-government and multisectoral partnerships. The challenge was embraced by ISPAH Congress delegates!

WCRF at ISPAH

World Cancer Research Fund’s (WCRF) Acting Director of Science and Public Affairs, Dr Giota Mitrou, spoke at a breakfast session hosted by ISPAH’s Sedentary Behaviour Council, “Evaluating the evidence on sedentary behaviour: examples from guideline committees”. Dr Mitrou discussed the processes implemented by WCRF’s Continuous Update Project (CUP), and specifically how the CUP Expert Panel evaluated and interpreted the evidence relating to sitting time and cancer. She was joined by Dr Rick Troiano, Programme Director in the Risk Factor Assessment Branch of the National Cancer Institute, and Tom Yates, Professor of Physical Activity, Sedentary Behaviour and Health from the University of Leicester. They discussed how the evidence pertaining to sitting time was evaluated for the physical activity guidelines being reviewed and revised by expert committees in the US and UK respectively.

My personal highlights

In terms of cancer research, there were numerous oral and poster presentations on the role of physical activity across the cancer continuum; from primary prevention through to improving health outcomes for long-term cancer survivors. Highlights, for me, included Alexander Mok from the University of Cambridge, who reported on the associations of ten year changes in physical activity with mortality (including cancer mortality) within the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk study. For each 1 kilojule/kilogram/day per year increase in physical activity energy expenditure over this period there was an 11 per cent lower risk for cancer mortality, and a 23 per cent lower risk for all-cause mortality. The good news, take-home message was that increasing physical activity in middle age, regardless of where adults are starting from, seems to increase longevity. 

The poster presentation by Dr Shahid Mahmood, of the University of Melbourne, demonstrated how the measurement error in self-reported estimates of physical activity can attenuate the risk estimates for disease; another key moment. Dr Mahmood’s work validated the International Physical Activity Questionnaire (short-form) against accelerometer-measured, moderate-vigorous physical activity. Using data from the Melbourne Collaborative Cohort Study, he demonstrated that there was a substantial change in colorectal cancer risk estimates after adjustment for the measurement error bias attributed to self-reporting. For participants reporting physical activity of 150 minutes per week versus no physical activity, the estimated risk reduction was 12 per cent without bias adjustment; after bias adjustment, the risk reduction was 48 per cent. This work suggests that the ‘true’ health benefits associated with physical activity may be substantially higher than is usually estimated using self-reported data. 

One final highlight was Dr Lisa Cadmus-Bertram (above), Assistant Professor of Kinesiology, Epidemiology from the University of Wisconsin-Madison, presenting data from a pilot trial of a wearable technology-based physical activity intervention for breast and colon cancer survivors. This trial demonstrated the feasibility of importing Fitbit data to electronic health records. If this successful trial protocol can be upscaled, it has enormous potential for integrating home-based physical activity interventions with oncology care. Dr Cadmus-Bertram’s ongoing work is exploring how wearable technology data within electronic health records can be utilised to provide clinical support for physical activity maintenance.

Brigid Lynch | 16 November 2018

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