Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 5844-5851
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.5844
What is the gut feeling telling us about physical activity in colorectal carcinogenesis?
Maja Cigrovski Berkovic, Vjekoslav Cigrovski, Ines Bilic-Curcic, Anna Mrzljak
Maja Cigrovski Berkovic, Department for Endocrinology, Diabetes and Metabolism, Clinical Hospital Dubrava, Zagreb 10000, Croatia
Maja Cigrovski Berkovic, Vjekoslav Cigrovski, Faculty of Kinesiology, University of Zagreb, Zagreb 10000, Croatia
Ines Bilic-Curcic, Department of Pharmacology, Faculty of Medicine, J J Strossmayer University Osijek, Osijek 31000, Croatia
Anna Mrzljak, Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia
Anna Mrzljak, Department of Medicine, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Author contributions: Cigrovski Berkovic M, Cigrovski V, Bilic-Curcic I and Mrzljak A wrote the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anna Mrzljak, MD, PhD, Associate Professor, Department of Medicine, Merkur University Hospital, Zajceva 19, Zagreb 10000, Croatia. anna.mrzljak@mef.hr
Received: August 7, 2020
Peer-review started: August 7, 2020
First decision: September 24, 2020
Revised: September 28, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: December 6, 2020
Processing time: 118 Days and 17.8 Hours
Abstract

In the last decades, more efforts are focused on the prevention and treatment of malignant diseases, given the increase in all cancers incidence A lifestyle change, including healthy eating habits and regular physical activity, has significantly impacted colorectal cancer prevention. The effect of dose-dependent physical activity on mortality and recurrence rates of colorectal carcinoma has been unequivocally demonstrated in observational studies. However, clear recommendations are not available on the frequency, duration, and intensity of exercise in patients with colorectal cancer due to the lack of evidence in randomized clinical trials. Regarding pathophysiological mechanisms, the most plausible explanation appears to be the influence of physical activity on reducing chronic inflammation and insulin resistance with a consequent positive effect on insulin growth factor 1 signaling pathways.

Keywords: Physical activity; Colorectal cancer; Insulin signaling pathway; Inflammation; Gut microbiota

Core Tip: Sedentary lifestyle is linked to the development of colorectal cancer (CRC); each 2-h increase in sitting time increases the risk of CRC development by 8%. Additionally, engaging in physical activity can prevent 15% of CRC, and by replacing 30 min of sedentary time with physical activity (either light or moderate-vigorous), cancer mortality can be reduced by 8% and 31%, respectively. Although the mechanisms of preventive and favorable effects of physical activity on CRC are still unknown, the most plausible are the influence on chronic inflammation and insulin resistance, with a positive effect on insulin growth factor 1 signaling pathways.