Diurnal Patterns of Accelerometer‐Measured Physical Activity and Sleep in Relation to Cancer Risk: Findings From a Nationally Representative Study

May 14, 2026International journal of cancer

Daily Patterns of Activity and Sleep Measured by Movement Trackers Linked to Cancer Risk in a National Study

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Abstract

The early-morning physical activity pattern is associated with a 26% lower cancer risk compared to the midday pattern.

Three diurnal patterns of physical activity were identified: early-morning, midday, and late-afternoon.
Sleep patterns were categorized as morning lark, night owl, and irregular.
The combination of early-morning physical activity and morning lark sleep was associated with a 31% reduction in cancer risk compared to midday physical activity with morning lark sleep.
The protective effect of early-morning physical activity against cancer risk was more pronounced in females.
No significant associations were found between sleep patterns and cancer risk.

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Physical activity (PA) and sleep are modifiable lifestyle factors, yet their circadian patterns in relation to cancer risk remain unclear. This study investigated their independent and joint associations with cancer risk. We analyzed data from 9038 adults aged ≥ 20 years in the 2011-2014 National Health and Nutrition Examination Survey. Circadian patterns of PA and sleep were derived from accelerometer data using k-means clustering. Weighted logistic regression assessed their independent and joint associations with cancer risk. Diurnal patterns were identified as early-morning (n = 2981), midday (n = 3497), and late-afternoon (n = 2560) for PA, and as morning lark (n = 4851), night owl (n = 2949), and irregular (n = 1238) for sleep. After adjusting for confounders, the early-morning PA pattern was associated with a 26% lower cancer risk compared with the midday PA pattern (OR = 0.74, 95% CI: 0.61-0.90), while the combined early-morning PA and morning lark sleep pattern conferred an even stronger protective effect compared with the midday PA and morning lark sleep joint pattern, corresponding to a 31% reduction (OR = 0.69, 95% CI: 0.49-0.96). Stratified analyses indicated that the inverse association of the early-morning PA pattern with cancer risk was stronger in females. No significant associations were observed between diurnal patterns of sleep and the risk of cancer. This study demonstrates that an early-morning PA pattern is associated with reduced cancer risk, with synergistically enhanced effects when combined with a morning lark sleep chronotype.

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Diurnal Patterns of Accelerometer‐Measured Physical Activity and Sleep in Relation to Cancer Risk: Findings From a Nationally Representative Study

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