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Diao X, Ling Y, Zeng Y, Wu Y, Guo C, Jin Y, Chen X, Feng S, Guo J, Ding C, Diao F, Du Z, Li S, Qiu H. Physical activity and cancer risk: a dose-response analysis for the Global Burden of Disease Study 2019. Cancer Commun (Lond) 2023; 43:1229-1243. [PMID: 37743572 PMCID: PMC10631483 DOI: 10.1002/cac2.12488] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE Adopting a healthy lifestyle, including regular physical activity, is widely believed to decrease cancer risk. This study aimed to quantitatively establish the dose-response relationships between total physical activity and the risk of breast, colon, lung, gastric, and liver cancers. METHODS A systematic review and dose-response analysis were conducted using PubMed and Embase from January 1, 1980 to March 20, 2023. Prospective cohort studies that examined the association between physical activity and the risks of any of the 5 outcomes were included. The search was confined to publications in the English language with a specific focus on human studies. Physical activity is standardized by using the data from US National Health and Nutrition Examination Surveys (NHANES) and the Global Burden of Disease 2019 database. RESULTS A total of 98 studies, involving a combined population of 16,418,361 individuals, were included in the analysis. Among the included studies, 57 focused on breast cancer, 17 on lung cancer, 23 on colon cancer, 5 on gastric cancer, and 7 on liver cancer. Overall, elevated levels of physical activity exhibited an inverse correlation with the risk of cancer. The dose-response curve for lung cancer exhibited a non-linear pattern, with the greatest benefit risk reduction observed at 13,200 MET-minutes/week of physical activity, resulting in a 14.7% reduction in risk (relative risk 0.853, uncertainty interval 0.798 to 0.912) compared to the inactive population. In contrast, the dose-response curves for colon, gastric, breast, and liver cancers showed linear associations, indicating that heightened levels of total physical activity were consistently associated with reduced cancer risks. However, the increase in physical activity yielded a smaller risk reduction for colon and gastric cancers compared to breast and liver cancers. Compared to individuals with insufficient activity (total activity level < 600 MET-minutes/week), individuals with high levels of activity (≥ 8,000 MET-minutes/week) experienced a 10.3% (0.897, 0.860 to 0.934) risk reduction for breast cancer; 5.9% (0.941, 0.884 to 1.001) for lung cancer; 7.1% (0.929, 0.909 to 0.949) for colon cancer; 5.1% (0.949, 0.908 to 0.992) for gastric cancer; 17.1% (0.829, 0.760 to 0.903) for liver cancer. CONCLUSIONS This study demonstrated a significant inverse relationship between total physical activity and the risk of breast, gastric, liver, colon, and lung cancers.
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Affiliation(s)
- Xiayao Diao
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Yudong Ling
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Yi Zeng
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Yueqian Wu
- Department of Medical StatisticsSchool of Public HealthSun Yat‐sen UniversityGuangzhouGuangdongP. R. China
| | - Chao Guo
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Yukai Jin
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Xiaojiang Chen
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Shoucheng Feng
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Jianrong Guo
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Chao Ding
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Feiyu Diao
- Department of General SurgerySun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouGuangdongP. R. China
| | - Zhicheng Du
- Department of Medical StatisticsSchool of Public HealthSun Yat‐sen UniversityGuangzhouGuangdongP. R. China
| | - Shanqing Li
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Haibo Qiu
- Department of Gastric SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
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Logan G, Somers C, Baker G, Connell H, Gray S, Kelly P, McIntosh E, Welsh P, Gray CM, Gill JMR. Benefits, risks, barriers, and facilitators to cycling: a narrative review. Front Sports Act Living 2023; 5:1168357. [PMID: 37795314 PMCID: PMC10546027 DOI: 10.3389/fspor.2023.1168357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
There is large potential to increase cycling participation worldwide. Participation in cycling is associated with lower risk of mortality from any cause, and incidence of cardiovascular disease and type 2 diabetes, as well as positive mental health and well-being. The largest potential for health gains likely to come from increasing participation amongst those who do not currently cycle regularly, rather than encouraging those who already cycle regularly to cycle more. Replacing car journeys with cycling can lead to reductions in air pollution emissions and lower pollutant exposure to the general population. Important gaps and uncertainties in the existing evidence base include: the extent to which the health benefits associated with cycling participation are fully causal due to the observational nature of much of the existing evidence base; the real-world economic cost-benefits of pragmatic interventions to increase cycling participation; and the most effective (combination of) approaches to increase cycling participation. To address these uncertainties, large-scale, long-term randomised controlled trials are needed to: evaluate the effectiveness, and cost-effectiveness, of (combinations of) intervention approaches to induce sustained long-term increases in cycling participation in terms of increases in numbers of people cycling regularly and number of cycling journeys undertaken, across a range of population demographic groups; establish the effects of such interventions on relevant outcomes related to health and wellbeing, economic productivity and wider societal impacts; and provide more robust quantification of potential harms of increasing cycling participation, such as collision risks.
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Affiliation(s)
- Greig Logan
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Camilla Somers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Tran TPT, Luu NM, Bui TT, Han M, Lim MK, Oh JK. Trajectory of physical activity frequency and cancer risk: Findings from a population-based cohort study. Eur Rev Aging Phys Act 2023; 20:4. [PMID: 36890434 PMCID: PMC9996897 DOI: 10.1186/s11556-023-00316-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 03/03/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Physical activity (PA) changes throughout an individual's life, but the association between such changes and cancer risk seems to be overlooked in the literature. Thus, this study aimed to examine the association between the trajectories of PA frequency and cancer incidence among middle-aged Korean adults. METHODS A total of 1,476,335 eligible participants (992,151 men and 484,184 women) aged ≥40 years from the National Health Insurance Service cohort (2002-2018) were included. Assessment of PA frequency was a self-reported measure, based on the question: "How many times per week do you perform exercise that makes you sweat?". PA frequency trajectories (i.e., trajectory classes of change in PA frequency) from 2002 to 2008 were identified using group-based trajectory modeling. Cox proportional hazards regression was used to assess the associations between the PA trajectories and cancer incidence. RESULTS Five PA frequency trajectories over 7 years were identified: persistently low (men:73.5%; women:74.7%), persistently moderate (men:16.2%; women:14.6%), high-to-low (men:3.9%; women:3.7%), low-to-high (men:3.5%; women:3.8%), and persistently high (men:2.9%; women:3.3%). Compared with persistently low frequency, maintaining a high PA frequency was associated with a lower risk of all cancers (Hazard ratio (HR) = 0.92, 95%CI = 0.87-0.98) and breast cancer (HR = 0.82, 95%CI = 0.70-0.96) among women. There was a lower risk for thyroid cancer among men in the high-to-low (HR = 0.83, 95%CI = 0.71-0.98), low-to-high (HR = 0.80, 95%CI = 0.67-0.96), and high PA trajectories (HR = 0.82, 95%CI = 0.68-0.99). There was a significant association between moderate trajectory and lung cancer in men (HR = 0.88, 95%CI = 0.80-0.95), in both smoking and non-smoking men. CONCLUSION Long-term persistent high frequency of PA as part of the daily routine should be widely promoted and encouraged to reduce the risk for all cancer development in women.
