br Table br Estimated proportion and numbers of cancer cases
Estimated proportion (%) and numbers of cancer cases attributable to insufficient physical activity in France in 2015, by sex, cancer site and reference.
a Proportion out of all cancer cases (excluding non-melanoma skin cancers). b Totals may differ because of rounding. c Half of the recommended level of physical activity in France.
estimate the effects of sedentary behaviour that includes very low-in-tensity activities. However, while there has been less research on se-dentary behaviour and cancer risk, there is accumulating evidence that sedentary behaviour is associated with an increased risk of several cancers [3,22] – something that should be considered in futures studies. Also, only the direct effect of insufficient physical activity on cancer occurrence was estimated in this study. Indirect effects, including mediation through co-factors such as obesity, may further increase our estimates. Fourth, the physical activity recommendations in the French Docetaxel were used to define the minimum risk exposure level, however this does not preclude that higher levels of total physical ac-tivity may provide additional optimum risk reduction for some cancer sites. Finally, the estimation of the PAF was based on the assumption that the association between insufficient physical activity and the stu-died cancer sites is causal . We thus assume that increasing physical activity at the population level would lead to a decline in the incidence of these cancers.
In conclusion, our study showed that insufficient physical activity is an important modifiable risk factor of cancer in France and further underpins the need for continuing targeted prevention efforts on the population level. In addition, lack of physical activity has also been causally associated with cardiovascular diseases, metabolic disorders, type 2 diabetes, depression and falls . As a result, the decrease in the prevalence of insufficiently active persons would also decrease the burden of these diseases .
MT, MA and IS contributed to data collection, study design, ana-lysis, and wrote the first draft of the paper. VD contributed to study design, data collection and finalising the report. LD, HF, FB and IM contributed to study design and drafting of the report. All authors read and approved the final report.
Role of the funding source
This work was funded by the French National Cancer Institute (INCa, grant nr. 2015-002). The funding source had no role in the collection, analysis or interpretation of the data or in the decision to submit the manuscript for publication.
Conflicts of interest statement
The authors would like to thank Catherine Hill from Institut Gustave Roussy (Villejuif) for critical input in several stages of the project and FRANCIM, Hospices Civils de Lyon and Florence de Maria (Santé Publique France) for the provision of the cancer data.
Appendix A. Supplementary data
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