Device-measured movement behaviours and cancer incidence in a population sample of UK adults: Dual 24-hour analyses of postural and intensity compositions

BMC Med. 2026 Jul 18. doi: 10.1186/s12916-026-05069-3. Online ahead of print.

ABSTRACT

BACKGROUND: Insufficient physical activity (PA) and excessive sedentary behaviour is associated with several cancers. Personalised approaches to increasing healthy movement behaviours over unhealthy behaviours may be more effective than a one-size-fits-all approach. Exploring both postures, and intensities across the 24-hour day may reveal actionable behavioural alternatives from current guidance.

METHODS: Using a novel dual-compositional approach, we assessed how differences in participant’s composition of 24-hour daily movement (postures and intensities) and sleep are differentially associated with PA-related cancer incidence (a composite of 13 sites linked with physical inactivity). This prospective analysis involved adults drawn from the UK Biobank accelerometry subsample each followed-up by health linkage. Participant’s daily movement was classified into two 24-hour compositions. Composition 1 (posture-focused): sleep duration, sedentary behaviour (SB), standing, moving at any intensity. Composition 2 (intensity-focused): sleep duration, sedentary time (ST), light PA (LPA), moderate PA (MPA), and vigorous PA (VPA). Secondary analysis combined VPA and MPA as moderate-to-vigorous PA (MVPA). PA-related cancer diagnoses were captured from health registry data for up to 9.5 years (y). Cox-proportional hazards models were adjusted for age, sex, education, smoking, alcohol, diet, parental cancer history, cardiovascular disease and medication use.

RESULTS: Analyses included 59,218 (55% female) participants (mean [SD] age: 61.7 [7.8]y), with a median follow-up of 8.0y [IQR: 7.4-8.5y; 464,640 person years] with 2,385 (4%) incident cancer events. Among the average, active participant, greater moving in place of other behaviours was associated with lower cancer risk, e.g. theoretically replacing 15 min of sleep or SB with 15 min of moving was associated with hazard ratios (HR) of 0.98 (95% Confidence Interval (95%CI): 0.97-0.99) and 0.98 (95%CI: 0.97-0.99), respectively. Similar risk reduction was observed with 30 min additional standing in place of sleep or SB. Regarding intensity, greater MVPA, in place of any behaviour proved most robustly associated with lower risk, although notably, the VPA component within MVPA proved the critical intensity.

CONCLUSIONS: Beyond MVPA, moving at any intensity, in place of other postures, was associated with reduced risk of cancer. However, greater standing may also provide a plausible behavioural adjunct or alternative, warranting further investigation.

PMID:42471677 | DOI:10.1186/s12916-026-05069-3