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Affiliation(s)
- Thi Phuong Thao Tran
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.,Hanoi University of Public Health, Hanoi, Vietnam
| | - Ngoc Minh Luu
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.,Hanoi Medical University, 1 Ton That Tung Street, Dong Da district, Hanoi, Vietnam
| | - Thi Tra Bui
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea
| | - Minji Han
- Division of Cancer Prevention, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea
| | - Jin-Kyoung Oh
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang-si, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
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5
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Qie R, Han M, Huang H, Sun P, Xie Y, He J, Zhang Y. Physical activity and risk of lung cancer: A systematic review and dose-response meta-analysis of cohort studies. JOURNAL OF THE NATIONAL CANCER CENTER 2023. [DOI: 10.1016/j.jncc.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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6
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Zou K, Sun P, Huang H, Zhuo H, Qie R, Xie Y, Luo J, Li N, Li J, He J, Aschebrook-Kilfoy B, Zhang Y. Etiology of lung cancer: Evidence from epidemiologic studies. JOURNAL OF THE NATIONAL CANCER CENTER 2022. [DOI: 10.1016/j.jncc.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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7
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Gao Y, Mi J, Liu Z, Song Q. Leisure Sedentary Behavior and Risk of Lung Cancer: A Two-Sample Mendelian Randomization Study and Mediation Analysis. Front Genet 2021; 12:763626. [PMID: 34777480 PMCID: PMC8582637 DOI: 10.3389/fgene.2021.763626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/18/2021] [Indexed: 12/20/2022] Open
Abstract
Leisure sedentary behavior, especially television watching, has been previously reported as associated with the risk of lung cancer in observational studies. This study aims to evaluate the causal association with two-sample Mendelian randomization (MR) analysis. Single nucleotide polymorphisms associated with leisure television watching, computer use, and driving were extracted from genome-wide association studies. Summary-level results of lung cancer overall and histological types were obtained from International Lung Cancer Consortium (ILCCO). In univariable MR using inverse-variance-weighted method, we observed causal effects of television watching on lung cancer [OR, 1.89, 95% confidence interval (CI), 1.41, 2.54; p = 2.33 × 10-5], and squamous cell lung cancer (OR, 2.37, 95% CI, 1.58, 3.55; p = 3.02 × 10-5), but not on lung adenocarcinoma (OR, 1.40, 95% CI, 0.94, 2.09; p = 0.100). No causal effects of computer use and driving on lung cancer were observed. Television watching significantly increased the exposure to several common risk factors of lung cancer. The associations of television watching with lung cancer and squamous cell lung cancer were compromised after adjusting for smoking quantity with multivariable MR. Our mediation analyses estimated indirect effects of television watching on lung cancer (beta, 0.31, 95% CI, 0.13, 0.52; p = 6.64 × 10-4) and squamous cell lung cancer (beta, 0.33, 95% CI, 0.14, 0.53, p = 4.76 × 10-4) mediated by smoking quantity. Our findings indicate that television watching is positively correlated with the risk of lung cancer, potentially mediated through affecting smoking quantity.
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Affiliation(s)
- Yan Gao
- Department of Oncology, Cancer Center, Remin Hospital of Wuhan University, Wuhan, China
| | - Jiarui Mi
- Master Program of Biomedicine, Karolinska Institutet, Solna, Sweden
| | - Zhengye Liu
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qibin Song
- Department of Oncology, Cancer Center, Remin Hospital of Wuhan University, Wuhan, China
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Occupational Physical Activity and Lung Cancer Risk: A Systematic Review and Meta-Analysis. Sports Med 2020; 50:1637-1651. [DOI: 10.1007/s40279-020-01312-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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9
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Jiang L, Sun YQ, Brumpton BM, Langhammer A, Chen Y, Nilsen TIL, Mai XM. Prolonged Sitting, Its Combination With Physical Inactivity and Incidence of Lung Cancer: Prospective Data From the HUNT Study. Front Oncol 2019; 9:101. [PMID: 30859092 PMCID: PMC6397867 DOI: 10.3389/fonc.2019.00101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/04/2019] [Indexed: 11/21/2022] Open
Abstract
Background: Prolonged sitting as a major sedentary behavior potentially contributes to illness, but its relation with lung cancer risk is unclear. Prolonged sitting can be presented in physically active or inactive individuals. Those who are extendedly seated and also physically inactive may represent the most sedentary people. We therefore aimed to prospectively examine if total sitting time daily itself or in combination with physical activity is associated with lung cancer incidence overall and histologic types. Methods: We included 45,810 cancer-free adults who participated in the second survey of HUNT Study in Norway (1995–97), with a median follow-up of 18.3 years. Total sitting time daily and physical activity were self-reported at baseline. Lung cancer cases were ascertained from the Cancer Registry of Norway. Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Results: In total, 549 participants developed lung cancer during the follow-up. Total sitting time daily was not associated with the incidence of lung cancer overall and histologic subtypes. Compared with participants sitting < 8 h daily and being physically active, those sitting ≥8 h daily (prolonged sitting) and being physically inactive had an increased incidence of lung cancer (overall: adjusted HR = 1.44, 95% CI: 1.07–1.94; small cell lung cancer: adjusted HR = 2.58, 95% CI: 1.23–5.41). Prolonged sitting only or physical inactivity only was not associated with the incidence of lung cancer. Conclusions: Our study suggested that prolonged sitting was not independently associated with lung cancer incidence. The combination of prolonged sitting and physical inactivity might increase the risk of lung cancer. However, residual confounding by smoking cannot be excluded completely even though smoking was adjusted for with detailed information.
