The Link Between Exercise and Preventing Colorectal Cancer

Colorectal cancer is being diagnosed for adults at younger ages than years past. Research shows nearly half of all colorectal cancer cases are being diagnosed in adults under the age of 65. 

While scientists are still working to understand the exact cause behind the rise, there are several risk factors that suggest a link to the disease. These include:

• smoking
• alcohol use
• environmental factors (PFAs, forever chemicals)
• dietary factors (red meat, processed foods, sugary drinks)
• inactivity
• obesity

One of the things many people can do to help prevent the disease, stay healthier during cancer treatment, and boost their health in survivorship is the same: physical activity.

With 15 years of experience treating cancer patients, Sheema Chawla, MD, DipABLM, works as a radiation oncologist with the Lipson Cancer Institute, using her expertise in lifestyle medicine to highlight how physical activity plays a vital role in health. She shares how exercise serves as a powerful tool for both lowering the risk of colorectal cancer and improving long-term health outcomes for survivors.

How exercise helps with colorectal cancer prevention

Physical activity is a powerful tool not only for colorectal cancer prevention, but also for improving the health of patients with cancer and those who are in survivorship.

Currently, experts recommend 150 minutes of mild to moderate exercise or 75 minutes of vigorous exercise each week. The mild-moderate-vigorous scale can be determined using a simple ‘talk test.’

• Mild: You can sing while exercising
• Moderate: You can talk but not sing while exercising
• Vigorous: You can’t sing or talk while exercising

There are many benefits to regular exercise in general. For the body’s gastrointestinal system specifically, exercise is shown to:

• reduce inflammation in the gut
• enhance gut transit time, reducing how long carcinogens stay in the gut
• decrease insulin resistance

“By exercising, you are facilitating better hormone regulation and boosting immunity not only against colorectal cancer, but also 6-7 other cancers that have physical inactivity as a risk factor,” Dr. Chawla said.

Specifically for colorectal cancer, exercise is shown to reduce the overall risk by 25 percent.

How exercise helps patients with colorectal cancer

Patients living with colorectal cancer also benefit from physical activity and exercise, which is a shift from guidance in previous years.

“Earlier, cancer care providers were taught that if the patient is undergoing treatment, they should rest, hydrate, and avoid overexertion,” Dr. Chawla said. “Today, the recommendation has significantly changed. This exercise guidance is no longer a ‘nice to have’ option; this is integrated into treatment.”

Patients should seek additional guidance from their oncologist and primary care provider about exercise if they are still experiencing:

• nausea/vomiting
• neuropathy from chemotherapy
• low blood count from chemotherapy
• fatigue from radiation
• recovery from surgery
• colostomy bag use

However, once a patient is cleared by their cancer care team and primary care provider, not only is exercise during cancer treatment considered safe, but current clinical guidance demonstrates physical activity is also beneficial to their health and recovery. Exercise helps to:

• improve fatigue symptoms
• build tolerance to chemotherapy and radiation with fewer side effects
• reduce levels of anxiety and depression
• improve functionality
• enrich quality of life
• enhance post-surgery recovery

Patients undergoing chemotherapy are encouraged by the American Society of Clinical Oncologists to engage in structured aerobic and strength training exercises.

How exercise helps colorectal cancer survivors

For people living in survivorship, physical activity is key to ensuring their chances of living longer are higher and their recurrence of cancer is lower.

One study published in 2025 showed both patients who took part in structured exercise programs and patients who did independent exercises had improved survival rates and lower risk of cancer recurrence.

“Any activity is better than no activity,” Dr. Chawla said. “Even if you can’t get the full recommended number of minutes per week, you can still fit movement into your day.”

If you need ideas on where to begin, try these options:

• Exercise programs like LiveStrong through the YMCA
• Walk, bike, swim, or run
• Use weights or resistance bands at home
• Search YouTube for cancer-specific exercise videos with trainers who explain things well

“Whether exercising happens in an office, gym, home, or outdoors, we have gathered a lot of evidence it is helpful not only in prevention, but also during treatment and survivorship of colorectal cancer,” Dr. Chawla said.

Getting screened for colorectal cancer

Currently, the American College of Gastroenterology and U.S. Preventive Services Task Force recommends beginning regular colorectal screenings at age 45. Most patients will continue regular screenings until age 75. However, if a patient has a life expectancy beyond 10 years, they can have a conversation with their primary care provider about whether to continue with these screenings.

For patients with a parent or sibling who was diagnosed with colorectal cancer before age 60 or multiple parents or siblings diagnosed at any age, the U.S. Preventive Services Task Force recommends beginning screenings at age 40 or 10 years before the youngest relative's age when they were diagnosed.

For example, if a patient's parent was diagnosed when they were 45, the patient should begin screenings at age 35.