||1R01CA227122-01A1 Interpret this number
||Univ Of North Carolina Chapel Hill
||Physical Activity, Sedentary Behavior, and Cancer Incidence in Women
In the United States in 2016, an estimated 600,000 people will die from cancer and 1.7 million new cases of
cancer will be diagnosed. Considering the life span, almost 40% of women and men will be diagnosed with
cancer at some point in their lifetime. Understanding amenable risk factors that contribute to this large public
health burden is essential. Observational studies consistently indicate associations between self-reported
physical activity and increased risk of many types of cancer, especially breast cancer. However, there is
insufficient evidence regarding the amount, intensity, duration, and types of physical activity required to reduce
cancer risk, especially for older women. Sedentary behavior may provide a more feasible intervention target,
especially for older adults. However, even less is known about sedentary behavior and cancer risk. To date,
no prospective studies have examined accelerometry-derived physical activity and sedentary behavior to risk
of incident cancer outcomes. Advances have been made in new measurement methods by our team, but have
not been applied to health outcomes to assess their value. In this application, we propose to assemble
accelerometry-assessed physical activity and sedentary behavior and cancer incident events and deaths from
two cohort studies of women: the Women's Health Study (WHS) and the Women's Health Initiative (WHI)
Study. We will apply sophisticated, yet directly interpretable, methods to determine which physical activity and
sedentary behavior features are most important for reducing cancer risk among more than 22,000 women 63
to 101 years of age. For both cohorts, one-week of accelerometry data were collected in a similar manner
during 2011-2014. Follow-up of both cohorts for adjudicated cancer outcomes is planned through 2020 and
likely beyond. We propose three aims. Aim 1 will apply novel and translational measures of accelerometry-
assessed physical activity and sedentary behavior using latent class analysis, an activity index, and machine
learning algorithms of raw accelerometry data for use in Aims 2 and 3. We will then investigate the association
of accelerometry-assessed physical activity (Aim 2) and sedentary behavior (Aim 3) to overall and site-specific
(e.g., breast, uterine, ovarian) incident and fatal cancer. This cost-efficient study will investigate in detail
whether and how patterns of frequency, duration, intensity, bouts, and type of physical activity and sedentary
behavior predict cancer outcomes. Identification of new cancer-protective patterns of physical activity and
sedentary behavior will provide much-needed evidence to inform physical activity and sedentary behavior
guidelines for disease prevention, can be used in interventions to reduce risk, and could revolutionize the
monitoring of human responses in physical activity and sedentary behavior interventions.
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