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Affiliation(s)
- Lin Jiang
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yi-Qian Sun
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ben Michael Brumpton
- Department of Thoracic Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Arnulf Langhammer
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Tom I L Nilsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
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Liu Y, Li Y, Bai YP, Fan XX. Association Between Physical Activity and Lower Risk of Lung Cancer: A Meta-Analysis of Cohort Studies. Front Oncol 2019; 9:5. [PMID: 30723700 PMCID: PMC6349707 DOI: 10.3389/fonc.2019.00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/02/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Epidemiological evidences regarding the association between physical activity and the risk of lung cancer are still controversial. Objectives: We aimed to investigate the relationship between physical activity and risk of lung cancer in men and women, as well as other high-risk populations such as cigarette smokers. Methods: We conducted a meta-analysis of cohort studies to evaluate the association between physical activity and risk of lung cancer. Relevant studies were identified by searching PubMed and Web of Knowledge through August 2018. Study-specific relative risk (RR) with 95% confidence interval (CI) were pooled using random effect model when significant heterogeneity was detected. Results:Twenty cohort studies with a total of 2,965,811 participants and 31,807 lung cancer cases were included. There was an inverse association between the physical activity and risk of lung cancer. Compared with the low level of physical activity, the pooled RR was 0.83 (95%CI: 0.77, 0.90), with significant heterogeneity (I2 = 62.6%, Pheterogeneity < 0.001). The corresponding pooled RRs were 0.90 (95%CI: 0.82, 0.99) for women and 0.81 (95%CI: 0.73, 0.90) for men. Smokers with a high level of physical activity were associated with a 10% lower risk for lung cancer (RR = 0.90, 95% CI: 0.84, 0.97), while the association was not significant among non-smokers (RR = 0.95, 95% CI: 0.88, 1.03). Subgroups analysis stratified by whether the studies adjusted for smoking intensity and durations yielded the same magnitude of RR. However, the RR for subgroups without adjustment for dietary factors was 0.74 (95%CI: 0.71, 0.77), which was significantly lower than that with dietary factors adjusted (RR = 0.89, 95%CI: 0.84, 0.95). Conclusions:Increased physical activity might be associated with lower risk of lung cancer. Such inverse association was identified among smokers rather than non-smokers. Large interventional studies are expected to further verify these findings.
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Affiliation(s)
- Yang Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yue Li
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yun-Peng Bai
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiao-Xi Fan
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
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11
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Risk of lung cancer and physical activity by smoking status and body mass index, the Norwegian Women and Cancer Study. Eur J Epidemiol 2018; 34:489-498. [DOI: 10.1007/s10654-018-0446-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
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12
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Lynch BM, Mahmood S, Boyle T. Sedentary Behaviour and Cancer. SEDENTARY BEHAVIOUR EPIDEMIOLOGY 2018. [DOI: 10.1007/978-3-319-61552-3_10] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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13
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Menvielle G, Dugas J, Franck JE, Carton M, Trétarre B, Stücker I, Luce D. Occupational prestige trajectory and the risk of lung and head and neck cancer among men and women in France. Int J Public Health 2017; 63:833-845. [PMID: 29222577 DOI: 10.1007/s00038-017-1063-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/15/2017] [Accepted: 11/25/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study aimed at investigating the associations between occupational prestige trajectories and lung and head and neck (HN) cancer risk and to assess to what extent smoking, alcohol drinking, and occupational exposures contribute to these associations. METHODS Using data from the ICARE case-control study (controls (2676 men/715 women), lung cancers (2019 men/558 women), HN cancers (1793 men/305 women), we defined occupational prestige trajectories using group-based modeling of longitudinal data. We conducted logistic regression models. RESULTS Among men, a gradient was observed from the downward "low to very low" trajectory to the stable very high trajectory. The associations were reduced when adjusting for tobacco and alcohol consumption and occupational exposures. Among women, when compared to the stable high trajectory, there was an increased cancer risk in all trajectories. The associations remained globally unchanged or even increased after adjustment for tobacco and alcohol consumption and did not change when adjusting for occupational exposures. The ORs were smaller for lung than for HN cancers in men. CONCLUSIONS Occupational prestige trajectory is strongly associated with lung and HN cancer risk in men and women.
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Affiliation(s)
- Gwenn Menvielle
- INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
| | - Julien Dugas
- INSERM, U 1085_IRSET, Pointe-À-Pitre, France.,University of Rennes 1, Rennes, France
| | - Jeanna-Eve Franck
- INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Matthieu Carton
- Institut Curie, PSL Research University, DRCI, Biométriesaint-Cloud, France
| | | | - Isabelle Stücker
- UVSQ, CESP, INSERM, Environmental Epidemiology of Cancer Team, University Paris Sud, Paris Saclay University, Villejuif, France
| | - Danièle Luce
- INSERM, U 1085_IRSET, Pointe-À-Pitre, France.,University of Rennes 1, Rennes, France
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14
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Matsuo T, So R, Sasai H, Ohkawara K. [Evaluation of Worker's Living Activity-time Questionnaire (JNIOSH-WLAQ) primarily to assess workers' sedentary behavior]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2017; 59:219-228. [PMID: 28954969 DOI: 10.1539/sangyoeisei.17-018-b] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The National Institute of Occupational Safety and Health, Japan (JNIOSH) developed a new Worker's Living Activity-time Questionnaire (JNIOSH-WLAQ) which primarily evaluates workers' sedentary behavior. The purpose of this study was to investigate the test-retest reliability and criterion validity of the WLAQ. METHODS One hundred and thirty eight workers completed the WLAQ twice in one week. During the week, they wore a thigh-worn inclinometer (activPAL) and maintained a daily log as criteria measurements. The WLAQ measures working time, commuting time, daily rest period (DRP), sleeping time, and time spent sitting within the four typical domains of a worker's life: (a) working time, (b) commuting time, (c) non-working time on a workday, and (d) non-workday. We calculated intraclass correlation coefficients (ICC) as a reliability value and Spearman's ρ as a validity value. Bland-Altman plots were used to assess any bias. RESULTS The analysis of WLAQ indicated favorable ICCs (0.72-0.98) for all living activity-times. The WLAQ had "strong" ρ values for working time (0.80) and DRP (0.83), a "very strong" ρ value for commuting time (0.96), and "moderate" ρ values for sleeping time during a workday (0.69) and a non-workday (0.53). As for the sitting time, the WLAQ had "moderate" ρ values for working time (0.67) and non-working time on a workday (0.59), a "strong" ρ value for commuting time (0.82), and a "low" ρ value for a non-workday (0.40). Bland-Altman plots showed a significant fixed bias for sitting time during working time and significant fixed and proportional biases for sitting time on a non-workday. CONCLUSIONS The study showed that the WLAQ has acceptable measurement features, which makes this questionnaire a reliable resource for future epidemiological surveys.
