Physical inactivity and cancer

This policy focuses on comprehensive and evidence-based policy initiatives designed to create supportive environments for Australians to increase their physical activity contributing to the prevention of cancer (and other chronic diseases). It will be updated as significant new literature is published or if there are important changes in the broader policy environment.

This policy forms part of the National Cancer Prevention Policy and was developed by Cancer Council’s expert Nutrition, Alcohol and Physical Activity Committee.

This policy was externally reviewed by the following experts: Dr Terry Boyle, Professor Catherine Granger and Kirsten Potoczky.

Contact us at cancercontrolpolicy@cancer.org.au.

Contents

• Overview
• Policy context
• Policy priorities
• Links between cancer and physical activity

Key policy priorities in summary

1. Transform environments through a multi-system approach to promote equitable opportunities for increased physical activity among all Australians.
2. Promote Australia’s physical activity and sedentary behaviour guidelines for all ages.
3. Enhance and update national children's physical activity data collection in a timely manner.
4. Foster collaboration and strategic partnerships that prioritise equitable access to physical activity.
5. Embed physical activity promotion within all health care settings through education and training on appropriate assessment, counselling and referrals to healthcare professionals.

Overview

Engaging in regular physical activity offers profound benefits to both physical and mental wellbeing. It plays a crucial role in preventing up to 13 different types of cancer ¹ and chronic diseases such as heart disease.² Emerging evidence also suggests a potential link between prolonged sedentary behaviour (sitting time) and an increased risk of some cancers.^3,4 In 2020-21, approximately three-quarters of the Australian population did not meet the recommended physical activity guidelines.⁵ Approximately five per cent of the cancer burden in Australia is attributed to physical inactivity.⁶

Physical activity can be defined as any type of bodily movement that results in an increased breathing and heart rate and the subsequent expenditure of energy.⁷ Sedentary behaviour is defined as the time spent in any behaviour characterised by low rates of energy expenditure (≤ 1.5 metabolic equivalents) while in a sitting, reclining or lying position (not including sleep).⁸

Physical activity has been shown to be protective against bowel cancer as well as breast (post-menopausal) and endometrial cancers.⁹ Some evidence indicates that physical activity may also decrease the risk of oesophageal, lung and liver cancer.⁹ There is strong evidence that vigorous intensity physical activity lowers the risk of pre-menopausal breast cancers.⁹ The World Cancer Research Fund recommends increasing physical activity as part of everyday life to maintain a healthy weight and protect against cancers.¹⁰

Higher rates of physical inactivity lead to adverse consequences across multiple domains, including health systems, the environment, economic progress, community welfare, and overall quality of life.¹¹ The significant global economic impact of physical inactivity is a cause for concern. The international cost of physical inactivity attributed to direct healthcare expenses, is estimated to reach INT$ 47.6 billion per year worldwide by 2030 if the prevalence of physical inactivity does not change.¹² In addition, physical inactivity related deaths contributed to US$ 13·7 billion in productivity losses, and 13·4 million disability-adjusted life-years (DALYs) worldwide.¹¹Effective policies and programs need to be implemented and/or scaled up to support people to increase their physical activity levels.¹²

Following a cancer diagnosis, there is a consistent and compelling body of evidence that demonstrates higher physical activity levels is associated with better quality of life, fewer and less severe treatment-related side effects and higher physical and mental health.¹³ Higher pre-diagnosis and post-diagnosis levels of physical activity have also been associated with improved survival outcomes for at least 11 cancer types.¹⁴ This evidence base supports global promotion of physical activity guidelines following a cancer diagnosis and care, but are not addressed in this policy.

The prioritisation of sun safety when promoting physical activity is also crucial. Australia has the highest rates of skin cancer in the world, and each year skin cancer accounts for about 80 per cent of all Australian cancer diagnoses.¹⁵ Many sporting activities take place in environments with little or no shade and on surfaces such as asphalt, sand and water which reflect ultraviolet (UV) radiation. Organisations, such as schools and sporting groups, and workplaces can play a major role in minimising UV radiation exposure by providing an environment where policies and procedures positively influence sun protective behaviours, for example, implementing a best-practice sun protection policy that includes all five forms of sun protection.¹⁶