The age-adjusted mortality rates of colorectal cancer have been rising in Taiwan over the past 2 decades, and colorectal cancer is now the third leading cause of cancer mortality in the county. We conducted a hospital-based case-control study to clarify the nature of the association between physical activity, water intake and colorectal-cancer risk in Taiwan, A total of 163 subjects (aged 33-80 years) with histologically confirmed primary colorectal cancer and 163 hospital controls were enrolled during 1992, Dietary intake, physical activity and other lifestyle activities were assessed using a comprehensive food-frequency and lifestyle-activity questionnaire. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic-regression analysis. A strong inverse dose-response relation between increased water intake and rectal cancer was found among men after adjustment for other risk factors (p for trend = 0.0005), The OR for rectal cancer among men in the highest tertile of water intake was 0.08 (95% CI, 0,0.02-0.35) compared with that among men in the lowest tertile (OR = I). Similar but not significant trends were seen among women (p = 0.29). The OR for colon cancer among men with active leisure-time physical activity was 0.19 (95% Cl, 0.05-0.77) times that: among sedentary men (p for trend 0.03), However, physical activity was not associated with colon-cancer risk among women (p = 0.48), No differences in the amount of water intake were found related to level of physical activity. These findings add to the evidence that leisure-time activity may reduce colon-cancer risk, not only in high-risk but also in low-risk populations, and support the potential beneficial effect of increased wafer intake in reducing colorectal-cancer risk. (C) 1999 Wiley-Liss, Inc.