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Affiliation(s)
- Tomoaki Matsuo
- Occupational Epidemiology Research Group, National Institute of Occupational Safety and Health.,Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health
| | - Rina So
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health
| | - Hiroyuki Sasai
- Graduate School of Arts and Sciences, The University of Tokyo
| | - Kazunori Ohkawara
- Faculty of Informatics and Engineering, University of Electro-Communications
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15
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He F, Chen LM, Xiong WM, Xu QP, Xiao RD, Li X, Lin T, Cai L. A case-control study of the association between self-reported occupational and recreational physical activity and lung cancer. Medicine (Baltimore) 2017; 96:e7923. [PMID: 28885346 PMCID: PMC6392977 DOI: 10.1097/md.0000000000007923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/01/2017] [Accepted: 08/03/2017] [Indexed: 11/26/2022] Open
Abstract
This case-control study with a Fujian population investigated whether self-reported occupational and recreational physical activity may be associated with lung cancer.The population comprised 1622 patients with newly diagnosed primary lung cancer and 1622 age- and gender-matched healthy controls.High-intensity occupational physical activity was associated with significantly higher risk of lung cancer (OR = 1.354, 95% CI: 1.068-1.717), especially nonsmall cell lung carcinoma (OR = 1.384, 95% CI: 1.087-1.762). Moderate or low intensity recreational physical activity was associated with reduced risk of lung cancer. The protective effect of recreational physical activity was observed in current or former smokers, but not never-smokers, and in subjects with normal or high BMI, but not low BMI, as well as people without a history of chronic lung disease. The frequency of recreational physical activity was associated with a linear reduction in the risk of lung cancer (P < .001), and also specifically nonsmall cell lung cancer (P < .001).Occupational and recreational physical activity was associated with different effects on the risk of lung cancer in a Fujian population. While recreational physical activity was associated with decreased risk of lung cancer, occupational physical activity was associated with increased risk of lung cancer.
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Affiliation(s)
- Fei He
- Department of Epidemiology, School of Public Health
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer
- Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health
| | - Li-mei Chen
- Department of Sports, School of Basic Medicine, Fujian Medical University
| | - Wei-min Xiong
- Department of Epidemiology, School of Public Health
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer
- Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health
| | - Qiu-ping Xu
- Department of Epidemiology, School of Public Health
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer
- Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health
| | - Ren-dong Xiao
- Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xu Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Tao Lin
- Department of Epidemiology, School of Public Health
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer
- Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health
| | - Lin Cai
- Department of Epidemiology, School of Public Health
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer
- Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health
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16
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Ho V, Parent ME, Pintos J, Abrahamowicz M, Danieli C, Richardson L, Bourbonnais R, Gauvin L, Siemiatycki J, Koushik A. Physical activity and lung cancer risk in men and women. Cancer Causes Control 2017; 28:309-318. [PMID: 28247218 DOI: 10.1007/s10552-017-0872-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 02/14/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Although evidence has accumulated that recreational physical activities (PA) may reduce lung cancer risk, there is little evidence concerning the possible role of a potentially more important source of PA, namely occupational PA. We investigated both recreational and lifetime occupational PA in relation to lung cancer risk in a population-based case-control study in Montreal, Canada (NCASES = 727; NCONTROLS = 1,351). METHODS Unconditional logistic regression was used to estimate odds ratios (OR), separately for men and women, adjusting for smoking, exposure to occupational carcinogens, and sociodemographic and lifestyle factors. RESULTS In both sexes, increasing recreational PA was associated with a lower lung cancer risk (ORMEN = 0.66, 95% confidence interval (CI) 0.47-0.92; ORWOMEN = 0.55, 95% CI 0.34-0.88, comparing the highest versus lowest tertiles). For occupational PA, no association was observed among women, while increasing occupational PA was associated with increased risk among men (ORMEN = 1.96, 95% CI 1.27-3.01). ORs were not modified by occupational lung carcinogen exposure, body mass index, and smoking level; results were similar across lung cancer histological types. CONCLUSIONS Our results support the previous findings for recreational PA and lung cancer risk. Unexpectedly, our findings suggest a positive association for occupational PA; this requires replication and more detailed investigation.
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Affiliation(s)
- Vikki Ho
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada
| | - Marie-Elise Parent
- INRS (Institut Armand-Frappier Research Center), Laval, QC, Canada.,CRCHUM (Centre de recherche du CHUM), Montréal, QC, Canada
| | - Javier Pintos
- CRCHUM (Centre de recherche du CHUM), Montréal, QC, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Coraline Danieli
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | | | | | - Lise Gauvin
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada
| | - Jack Siemiatycki
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada
| | - Anita Koushik
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada.
