{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:45:29Z","timestamp":1786977929737,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    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 \u2265\u200920\u2009years in the 2011\u20132014 National Health and Nutrition Examination Survey. Circadian patterns of PA and sleep were derived from accelerometer data using k\u2010means clustering. Weighted logistic regression assessed their independent and joint associations with cancer risk. Diurnal patterns were identified as early\u2010morning (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092981), midday (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20093497), and late\u2010afternoon (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092560) for PA, and as morning lark (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094851), night owl (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092949), and irregular (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091238) for sleep. After adjusting for confounders, the early\u2010morning PA pattern was associated with a 26% lower cancer risk compared with the midday PA pattern (OR\u2009=\u20090.74, 95% CI: 0.61\u20130.90), while the combined early\u2010morning 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\u2009=\u20090.69, 95% CI: 0.49\u20130.96). Stratified analyses indicated that the inverse association of the early\u2010morning 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\u2010morning PA pattern is associated with reduced cancer risk, with synergistically enhanced effects when combined with a morning lark sleep chronotype.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70475","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:39:17Z","timestamp":1778733557000},"page":"1167-1175","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diurnal Patterns of Accelerometer\u2010Measured Physical Activity and Sleep in Relation to Cancer Risk: Findings From a Nationally Representative Study"],"prefix":"10.1002","volume":"159","author":[{"given":"Bowen","family":"Chen","sequence":"first","affiliation":[{"name":"The Fourth School of Clinical Medicine Zhejiang Chinese Medical University  Hangzhou Zhejiang China"},{"name":"Center of Clinical Evaluation The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese Medicine  Hangzhou Zhejiang China"},{"name":"School of Public Health Zhejiang Chinese Medical University  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Public Health Zhejiang Chinese Medical University  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yining","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology The Second Xiangya Hospital, Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaojie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, Graduate School of Medicine Hirosaki University  Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Liu","sequence":"additional","affiliation":[{"name":"Center of Clinical Evaluation The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese Medicine  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-6769","authenticated-orcid":false,"given":"Jianhui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Public Health Zhejiang University School of Medicine  Hangzhou China"},{"name":"Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21763"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-019-0110-3"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2022.01.005"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.060911"},{"key":"e_1_2_13_7_1","first-page":"126","article-title":"Physical Activity, Exercise, and Physical Fitness: Definitions and Distinctions for Health\u2010Related Research","volume":"100","author":"Caspersen C. 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