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Abstract
Background: Colon cancer is among the leading causes of cancer mortality and its incidence is increasing worldwide. This
is true in spite of broad basic research into colon cancer while, concurrently, physical activity has been shown to offer
significant preventive potential. This background led to the formulation of the following research questions:
Why is physical activity so effective in decreasing the incidence of colon cancer?
Is there a common denominator to colon cancer and physical activity, which has a reciprocal function?
Knowing the potential for public health impact of physical activity on colon cancer, has physical activity-colon cancer
relationship been in the forefront of research efforts?
Methods: Content analysis of archival literature has been carried out on census of 32,822 message units, extracted from
the National Library of Medicine and its PubMed database. The following search terms were used: colon cancer, physical
activity, melatonin, age/genetics, diet (obesity, vitamin D, calcium), immunity/inflammation, and bioactive substances
incorporating insulin-like growth factor 1, interleukins, and prostaglandins. The research timeframe for each category began
with the first article published and ended with the last one printed in 2005.
Results/Conclusions: The effectiveness of physical activity in decreasing the incidence of colon cancer is likely the result
of its biologic activity within not one or two but all of the major known colon cancer etiologies, demonstrating a powerful
reciprocal relationship. Melatonin is identified as a plausible common denominator of colon cancer and physical activity.
The greatest volume of publications deals with colon cancer and genetics. A significant societal health care impact could
be achieved by adopting physical activity as a major cancer control strategy.
Keywords: colon cancer, physical activity, melatonin, exercise, content analysis
Introduction
The incidence of colon cancer is increasing worldwide. Ten million people developed colon cancer in
2000 and about five million died from this cancer. Many risk factors are known and include: diet, inadequate physical activity, obesity, alcohol consumption, and smoking, as well as family history and aging.
The most prominent among the etiologic factors are physical inactivity and obesity, which are strongly
and consistently associated with higher risk of colon cancer (Willer, 2003). Emmons et al. (2005) state
that colorectal cancer (CRC) is the fourth leading cause of cancer and the second leading cause of
cancer death in the United States.
A strong preventing influence of physical activity on colon cancer development has been well
documented in the literature. The mechanisms of action, however, have been mostly hypothesized
(Slattery et al. 1997; McTiernan et al. 1998; Thune and Furgber, 2001; Peters et al. 2001).
This study attempted to shed additional light on how and why a single preventive step, physical
activity, can be so highly effective in lowering colon cancer incidence. A search has also been made to
identify a plausible common denominator for colon cancer and physical activity that expresses reciprocal
relationship.
An archival literature research, through content analysis methodology, was chosen as the framework
for this study. The three-dimensionality of this study had the following parameters: the breadth
Correspondence: Ivo P. Janecka, M.D., M.B.A., Ph.D., 333 Westbrook Rd., St. Helena Island, SC 22920.
Email: Janecka@post.harvard.edu
Copyright in this article, its metadata, and any supplementary data is held by its author or authors. It is published under the
Creative Commons Attribution By licence. For further information go to: http://creativecommons.org/licenses/by/3.0/.
81
Janecka
Results
Physical activity was documented to exert its beneficial influence in all previously identified main
colon cancer etiologic categories. Physical activity
and colon cancer have a strong but reciprocal
mutual relationship. With decreasing physical
activity there is increasing incidence of colon
cancer and vice versa.
Melatonin was identified as a plausible common
denominator to colon cancer and physical activity
due to the fact that it takes an active but reciprocal
part in all colon cancer etiologic categories. It is
diminished during cancer development but its level
rises with moderate and strenuous physical
activity.
The numbers of publications identified are summarized in Figure 1. It illustrates that 10,047
articles were published on the topic of colon cancer and genetics but only 249 dealing with colon
cancer and physical activity. Similarly, only 243
articles were published addressing colon cancer
and obesity. The second highest volume of publications dealt with colon cancer and immunity.
Figure 2 highlights the fact that physical activity
takes part in all colon cancer etiologic categories.
Under positive influence of physical activity, these
82
Discussion
10000
8000
6000
4000
2000
Figure 1. Number of publications for search term combinations of colon cancer and etiologic categories including the first publication year.
Janecka
Figure 2. Number of publications for search term combinations of physical activity and its health benefits categories including the first
publication year.
Figure 3. Number of publications for search term combinations of colon cancer (CA) and etiologic categories, and physical activity (PA) and
its health benefits categories including the first publication year.
Note: Negligible numbers of articles for search terms CA-Transit time (85), PA-Transit time (68), CA-Hyperinsulinemia (52).
Janecka
Conclusions
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