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17
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Wang A, Qin F, Hedlin H, Desai M, Chlebowski R, Gomez S, Eaton CB, Johnson KC, Qi L, Wactawski-Wende J, Womack C, Wakelee HA, Stefanick ML. Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women: The Women's Health Initiative. Int J Cancer 2016; 139:2178-92. [PMID: 27439221 PMCID: PMC5501309 DOI: 10.1002/ijc.30281] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 06/10/2016] [Accepted: 06/20/2016] [Indexed: 01/02/2023]
Abstract
Physical activity has been associated with lower lung cancer incidence and mortality in several populations. We investigated these relationships in the Women's Health Initiative Observational Study (WHI-OS) and Clinical Trial (WHI-CT) prospective cohort of postmenopausal women. The WHI study enrolled 161,808 women aged 50-79 years between 1993 and 1998 at 40 U.S. clinical centers; 129,401 were eligible for these analyses. Cox proportional hazards models were used to assess the association of baseline physical activity levels [metabolic equivalent (MET)-min/week: none <100 (reference), low 100 to <500, medium 500 to <1,200, high 1,200+] and sedentary behavior with total lung cancer incidence and mortality. Over 11.8 mean follow-up years, 2,148 incident lung cancer cases and 1,365 lung cancer deaths were identified. Compared with no activity, higher physical activity levels at study entry were associated with lower lung cancer incidence [p = 0.009; hazard ratios (95% confidence intervals) for each physical activity category: low, HR: 0.86 (0.76-0.96); medium, HR: 0.82 (0.73-0.93); and high, HR: 0.90 (0.79-1.03)], and mortality [p < 0.0001; low, HR: 0.80 (0.69-0.92); medium, HR: 0.68 (0.59-0.80); and high, HR: 0.78 (0.66-0.93)]. Body mass index (BMI) modified the association with lung cancer incidence (p = 0.01), with a stronger association in women with BMI < 30 kg/m(2) . Significant associations with sedentary behavior were not observed. In analyses by lung cancer subtype, higher total physical activity levels were associated with lower lung cancer mortality for both overall NSCLC and adenocarcinoma. In conclusion, physical activity may be protective for lung cancer incidence and mortality in postmenopausal women, particularly in non-obese women.
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Affiliation(s)
- Ange Wang
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - FeiFei Qin
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA
| | - Manisha Desai
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA
| | - Rowan Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | | | - Charles B Eaton
- Department of Family Medicine, Memorial Hospital of Rhode Island, and Department of Epidemiology, School of Public Health at Brown University, Providence, RI
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, Davis, CA
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY
| | - Catherine Womack
- Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Heather A Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Marcia L Stefanick
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA.
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18
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Schmid D, Ricci C, Behrens G, Leitzmann MF. Does smoking influence the physical activity and lung cancer relation? A systematic review and meta-analysis. Eur J Epidemiol 2016; 31:1173-1190. [PMID: 27502335 DOI: 10.1007/s10654-016-0186-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/09/2016] [Indexed: 10/21/2022]
Abstract
Research suggests an inverse association between physical activity and lung cancer. However, whether the relation is modified by degree of smoking adjustment has not been summarized. We conducted a meta-analysis of physical activity and lung cancer focusing on evaluating whether smoking status and the degree of smoking adjustment influenced the association. Comparing high versus low physical activity levels from 25 observational studies yielded a lung cancer summary relative risk (RR) of 0.79 [95 % confidence interval (CI) = 0.72-0.87], with RRs of 0.87 (95 % CI = 0.80-0.94) for cohort studies and 0.57 (95 % CI = 0.46-0.71) for case-control studies. In further analyses restricted to cohort studies, physical activity was inversely related to lung cancer among former smokers (RR = 0.68, 95 % CI = 0.51-0.90) and current smokers (RR = 0.80, 95 % CI = 0.70-0.90), whereas the association was null among never smokers (RR = 1.05, 95 % CI = 0.78-1.40, p interaction = 0.26). The degree of smoking adjustment did not modify the association (p interaction = 0.73). Physical activity was unrelated to lung cancer among never smokers but it was inversely associated with lung cancer among former and current smokers. Although the physical activity and lung cancer relation was not modified by smoking status or degree of smoking adjustment, residual confounding by smoking remains a possible explanation for the relations observed.
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Affiliation(s)
- Daniela Schmid
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - Cristian Ricci
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Gundula Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
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19
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Menvielle G, Franck JE, Radoï L, Sanchez M, Févotte J, Guizard AV, Stücker I, Luce D. Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study. Eur J Epidemiol 2016; 31:1213-1221. [PMID: 27417979 DOI: 10.1007/s10654-016-0182-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/06/2016] [Indexed: 11/25/2022]
Abstract
Smoking only partly explains the higher lung cancer incidence observed among socially deprived people. Occupational exposures may account for part of these inequalities, but this issue has been little investigated. We investigated the extent to which smoking and occupational exposures to asbestos, silica and diesel motor exhaust mediated the association between education and lung cancer incidence in men. We analyzed data from a large French population-based case-control study (1976 lung cancers, 2648 controls). Detailed information on lifelong tobacco consumption and occupational exposures to various carcinogens was collected. We conducted inverse probability-weighted marginal structural models. A strong association was observed between education and lung cancer. The indirect effect through smoking varied by educational level, with the strongest indirect effect observed for those with the lowest education (OR = 1.34 (1.14-1.57)). The indirect effect through occupational exposures was substantial among men with primary (OR = 1.22 (1.15-1.30) for asbestos and silica) or vocational secondary education (OR = 1.18 (1.12-1.25)). The contribution of smoking to educational differences in lung cancer incidence ranged from 22 % (10-34) for men with primary education to 31 % (-3 to 84) for men with a high school degree. The contribution of occupational exposures to asbestos and silica ranged from 15 % (10-20) for men with a high school degree to 20 % (13-28) for men with vocational secondary education. Our results highlight the urgent need for public health policies that aim at decreasing exposure to carcinogens at work, in addition to tobacco control policies, if we want to reduce socioeconomic inequalities in the cancer field.
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Affiliation(s)
- Gwenn Menvielle
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.
