Objectives:There is strong evidence that not enough physical activity is among the most critical risk factors for cancer disease and premature mortality. The literature on the benefits of regular physical activity regarding cancer disease has grown in the last decades. This review aimed to present the current findings on the effect of prediagnosis physical activity on cancer incidence and mortality published between January 2019 and October 2024; this study summarizes the previous evidence, as well as the literature underlying biological mechanisms operating in the exercise–cancer relationship. The review also highlights gaps in the existing research and identifies future research directions.Methods:Medline/PubMed, ScienceDirect, and Google Scholar were searched with the search terms “physical activity” and “physical exercise” in conjunction with the MeSH terms for “cancer” and “carcinoma”. Primary, review, and meta-analysis studies published in English were included if they reported a measure of the effect size of prediagnosis physical activity on cancer incidence and/or cancer mortality.Results:Evidence from 37 observational studies and 10 reviews were included in this systematic review; 22 studies reported the effect of physical activity on cancer incidence, and 15 studies on cancer mortality. Of the 37 included observational studies, 19 confirmed the previous evidence that physical activity significantly decreased all-cancer-combined and cancer-specific site incidences, and 10 studies focused on cancer mortality. However, the molecular mechanisms involved in this process require future studies. The most convincing evidence maintains the effects of physical activity on body weight and fat, insulin resistance, sex hormones, regulation of redox homeostasis, enhancing the antioxidant defense system, and reducing oxidative stress.Conclusions:These data demonstrate substantial prevention against several cancer incidences and mortality among patients who performed regular physical activity, of which dose meets at least the WHO’s guidelines. Further prospective cohort studies and long-term RCT studies are warranted to address a safe and personalized activity dose for cancer-site prevention, identify more precisely the biological mechanisms operating in the physical activity–cancer relationship, and promote the benefits of being physically active.
目的：有充分证据表明，体力活动不足是癌症疾病和过早死亡的最关键风险因素之一。过去几十年间，关于规律体力活动对癌症益处的文献不断增长。本综述旨在呈现2019年1月至2024年10月期间发表的关于诊断前体力活动对癌症发病率和死亡率影响的最新研究结果，总结既往证据以及运动-癌症关系中生物学机制的相关文献，同时指出现有研究的不足并明确未来研究方向。 方法：通过Medline/PubMed、ScienceDirect和Google Scholar数据库，以"体力活动"和"体育锻炼"结合"癌症"和"癌"的MeSH术语进行检索。纳入标准为：以英文发表、报告诊断前体力活动对癌症发病率和/或死亡率效应量测量值的原始研究、综述及荟萃分析。 结果：本系统综述共纳入37项观察性研究和10篇综述，其中22项研究报道体力活动对癌症发病率的影响，15项研究关注癌症死亡率。在37项观察性研究中，19项证实了既往证据，即体力活动显著降低全癌合并及特定部位癌症发病率，10项研究聚焦癌症死亡率。然而，该过程涉及的分子机制仍需未来研究。最具说服力的证据表明体力活动通过影响体重与体脂、胰岛素抵抗、性激素水平、调节氧化还原稳态、增强抗氧化防御系统及降低氧化应激等途径发挥作用。 结论：这些数据表明，达到世界卫生组织指南最低标准的规律体力活动对多种癌症发病率和死亡率具有显著预防作用。未来需开展前瞻性队列研究和长期随机对照试验，以确定针对特定部位癌症的安全个性化活动剂量，更精确地阐明体力活动-癌症关系中的生物学机制，并推广体力活动的健康效益。
Physical Activity and Cancer Incidence and Mortality: Current Evidence and Biological Mechanisms
肿瘤(癌症)患者之家