Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer

Long H Nguyen^{1

2}, Po-Hong Liu², Xiaobin Zheng^{3

4}, NaNa Keum^{5

6}, Xiaoyu Zong³, Xiao Li³, Kana Wu⁵, Charles S Fuchs⁷, Shuji Ogino^{8

9

10}, Kimmie Ng¹¹, Walter C Willett^{5

8

12}, Andrew T Chan^{1

2

10

13

14}, Edward L Giovannucci^{5

8}, Yin Cao^{3

15}

Affiliations

¹ Division of Gastroenterology.
² Division of Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
³ Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO.
⁴ Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases XBZ and Department of Colorectal Surgery XBZ, the Six Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China.
⁵ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
⁶ Department of Food Science and Biotechnology, Dongguk University, Goyang, Republic of Korea.
⁷ Yale Cancer Center, New Haven, CT.
⁸ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
⁹ Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
¹⁰ Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (SO, ELG).
¹¹ Broad Institute of MIT and Harvard, Cambridge, MA.
¹² Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
¹³ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
¹⁴ Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA.
¹⁵ Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.

PMID: 30740587
PMCID: PMC6361621
DOI: 10.1093/jncics/pky073

Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer

Long H Nguyen et al. JNCI Cancer Spectr. 2018 Nov.

. 2018 Nov;2(4):pky073.

doi: 10.1093/jncics/pky073. Epub 2019 Jan 25.

Authors

Affiliations

¹ Division of Gastroenterology.
² Division of Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
³ Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO.
⁴ Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases XBZ and Department of Colorectal Surgery XBZ, the Six Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China.
⁵ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
⁶ Department of Food Science and Biotechnology, Dongguk University, Goyang, Republic of Korea.
⁷ Yale Cancer Center, New Haven, CT.
⁸ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
⁹ Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
¹⁰ Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (SO, ELG).
¹¹ Broad Institute of MIT and Harvard, Cambridge, MA.
¹² Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
¹³ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
¹⁴ Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA.
¹⁵ Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.

PMID: 30740587
PMCID: PMC6361621
DOI: 10.1093/jncics/pky073

Abstract

Background: Colorectal cancer (CRC) diagnosed before age 50 years, or young-onset CRC, is increasing globally with undefined etiology. A sedentary lifestyle is an emerging risk factor for CRC after age 50 years, but its role in young-onset CRC is unknown.

Methods: We prospectively evaluated sedentary behaviors, primarily time watching television (TV), and risk of young-onset CRC among 89 278 women in the Nurses' Health Study II ages 25-42 years at recruitment (1991-2011). We used Cox proportional hazards modelling to estimate relative risks (RR) and 95% confidence intervals (CIs). Statistical tests were two-sided.

Results: We documented 118 young-onset CRCs over 1 262 540 person-years. Sedentary TV viewing time was statistically significantly associated with increased risk of young-onset CRC, after adjusting for putative risk factors, including obesity and physical activity. Compared 7 hours, women with 7.1-14 hours per week of TV time had a multivariable relative risk (RR) of 1.12 (95% confidence interval [CI] = 0.72 to 1.75), further increased for greater than14 hours per week (RR = 1.69, 95% CI = 1.07 to 2.67, P _trend = .03). This association was observed among participants without a CRC family history and was more pronounced for rectal cancer (RR for >14 vs <7 hours per week 2.44, 95% CI = 1.03 to 5.78, P _trend = .04). Overweight or obese participants may be more susceptible.

Conclusion: Independent of exercise and obesity, prolonged sedentary TV viewing time, a surrogate for a more inactive lifestyle, was associated with increased risk of young-onset CRC, particularly of the rectum. These findings provide further evidence on the importance of maintaining an active lifestyle.

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Figures

**Figure 1.**
Subgroup analyses of sedentary TV viewing time and risk of young-onset CRC diagnosed prior to age 50 years. BMI = body mass index; MET = metabolic equivalent of tasks; CI = confidence interval; RR = relative risk. *RR was for the comparison of >14 versus 0-7 hours per week of sedentary TV viewing time; was adjusted for the same set of covariates as denoted in model 3 of Table 2 with the exception of each strata-defining covariate. †Calculated using the median of each sedentary behavior category as a continuous variable. ‡Calculated using log likelihood ratio test.

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Comment in

Does as Little as Two Hours a Day of Television Viewing Increase the Risk of Young-Onset Colorectal Cancer?
Vardy J, Kay S, Turner J, van der Ploeg HP. Vardy J, et al. JNCI Cancer Spectr. 2019 Jan 25;2(4):pky074. doi: 10.1093/jncics/pky074. eCollection 2018 Oct. JNCI Cancer Spectr. 2019. PMID: 31360887 Free PMC article. No abstract available.

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Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer

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Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer

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