Unraveling the link between cardiorespiratory fitness and cancer: a state-of-the-art review

Sep 21, 2026

Cardiorespiratory fitness (CRF) reflects an individual’s capacity for physical activity while also capturing broader effects tied to the biology of aging. This state-of-the-art review synthesizes evidence on how CRF influences overall cancer risk and risk at specific sites. It examines potential biological mechanisms, evaluates clinical implications, highlights gaps and limitations in the existing evidence base, and outlines priorities for future research.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages27

Reading Time1 h 8 min

AccessFree to download

Abstract

Biological mechanisms and cancer risk patterns

Clinical implications and evidence gaps

Future research directions

Introduction

Cancer as a public health burden

Physical activity and cancer prevention

CRF as an outcome and clinical indicator

GeroScience (2024) 46:5559–5585 [https://doi.org/10.1007/s11357-024-01222-z](https://doi.org/10.1007/s11357-024-01222-z) Unraveling the link between cardiorespiratory fitness and cancer: a state‑of‑the‑art review Setor K. Kunutsor · Leonard A. Kaminsky · Andrea Lehoczki · Jari A. Laukkanen Received: 9 May 2024 / Accepted: 24 May 2024 / Published online: 3 June 2024 © The Author(s) 2024 Abstract Cardiorespiratory fitness (CRF) not only reflects an individual’s capacity to perform physical activities but also encapsulates broader effects on the basic biology of aging. This review aims to summarize the evidence on the influence of CRF on overall and site-specific cancer risks. It delves into the biological mechanisms through which CRF may exert its effects, explores the clinical implications of these findings, identifies gaps in the current evidence base, and suggests directions for future research. The synthesis of findings reveals that higher CRF levels (general threshold of >7 METs) are consistently associated with a reduced risk of a range of cancers, Supplementary Information The online version contains supplementary material available at [https://doi](https://doi). org/10.1007/s11357-024-01222-z. S. K. Kunutsor (*) Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE5 4WP, UK e-mail: [skk31@cantab.net](skk31@cantab.net) L. A. Kaminsky Clinical Exercise Physiology, College of Health, Ball State University, Muncie, IN, USA A. Lehoczki Department of Public Health, Semmelweis University, Budapest, Hungary A. Lehoczki Doctoral College, Health Sciences Program, Semmelweis University, Budapest, Hungary including head and neck, lung, breast, gastrointestinal, particularly pancreatic and colorectal, bladder, overall cancer incidence and mortality, and potentially stomach and liver, bile duct, and gall bladder cancers. These inverse associations between CRFand cancer risk do not generally differ across age groups, sex, race, or adiposity, suggesting a universal protective effect of CRF. Nonetheless, evidence linking CRF with skin, mouth and pharynx, kidney, and endometrial cancers is limited and inconclusive. Conversely, higher CRF levels may be potentially linked to an increased risk of prostate cancer and hematological malignancies, such as leukemia and myeloma, although the evidence is still not conclusive. CRF appears to play a significant role in reducing the risk of several cancers through various biological mechanisms, including inflammation reduction, immune A. Lehoczki Department of Haematology and Stem Cell Transplantation, National Institute for Haematology and Infectious Diseases, South Pest Central Hospital, 1097 Budapest, Hungary J. A. Laukkanen Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland J. A. Laukkanen Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland system enhancement, hormonal regulation, and metabolic improvements. Overall, enhancing CRF through regular physical activity offers a vital, accessible strategy for reducing cancer risk and extending the health span. Future research should aim to fill the existing evidence gaps regarding specific cancers and elucidate the detailed dose–response relationships between CRF levels and cancer risk. Studies are also needed to elucidate the causal relationships and mechanistic pathways linking CRF to cancer outcomes. Keywords Cardiorespiratory fitness · Cancer · Mortality · Physical activity · Exercise · Mendelian randomization Introduction Cancer remains a leading cause of morbidity and mortality worldwide, presenting a significant public health burden with millions of new cases and deaths annually [1] . The epidemiology of cancer is complex, influenced by a myriad of risk factors ranging from genetic predispositions to lifestyle choices [2] . Among these, physical activity (PA) emerges a

FAQs

What is the main goal of the review on CRF and cancer?

To summarize evidence on how cardiorespiratory fitness affects overall and site-specific cancer risks, including mechanisms, clinical implications, and directions for future research.

How do higher CRF levels generally relate to cancer risk?

Higher CRF levels are consistently associated with reduced risk across a range of cancers, suggesting a protective effect.

Are all cancer types equally supported by the evidence on CRF?

No. Evidence for some cancers is limited or inconclusive, while possible increased risk has been suggested for prostate cancer and certain hematological malignancies.

Sep 21, 2026

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