| | - Jeanna-Eve Franck
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France
| | - Loredana Radoï
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Descartes, Paris, France
| | - Marie Sanchez
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Sud 11, Kremlin-Bicêtre, France
| | - Joëlle Févotte
- Unité Mixte de Recherche Épidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE), Université Claude Bernard Lyon 1, 69373, Lyon, France
| | | | - Isabelle Stücker
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Sud 11, Kremlin-Bicêtre, France
| | - Danièle Luce
- Inserm U 1085, IRSET, Pointe-à-Pitre, France
- University of Rennes 1, Rennes, France
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20
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Brenner DR, Yannitsos DH, Farris MS, Johansson M, Friedenreich CM. Leisure-time physical activity and lung cancer risk: A systematic review and meta-analysis. Lung Cancer 2016; 95:17-27. [PMID: 27040847 DOI: 10.1016/j.lungcan.2016.01.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/21/2016] [Accepted: 01/29/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We conducted a systematic review and meta-analysis of the association between recreational physical activity and lung cancer risk to update previous analyses and to examine population subgroups of interest defined by smoking status and histology. MATERIALS AND METHODS We searched the PubMed database for studies up to May 2015. Individual study characteristics were abstracted including study design, number of cases, assessment of recreational physical activity and type and level of adjustment for confounding factors. Combined effect estimates were calculated for the overall associations and across subgroups of interest. RESULTS We identified 28 studies that were eligible for inclusion in the meta-analysis. The overall analysis indicated an inverse association between recreational physical activity and lung cancer risk (Relative Risk (RR), 0.76; 95% Confidence Interval (CI), 0.69-0.85, p-value: <0.001). Similar inverse associations with risk were also noted for all evaluated histological subtypes, including adenocarcinoma (RR, 0.80; 95% CI, 0.72-0.88), squamous (RR, 0.80; 95% CI, 0.71-0.90) and small cell (RR, 0.79; 95% CI, 0.66-0.94). When we examined effects by smoking status, inverse associations between recreational physical activity and lung cancer risk were observed among former (RR, 0.77; 95% CI, 0.69-0.85) and current smokers (RR, 0.77; 95% CI, 0.72-0.83), but not among never smokers (RR, 0.96; 95% CI, 0.79-1.18). CONCLUSION Results from this meta-analysis suggest that regular recreational physical activity may be associated with reduced risk of lung cancer. Only four studies examining never smokers were identified, suggesting the need for additional research in this population.
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Affiliation(s)
- Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Canada.
| | - Demetra H Yannitsos
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
| | - Megan S Farris
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
| | - Mattias Johansson
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Canada
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Abstract
OBJECTIVE Previous studies concerning the association between physical activity (PA) and risk of lung cancer yielded mixed results. We investigated the association by performing a meta-analysis. DATA SOURCES Relevant studies were identified by searching PubMed and EMBASE to January 2014. Twelve cohort studies and 6 case-control studies involving 2 468 470 participants and 26 453 cases of lung cancer were selected for meta-analysis. MAIN RESULTS We calculated the summary relative risk (RR) and 95% confidence intervals (CIs) using random-effects models. The analyses showed that individuals who participated in any amount of PA had an RR of 0.79 (95% CI, 0.73-0.86) for risk of lung cancer. Those who participated in high PA (vs low PA) had an RR of 0.75 (95% CI, 0.68-0.84). Stratifying by study design (case-control and cohort studies), smoking status (current, former, and never smokers), and gender, similar inverse associations were found for all the subgroups except for never smokers subgroup. CONCLUSIONS Pooled results from observational studies support a protective effect of PA against lung cancer.
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22
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Matsuo T, Sasai H, So R, Ohkawara K. Percentage-Method Improves Properties of Workers' Sitting- and Walking-Time Questionnaire. J Epidemiol 2016; 26:405-12. [PMID: 26853102 PMCID: PMC4967661 DOI: 10.2188/jea.je20150169] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Does asking for the percentage of time spent sitting during work (P-method) instead of asking for the absolute length of time spent sitting (T-method) improve properties of the workers’ sitting- and walking-time questionnaire (WSWQ)? The purpose of this study was to investigate whether questioning technique influences test-retest reliability and criterion validity of the WSWQ. Methods Sixty-five Japanese workers completed each version of the WSWQ in random order. Both questionnaires assessed quantities of time spent sitting or walking (including standing) during work time, non-working time on a workday, and anytime on a non-workday. Participants wore the thigh-worn inclinometer (activPAL) as criterion measure. Intraclass correlation coefficients (ICC) and Spearman’s ρ were used for the analyses. Results For all three domains, values of reliability and validity with the P-method tended to be higher than with the T-method: ICC values ranged from 0.48–0.85 for the T-method and from 0.71–0.85 for the P-method; Spearman’s ρ values ranged from 0.25–0.58 for the T-method and from 0.42–0.65 for the P-method. The validities with both methods on a workday (0.51–0.58 for the T-method and 0.56–0.65 for the P-method) were higher than validities on a non-workday (0.25–0.45 for the T-method and 0.42–0.60 for the P-method). In post-survey interviews, 48 participants (77%) chose the P-method as their preferred questioning style. Conclusions The study revealed that the P-method WSWQ had better reliability, validity, and ease of answering than the T-method, suggesting that the P-method can improve properties of the WSWQ and consequently advance the quality of epidemiological surveys in this field.
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Affiliation(s)
- Tomoaki Matsuo
- Hazard Evaluation and Epidemiology Research Group, National Institute of Occupational Safety and Health
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23
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Liu L, Shi Y, Li T, Qin Q, Yin J, Pang S, Nie S, Wei S. Leisure time physical activity and cancer risk: evaluation of the WHO's recommendation based on 126 high-quality epidemiological studies. Br J Sports Med 2015; 50:372-8. [PMID: 26500336 DOI: 10.1136/bjsports-2015-094728] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The WHO has concluded that physical activity reduces the risk of numerous diseases. However, few systemic reviews have been performed to assess the role of leisure time physical activity (LTPA) in lowering the risk of cancer in a dose-dependent manner and furthermore the suitability of recommendation of physical activity by the WHO. METHODS A systematic review and meta-analysis was designed to estimate cancer risk by LTPA in binary comparison and in a dose-dependent manner. MEDLINE and Web of Science were searched up to 30 December 2014 without language restrictions. Reference lists were reviewed for potential articles. RESULTS A total of 126 studies were recruited into the meta-analysis. Overall, the total cancer risk was reduced by 10% in people who undertook the most LTPA as compared with those who did the least. Dose-response meta-analysis indicated that the current WHO recommendation (equal to an average of 10 metabolic equivalents of energy hours per week) induced a 7% (95% CI 5% to 9%) cancer reduction. Moreover, the protective role of LTPA against cancer becomes saturated at 20 metabolic equivalents of energy hours per week, with a relative risk of 0.91 (95% CI 0.88 to 0.93). Subanalyses results based on cancer types showed that LTPA only exhibited significant protection against breast cancer and colorectal cancer. CONCLUSIONS Our meta-analysis indicates that the current WHO recommendation of physical activity can result in a 7% reduction in cancer risk, which is mainly attributed to its protective role against breast cancer and colorectal cancer. Furthermore, two-fold of current recommendation level is considered to give its saturated protection against cancer.
