Urological cancer (UC) is associated with significant adverse outcomes and poses a major global health burden. Although physical activity (PA) may reduce the risk of a single cancer site of UC through multiple pathways, whether PA is associated with the whole of UC is largely unknown. This study assesses the reduction in the risk of UC (including bladder, prostate, and renal cancer) associated with PA. We analyze data from 95 studies comprising 176 risk estimates based on 11,255,721 participants. Compared to low PA levels, high PA levels are associated with 9, 13, 6, and 11% lower risks of urological, bladder, prostate, and renal cancer, respectively. This association is stronger in case-control studies (14%) than cohort studies (7%), women experience a greater risk reduction (14%) than men (7%), and occupational PA is more protective than recreational PA (16% vs. 11%). This study provides comprehensive information on the inverse relationship between PA and UC risk. The evidence indicates that PA as prehabilitation may improve physical fitness and reduce UC risk, particularly for certain types of malignancies. International PA guidelines should encourage PA to reduce the risk of UC. However, the highest amount of PA is not always the best. Future studies should determine the maximum beneficial duration and frequency of PA.
© 2026. The Author(s).