August 09, 2018
3 min read

Public lacks awareness of link between physical activity, cancer risk

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Photo of Erika Waters 2018
Erika A. Waters

Few individuals reported being aware of the association between insufficient physical activity and increased risk for cancer, according to findings from a cross-sectional survey.

“To ensure that lay people understand the full impact of physical activity on their health, health communication researchers and practitioners should consider broadening their interventions to raise awareness that insufficient physical activity may increase the risk of not only cardiovascular diseases and diabetes, but many other diseases as well, and that increasing physical activity can improve overall health and well-being,” Erika A. Waters, PhD, MPH, associate professor of surgery in the department of surgery at Washington University School of Medicine in St. Louis, and colleagues wrote.

Poor physical activity has been a modifiable risk factor for several common diseases, including certain cancers and heart disease. Yet, little is known about the public’s knowledge of the association between inadequate physical activity and increased risk for poor health outcomes.

Research has indicated individuals from socio-demographically challenged populations experience high morbidity and mortality from diseases associated with lack of physical activity and tend to engage in physical activity at a lower rate than other populations.

Researchers performed a secondary cross-sectional analysis of data from a diverse U.S. sample to determine which populations understand the importance of physical activity to decrease risk for multiple chronic diseases, and demographic factors associated with awareness and understanding.

“The importance of awareness of the role of physical activity in health is recognized by many researchers and practitioners, who often include educational material about the topic in individual-level interventions and mass media campaigns,” researchers wrote. “However, the empirical research that examines awareness of the relationship between insufficient physical activity and disease risk is limited. ... Monitoring awareness in the population is important for identifying potential health disparities.”

Investigators used data to develop a smartphone-based risk assessment tool to communicate personalized risk estimates for the following health conditions commonly associated with insufficient physical activity: heart disease, diabetes, stroke, colon cancer and, for women only, breast cancer.

Individuals from a previous parent study (n = 1,661) responded to an online cross-sectional survey. Among these, researchers randomly selected 361 (median age, 47 years) individuals who were asked an open-ended question asking what illnesses they believed were caused by insufficient physical activity. Participants could provide up to three responses, which researchers used content analysis to code.

Overall, those surveyed had the highest awareness of health outcomes related to insufficient levels of physical exercise for cardiovascular (63.5%) and metabolic (65.8%) problems.


Only 3.4% of those surveyed understood that insufficient physical activity increased risk for cancer (3.4%), which the researchers attributed to public health campaigns focused on benefits for the heart and weight loss, but not cancer.

“Few members of the public realize that physical inactivity can increase their risk for cancer,” Waters told HemOnc Today. “This information may empower patients to take control of their health by taking action to reduce their cancer risk.”

Other codes found included: musculoskeletal (10.5%), fatigue (2%), psychiatric (8%), respiratory (3.4%), gastrointestinal (0.9%), other (2.8%) and unexpected interpretation (1.4%).

Among the respondents, 55.6% named fewer than three diseases.

Code frequencies appeared similar across demographic groups (P > .05).

Physical activity intentions and behavior appeared higher among people who either mentioned cardiovascular (P for intention = .001; P for behavior = .001) or metabolic (P for intention = .01; P for behavior = .005) conditions, or those who named fewer than three diseases (P for intention = .006; P for behavior = .001).

Researchers noted the study design created a limitation in the lack of ability to make inferences concerning the association between mentioning a code and physical activity intentions or behavior.

“Future research using longitudinal methods and employing an intervention approach are needed,” the researchers wrote.

They added that expanded intervention efforts are needed to increase awareness and should be combined with individual and multilevel interventions to “bridge the gap” between knowledge and behavior.

“Clinicians should inform their patients that physical activity can reduce their cancer risk, in addition to providing cardiovascular and metabolic benefits,” Waters told HemOnc Today. – by Melinda Stevens

For more information:

Erika A. Waters, PhD, MPH, can be reached at Department of Surgery, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8100, Saint Louis, MO 63110; email:

Disclosures: The authors report no relevant financial disclosures.