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Affiliation(s)
- Li Liu
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yun Shi
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tingting Li
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Qin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieyun Yin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuo Pang
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Household physical activity and cancer risk: a systematic review and dose-response meta-analysis of epidemiological studies. Sci Rep 2015; 5:14901. [PMID: 26443426 PMCID: PMC4595663 DOI: 10.1038/srep14901] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 09/11/2015] [Indexed: 12/13/2022] Open
Abstract
Controversial results of the association between household physical activity and cancer risk were reported among previous epidemiological studies. We conducted a meta-analysis to investigate the relationship of household physical activity and cancer risk quantitatively, especially in dose-response manner. PubMed, Embase, Web of science and the Cochrane Library were searched for cohort or case-control studies that examined the association between household physical activity and cancer risks. Random–effect models were conducted to estimate the summary relative risks (RRs), nonlinear or linear dose–response meta-analyses were performed to estimate the trend from the correlated log RR estimates across levels of household physical activity quantitatively. Totally, 30 studies including 41 comparisons met the inclusion criteria. Total cancer risks were reduced 16% among the people with highest household physical activity compared to those with lowest household physical activity (RR = 0.84, 95% CI = 0.76–0.93). The dose-response analyses indicated an inverse linear association between household physical activity and cancer risk. The relative risk was 0.98 (95% CI = 0.97–1.00) for per additional 10 MET-hours/week and it was 0.99 (95% CI = 0.98–0.99) for per 1 hour/week increase. These findings provide quantitative data supporting household physical activity is associated with decreased cancer risk in dose-response effect.
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Koutsokera A, Kiagia M, Saif MW, Souliotis K, Syrigos KN. Nutrition Habits, Physical Activity, and Lung Cancer: An Authoritative Review. Clin Lung Cancer 2013; 14:342-50. [DOI: 10.1016/j.cllc.2012.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 12/03/2012] [Accepted: 12/09/2012] [Indexed: 01/25/2023]
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26
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Sun JY, Shi L, Gao XD, Xu SF. Physical activity and risk of lung cancer: a meta-analysis of prospective cohort studies. Asian Pac J Cancer Prev 2013; 13:3143-7. [PMID: 22994724 DOI: 10.7314/apjcp.2012.13.7.3143] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies investigating the association of physical activity with risk of lung cancer reported conflicting results. In order to update and improve available evidence on any link, a meta-analysis was performed. METHOD We searched the PubMed database for prospective cohort studies investigating the relation of physical activity with risk of lung cancer. The pooled relative risk (RR) with its 95% confidence intervals (95%CI) was used to assess the association. RESULTS We included 14 prospective studies with a total of 1,644,305 participants, with 14,074 incident lung cancer cases documented during follow-up. Meta-analysis of all 14 studies suggested both high and medium levels of physical activity to be associated with decreased risk of lung cancer compared to the reference group with low level of physical activity (for high level, RR = 0.77, 95%CI 0.73-0.81, P < 0.001; for medium level, RR = 0.87, 95%CI 0.83-0.90, P < 0.001). Subgroup analyses by gender found obvious associations in both men and women. No publication bias was observed. CONCLUSION Our findings suggest that high and medium levels of physical activity have a beneficial effect on lung cancer by reducing the overall risk of tumour development among both men and women.
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Affiliation(s)
- Jia-Yang Sun
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, China
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27
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Ukawa S, Tamakoshi A, Wakai K, Noda H, Ando M, Iso H. Prospective cohort study on television viewing time and incidence of lung cancer: findings from the Japan Collaborative Cohort Study. Cancer Causes Control 2013; 24:1547-53. [DOI: 10.1007/s10552-013-0231-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/08/2013] [Indexed: 12/15/2022]
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28
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Buffart LM, Singh AS, van Loon ECP, Vermeulen HI, Brug J, Chinapaw MJM. Physical activity and the risk of developing lung cancer among smokers: a meta-analysis. J Sci Med Sport 2013; 17:67-71. [PMID: 23528254 DOI: 10.1016/j.jsams.2013.02.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 02/20/2013] [Accepted: 02/26/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the relationship between physical activity and lung cancer among smokers and whether this relationship differed according to physical activity intensity, smoking status, and gender. DESIGN Meta-analysis. METHODS A computerized bibliographical search was conducted in five databases. Study inclusion criteria were: (i) the study population was not diagnosed with lung cancer at baseline; (ii) the study provided information concerning the effect size of physical activity on the risk of developing lung cancer in smokers; and (iii) the study distinguished different physical activity intensity levels. Two authors independently extracted data and assessed the methodological quality. Pooled rate ratios (RR) were calculated for all data, and for subgroups of physical activity intensity, smoking status, and gender. RESULTS Pooled RRs of 7 cohort studies showed that physical activity was associated with a reduced risk of lung cancer in smokers (RR=0.82, 95% CI=0.77; 0.87). We did not find clear dose-response relationship regarding exercise or smoking intensity, i.e. high levels of physical activity did not show a higher risk reduction than moderate physical activity levels, and the association between physical activity and risk reduction did not differ between heavy and light smokers. The reduced risk associated with physical activity was greater in women than in men (p=0.03), but this finding was based on only one study that reported data on women. CONCLUSIONS Results of this meta-analysis indicate that leisure time physical activity is associated with reduced risk of developing lung cancer among smokers. Future studies should provide insight into a potential dose-response relationship, and should use reliable and valid physical activity measurements.
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Affiliation(s)
- Laurien M Buffart
- VU University Medical Center, Department of Epidemiology and Biostatistics, The Netherlands.
