Preventable fractions of colon and breast cancers by increasing physical activity in Brazil: perspectives from plausible counterfactual scenarios

Leandro Fórnias Machado de Rezende, Leandro Martin Totaro Garcia, Grégore Iven Mielke, Dong Hoon Lee, Kana Wu, Edward Giovannucci, José Eluf-Neto

Research output: Contribution to journalArticlepeer-review


Background: Physical activity is associated with lower risk of colon and breast cancers. Herein we estimated preventable fractions of colon and breast cancers in Brazil by increasing population-wide physical activity to different counterfactual scenarios. Methods: We used data from a representative national survey in Brazil and corresponding relative risks of colon and postmenopausal breast cancers from a meta-analysis. Estimated cancer incidence was retrieved from GLOBOCAN and Brazilian National Cancer Institute. Five counterfactual scenarios for physical activity were considered: (i) theoretical minimum risk exposure level (≥8,000 metabolic equivalent of tasks-minute/week – MET-min/week); (ii) physical activity recommendation (≥600 MET-min/week); (iii) a 10% reduction in prevalence of insufficient physical inactivity (<600 MET-min/week); (iv) physical activity level in each state equals the most active state in Brazil; (v) closing the gender differences in physical activity. Results: About 19% (3,630 cases) of colon cancers and 12% (6,712 cases) of postmenopausal breast cancers could be prevented by increasing physical activity to ≥8,000 MET-min/week. Plausible counterfactual scenarios suggested the following impact on cancer prevention: reaching physical activity recommendation: 1.7% (1,113 cases) of breast and 6% (1,137 cases) of colon; 10% reduction in physical inactivity prevalence: 0.2% (111 cases) of breast and 0.6% (114 cases) of colon; most active state scenario: 0.3% (168 cases) of breast and 1% (189 cases) of colon; reducing gender differences in physical activity: 1.1% (384 cases) of breast and 0.6% (122 cases) of colon. Conclusions: High levels of physical activity are required to achieve a sizable impact on breast and colon cancer prevention in Brazil.

Original languageEnglish
Pages (from-to)38-45
Number of pages8
JournalCancer Epidemiology
Publication statusPublished - 2018 Oct

Bibliographical note

Funding Information:
Leandro Fórnias Machado de Rezende receives a doctoral scholarship from Sao Paulo Research Foundation (FAPESP) , grant # 2014/25614-4 and # 2016/21390-0 . Leandro Martin Totaro Garcia has undertaken this work under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence which is funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust.

Publisher Copyright:
© 2018 The Authors

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology
  • Cancer Research


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