ReviewThe Lancet. Oncology2017
Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence.
Review in The Lancet. Oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 326 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
326 citing papers in PubMed, 12 syntheses or guidelines pooled it, 668 citations in OpenAlex.
- Toward Participatory Precision Health With Co-Designed Recommendations: Systematic Review of Just-in-Time Adaptive Interventions in Adolescents and Young Adults.Journal of medical Internet research · 2026Pooled it
- Asian Pacific Association of Gastroenterology task force recommendations on surveillance forGut · 2026Guideline
- Towards a better understanding of brief lifestyle interventions in noncommunicable diseases: a concept analysis.BMC public health · 2025Pooled it
- Association between adhering to a dietary approach to stop hypertension and risk of colorectal cancer: a systematic review and meta-analysis.BMC gastroenterology · 2025Pooled it
- Association between domain-specific sedentary behaviour and endometrial cancer: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- Use of Dietary Fibers in Reducing the Risk of Several Cancer Types: An Umbrella Review.Nutrients · 2023Pooled it
- Leisure-time physical activity and gastric cancer risk: A pooled study within the Stomach cancer Pooling (StoP) Project.PloS one · 2023Pooled it
- Pooled it
- Dietary patterns and breast cancer risk, prognosis, and quality of life: A systematic review.Frontiers in nutrition · 2022Pooled it
- A Meta-Analysis of Induced Abortion, Alcohol Consumption, and Smoking Triggering Breast Cancer Risk among Women from Developed and Least Developed Countries.International journal of clinical practice · 2022Pooled it
- Dietary inflammatory index and pancreatic cancer risk: a systematic review and dose-response meta-analysis.Public health nutrition · 2021Pooled it
- Physical activity and exercise in adults diagnosed with primary brain cancer: a systematic review.Journal of neuro-oncology · 2021Pooled it
- Spillover effect of a dietary intervention on physical activity in a randomized controlled trial with colorectal cancer patients.The international journal of behavioral nutrition and physical activity · 2025Trial
- Trial
- Exercise Training Reduces the Inflammatory Response and Promotes Intestinal Mucosa-Associated Immunity in Lynch Syndrome.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023Trial
- Trial
- Impact of Reducing Sitting Time in Women with Fibromyalgia and Obesity: A Randomized Controlled Trial.International journal of environmental research and public health · 2021Trial
- Shaping the future of early-onset colorectal cancer prevention.Nature reviews. Cancer · 2026Review
- Designing for Autonomous Motivation: Qualitative Interview Study on Pre-Enrollment Preferences of Survivors of Cancer for Digital Health Behavior Change Programs.Journal of medical Internet research · 2026Article
- Associations between lifestyle, genetic liability for severe mental illness and risk of incident somatic illnesses.Translational psychiatry · 2026Article
266 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age <8 years) having the strongest apparent association with cancer incidence. However, randomised controlled trials of diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.