Steps per day and cancer risk

A population based cohort study investigated (1):

• the associations of daily step counts with cancer and cardiovascular disease incidence and mortality and all-cause mortality
• also investigated whether he intensity of steps have additional benefits

Study design:

• used data from the UK Biobank for 2013 to 2015 (median follow-up, 7 years) and included adults 40 to 79 years old in England, Scotland, and Wales
  • participants were invited by email to partake in an accelerometer study. Registry-based morbidity and mortality were ascertained through October 2021. Data analyses were performed during March 2022
• baseline wrist accelerometer-measured daily step count and established cadence-based step intensity measures (steps/min):
  • incidental steps, (<40 steps/min),
  • purposeful steps (>=40 steps/min);
  • peak-30 cadence (average steps/min for the 30 highest, but not necessarily consecutive, min/d)
• endpoints
  • all-cause mortality and primary and secondary CVD or cancer mortality and incidence diagnosis
    • for cancer, analyses were restricted to a composite cancer outcome of 13 sites that have a known association with reduced physical activity
    • linear mean rate of change (MRC) in the log-relative hazard ratio for each outcome per 2000 daily step increments were also estimated

Study results:

• study population of 78,500 individuals (mean [SD] age, 61 [8] years; 43,418 [55%] females; 75,874 [97%] White individuals) was followed for a median of 7 years during which 1325 participants died of cancer and 664 of CVD (total deaths 2179)
• were 10,245 incident CVD events and 2813 cancer incident events during the observation period
• more daily steps were associated with a lower risk of all-cause (MRC, -0.08; 95% CI, -0.11 to -0.06), CVD (MRC, -0.10; 95% CI, -0.15 to -0.06), and cancer mortality (MRC, 95% CI, -0.11; -0.15 to -0.06) for up to approximately 10,000 steps
• similarly, accruing more daily steps was associated with lower incident disease
• peak-30 cadence was consistently associated with lower risks across all outcomes, beyond the benefit of total daily steps

Key points:

• population-based prospective cohort study using UK Biobank data for 78,500 individuals found that more steps per day (up to about 10,000 steps) was associated with declines in mortality risks and decreased cancer and CVD incidence
  • peak-30 cadence (stepping intensity) showed consistent associations with improved morbidity and mortality rates
    
    
• findings indicate that accumulating more steps per day (up to about 10,000) may be associated with a lower risk of all-cause, cancer, and CVD mortality and incidence of cancer and CVD; higher step intensity may provide additional benefits

Analysis of 10 systematic reviews of observational studies found higher daily steps linked to more benefits than harms for range of health-related outcomes, including all-cause mortality, cardiovascular event, skeletal muscle lesions, metabolic diseases and respiratory disease (2).

Reference:

1. del Pozo Cruz B, Ahmadi MN, Lee I, Stamatakis E. Prospective Associations of Daily Step Counts and Intensity With Cancer and Cardiovascular Disease Incidence and Mortality and All-Cause Mortality. JAMA Intern Med. Published online September 12, 2022. doi:10.1001/jamainternmed.2022.4000
2. Xu C, Jia J, Zhao B, et alObjectively measured daily steps and health outcomes: an umbrella review of the systematic review and meta-analysis of observational studiesBMJ Open 2024;14:e088524.