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  • br When comparing our results for the year alone which

    2020-08-18


    When comparing our results for the year 2045 alone, which 512-64-1 beyond the influence of LAT and LAG times,
    Table 5
    Number (#) and percentage of avoidable cancers during 2016e2045 and in 2045 in Iceland, under different scenarios of physical activity levels, compared with constant levels. (The numbers in parentheses refer to the single year 2045.)
    Cancer site Scenario Aa
    Scenario Bb
    Scenario Cc
    MET, metabolic equivalents. a A total elimination of deficit in physical activity in year 2016.
    d Percentage of avoidable cancer cases out of total number of ex-pected cases for the three selected cancer sites.
    Table 6
    Number (#) and percentage of avoidable cancers during 2016e2045 and in 2045 in Norway, under different scenarios of physical activity levels, compared with constant levels. (The numbers in parentheses refer to the single year 2045.)
    Cancer site
    Scenario Aa
    Scenario Bb
    Scenario Cc
    MET, metabolic equivalents. a A total elimination of deficit in physical activity in year 2016.
    d Percentage of avoidable cancer cases out of total number of ex-pected cases for the three selected cancer sites.
    Table 7
    Number (#) and percentage of avoidable cancers during 2016e2045 and in 2045 in Sweden, under different scenarios of physical activity levels, compared with constant levels. (The numbers in parentheses refer to the single year 2045.)
    Cancer site Scenario Aa
    Scenario Bb
    Scenario Cc
    MET, metabolic equivalents. a A total elimination of deficit in physical activity in year 2016.
    d Percentage of avoidable cancer cases out of total number of ex-pected cases for the three selected cancer sites.
    with estimates of the PAF from other studies [23,25e29], our results are lower. This is probably because the Nordic populations tend to be more physi-cally active compared with other Western populations 512-64-1 [7]and also because of differences in the way the calcu-lations were made. A comparison of the PAF estimates across studies is difficult because of great heterogeneity between studies. The methodology for measuring phys-ical activity, differing definitions of sufficient levels of physical activity, varying effect sizes of the RR esti-mates, as well as measures of different domains of physical activity (i.e. occupational, leisure time and total), lead to differing PAF values. We based our cal-culations on the RR estimates for recreational physical 
    activity in MET-h published by the WCRF CUP [1], with a lower reduction in risk compared with the RR estimates used by Parkin, Brown et al. and Brenner [23,26,27] and lower than indicated by other studies [25,30]. De Vries et al. used the Prevent model to esti-mate the impact of increasing physical activity on colon cancer incidence in seven European countries. They found the proportion of avoidable cancer cases in Denmark to be 6% for males and 11% for females in a 30-year period [31]. The reason for the large discrepancy between our study and the results from de Vries et al. is likely because of the use of different RR estimates but to some extent also because of a difference in how physical activity was measured and categorised. The RR esti-mates in the study by de Vries et al. were close to RR estimates seen in other studies when comparing lowest to highest groups in terms of physical activity, but they applied the RR estimates to all subjects with less than recommended levels of physical activity in comparison to those with physical activity levels according to recommendations.
    For prevention of cancer, the optimal levels of physical activity according to domain, intensity and frequency are not well established. However, there is strong evidence for a dose-response relationship between increasing levels of physical activity and reduced risk of breast and colon cancer, as well as moderate evidence of a dose-response effect for endometrial cancer [32]. The WHO recommends at least 150 min of moderate or 75 min of vigorous physical activity weekly, which is equivalent to 7.5 MET-h. However, we estimated the number of avoidable cancer cases based on the assumption that sufficient physical activity requires 15 MET-h or more weekly. This cut-off point is in accordance with the cut-off point used by Parkin [23]. In addition, the cut-off point is in accordance with the WHO’s statement that for additional health benefits, adults should increase their moderate or vigorous intensity physical activity to 300 min or 150 min per week, respectively. One should also keep in mind that the minimum WHO guidelines for physical activity are not specifically defined for reducing cancer risk but rather to be generic in relation to reducing the risk of several non-communicable diseases.