Key policy priorities in summary
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
- Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Pineros M, et al.. Global Cancer Observatory: Cancer Today. [homepage on the internet] Lyon, France: International Agency for Research on Cancer; 2018 [cited 2020 Apr 24]. Available from: https://gco.iarc.fr/today.
- Australian Institute of Health and Welfare. Cancer data in Australia. Canberra: AIHW; 2020 [cited 2020 Sep 10]. Report No.: Cat no. CAN 122. Available from: https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/acim-books.
- Fransen M, Karahalios A, Sharma N, English DR, Giles GG, Sinclair RD. Non-melanoma skin cancer in Australia. Med J Aust 2012 Nov 19;197(10):565-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23163687.
- Olsen CM, Wilson LF, Green AC, Bain CJ, Fritschi L, Neale RE, et al. Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use. Aust N Z J Public Health 2015 Oct;39(5):471-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26437734.
- Shih ST, Carter R, Sinclair C, Mihalopoulos C, Vos T. Economic evaluation of skin cancer prevention in Australia. Prev Med 2009 Nov;49(5):449-53 Available from: http://www.ncbi.nlm.nih.gov/pubmed/19747936.
- Dobbinson SJ, Wakefield MA, Jamsen KM, Herd NL, Spittal MJ, Lipscomb JE, et al. Weekend sun protection and sunburn in Australia trends (1987-2002) and association with SunSmart television advertising. Am J Prev Med 2008 Feb;34(2):94-101 Available from: http://www.ncbi.nlm.nih.gov/pubmed/18201638.
- Sinclair C, Foley P. Skin cancer prevention in Australia. Br J Dermatol 2009 Nov;161 Suppl 3:116-23 Available from: http://www.ncbi.nlm.nih.gov/pubmed/19775367.
- Slevin T, Clarkson J, English D. Skin Cancer Control Western Australia: Is it Working and What Have we Learned? Radiat Prot Dosimetry 2000;91(1-3): 303-6 Available from: http://rpd.oxfordjournals.org/content/91/1-3/303.abstract.
- Staples MP, Elwood M, Burton RC, Williams JL, Marks R, Giles GG. Non-melanoma skin cancer in Australia: the 2002 national survey and trends since 1985. Med J Aust 2006 Jan 2;184(1):6-10 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16398622.
- Thursfield V, Giles G. Skin Cancer. Carlton: Cancer Epidemiology Centre, Cancer Council Victoria; 2007. Report No.: 44. Available from: http://www.cancervic.org.au/downloads/cec/CanStats/44-Skin-cancer.pdf.
- Tabbakh T, Volkov A, Wakefield M, Dobbinson S. Implementation of the SunSmart program and population sun protection behaviour in Melbourne, Australia: Results from cross-sectional summer surveys from 1987 to 2017. PLoS Med 2019 Oct;16(10):e1002932 Available from: http://www.ncbi.nlm.nih.gov/pubmed/31593565.