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Association of sedentary work with colon and rectal cancer: systematic review and meta-analysis
  1. JaeYong Lee1,
  2. Jongin Lee1,
  3. Joonho Ahn1,
  4. Dong-wook Lee2,
  5. Hyoung-Ryoul Kim1,
  6. Mo-Yeol Kang1
  1. 1 Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
  2. 2 Department of Preventive Medicine, Occupational & Environmental Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Dr Mo-Yeol Kang, Occupational and Environmental Medicine, Seoul Saint Mary's Hospital, Seoul 06591, Korea (the Republic of); snaptoon{at}


Objectives There has been no research on sedentary behaviour in the occupational domain that occupies a large portion of the daily life.

Methods We conducted a meta-analysis to investigate the association between sedentary work and colorectal cancer. We searched PubMed, Embase and Cochrane databases up to 12 August 2020 for peer-reviewed journal articles that assessed the association between sedentary work and colon or rectal cancer. Pooled estimates of ORs were obtained using random effects models. Statistical tests for publication bias, heterogeneity and sensitivity analysis were applied.

Results Of the 5 381 studies initially identified, 23 studies with 64 reports were eligible for inclusion. Sedentary work significantly increased the risk of colon cancer (pooled OR=1.21, 95% CI 1.11 to 1.31, p value ≤0.0001) and rectal cancer (pooled OR=1.08, 95% CI 1.00 to 1.16, p value=0.0395). The adjustment for leisure time physical activity attenuated the association and made the risk estimates non-significant for sedentary behaviour, but the association was independent of sex, control of body mass index and assessment of sedentary behaviour.

Conclusions We found evidence of association between sedentary work and the risk of colon or rectal cancer. Limiting excessive sedentary work could be an important means of preventing colon and rectal cancer.

  • occupational health
  • epidemiology
  • meta-analysis
  • gastroenterology
  • public health

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  • JL and JL contributed equally.

  • Contributors JYL and JL contributed equally to the study. H-RK and M-YK designed the study. JYL and M-YK designed the search strategy. JYL, JL and M-YK conducted the searches, retrieved articles and screened the full text of potentially relevant articles. JYL and JL did statistical analysis. JYL and M-YK wrote the first draft of the manuscript, and JYL, D-wL, H-RK and JA contributed writing to subsequent versions of the manuscript. All authors reviewed the study findings and read and approved the final version before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.