| | - Amika S Singh
- VU University Medical Center, Department of Public and Occupational Health, The Netherlands
| | - Edwin C P van Loon
- VU University Medical Center, Department of Public and Occupational Health, The Netherlands
| | - H Ivan Vermeulen
- VU University Medical Center, Department of Public and Occupational Health, The Netherlands
| | - Johannes Brug
- VU University Medical Center, Department of Epidemiology and Biostatistics, The Netherlands
| | - Mai J M Chinapaw
- VU University Medical Center, Department of Public and Occupational Health, The Netherlands
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Kossman DA, Williams NI, Domchek SM, Kurzer MS, Stopfer JE, Schmitz KH. Exercise lowers estrogen and progesterone levels in premenopausal women at high risk of breast cancer. J Appl Physiol (1985) 2011; 111:1687-93. [PMID: 21903887 DOI: 10.1152/japplphysiol.00319.2011] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Experimental and clinical data support a role for estrogens in the development and growth of breast cancer, and lowered estrogen exposure reduces breast cancer recurrence and new diagnoses in high-risk women. There is varied evidence that increased physical activity is associated with breast cancer risk reduction in both pre- and postmenopausal women, perhaps via lowered estrogen levels. The purpose of this study was to assess whether exercise intervention in premenopausal women at increased breast cancer risk reduces estrogen or progesterone levels. Seven healthy premenopausal women at high risk for breast cancer completed a seven-menstrual-cycle study. The study began with two preintervention cycles of baseline measurement of hormone levels via daily first-morning urine collection, allowing calculation of average area under the curve (AUC) hormone exposure across the menstrual cycle. Participants then began five cycles of exercise training to a maintenance level of 300 min per week at 80-85% of maximal aerobic capacity. During the last two exercise cycles, urinary estradiol and progesterone levels were again measured daily. Total estrogen exposure declined by 18.9% and total progesterone exposure by 23.7%. The declines were mostly due to decreased luteal phase levels, although menstrual cycle and luteal phase lengths were unchanged. The study demonstrated the feasibility of daily urine samples and AUC measurement to assess hormone exposure in experimental studies of the impact of interventions on ovarian hormones. The results suggest value in exercise interventions to reduce hormone levels in high-risk women with few side effects and the potential for incremental benefits to surgical or pharmacologic interventions.
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Affiliation(s)
- D A Kossman
- National Analysts Worldwide, Philadelphia, PA, USA
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30
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Nahleh Z, Bhatti NS, Mal M. How to reduce your cancer risk: mechanisms and myths. Int J Gen Med 2011; 4:277-87. [PMID: 21556314 PMCID: PMC3085237 DOI: 10.2147/ijgm.s18657] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Indexed: 12/14/2022] Open
Abstract
Cancer prevention continues to be a high research priority and the most optimal way to ultimately lower the economic and psychological burden of cancer. Many known risk factors associated with cancer are related to dietary and lifestyle factors and can be avoided. These risk factors include among others, smoking, obesity, alcohol, physical inactivity, and carcinogens in diet. This article reviews the biological mechanisms leading to cancer in association with these factors, highlights important achievable cancer prevention methods, addresses commonly asked questions about lifestyle and cancer, and dispels some of the myths about cancer prevention.
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Affiliation(s)
- Zeina Nahleh
- Division of Hematology-Oncology, Department of Internal Medicine, TTUHSC-Paul L Foster School of Medicine, El Paso, TX, USA
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31
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Papathomas M, Molitor J, Richardson S, Riboli E, Vineis P. Examining the joint effect of multiple risk factors using exposure risk profiles: lung cancer in nonsmokers. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:84-91. [PMID: 20920953 PMCID: PMC3018505 DOI: 10.1289/ehp.1002118] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 10/04/2010] [Indexed: 05/18/2023]
Abstract
BACKGROUND Profile regression is a Bayesian statistical approach designed for investigating the joint effect of multiple risk factors. It reduces dimensionality by using as its main unit of inference the exposure profiles of the subjects that is, the sequence of covariate values that correspond to each subject. OBJECTIVES We applied profile regression to a case-control study of lung cancer in nonsmokers, nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, to estimate the combined effect of environmental carcinogens and to explore possible gene-environment interactions. METHODS We tailored and extended the profile regression approach to the analysis of case-control studies, allowing for the analysis of ordinal data and the computation of posterior odds ratios. We compared and contrasted our results with those obtained using standard logistic regression and classification tree methods, including multifactor dimensionality reduction. RESULTS Profile regression strengthened previous observations in other study populations on the role of air pollutants, particularly particulate matter ≤ 10 μm in aerodynamic diameter (PM10), in lung cancer for nonsmokers. Covariates including living on a main road, exposure to PM10 and nitrogen dioxide, and carrying out manual work characterized high-risk subject profiles. Such combinations of risk factors were consistent with a priori expectations. In contrast, other methods gave less interpretable results. CONCLUSIONS We conclude that profile regression is a powerful tool for identifying risk profiles that express the joint effect of etiologically relevant variables in multifactorial diseases.
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Affiliation(s)
- Michail Papathomas
- Department of Epidemiology and Biostatistics, Imperial College London, United Kingdom.
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32
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Occupational sitting and health risks: a systematic review. Am J Prev Med 2010; 39:379-88. [PMID: 20837291 DOI: 10.1016/j.amepre.2010.05.024] [Citation(s) in RCA: 320] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 04/25/2010] [Accepted: 05/29/2010] [Indexed: 11/21/2022]
Abstract
CONTEXT Emerging evidence suggests that sedentary behavior (i.e., time spent sitting) may be negatively associated with health. The aim of this study was to systematically review the evidence on associations between occupational sitting and health risks. EVIDENCE ACQUISITION Studies were identified in March-April 2009 by literature searches in PubMed, PsycINFO, CENTRAL, CINAHL, EMBASE, and PEDro, with subsequent related-article searches in PubMed and citation searches in Web of Science. Identified studies were categorized by health outcome. Two independent reviewers assessed methodologic quality using a 15-item quality rating list (score range 0-15 points, higher score indicating better quality). Data on study design, study population, measures of occupational sitting, health risks, analyses, and results were extracted. EVIDENCE SYNTHESIS 43 papers met the inclusion criteria (21% cross-sectional, 14% case-control, 65% prospective); they examined the associations between occupational sitting and BMI (n=12); cancer (n=17); cardiovascular disease (CVD, n=8); diabetes mellitus (DM, n=4); and mortality (n=6). The median study-quality score was 12 points. Half the cross-sectional studies showed a positive association between occupational sitting and BMI, but prospective studies failed to confirm a causal relationship. There was some case-control evidence for a positive association between occupational sitting and cancer; however, this was generally not supported by prospective studies. The majority of prospective studies found that occupational sitting was associated with a higher risk of DM and mortality. CONCLUSIONS Limited evidence was found to support a positive relationship between occupational sitting and health risks. The heterogeneity of study designs, measures, and findings makes it difficult to draw definitive conclusions at this time.
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Sui X, Lee DC, Matthews CE, Adams SA, Hébert JR, Church TS, Lee CD, Blair SN. Influence of cardiorespiratory fitness on lung cancer mortality. Med Sci Sports Exerc 2010. [PMID: 19996990 DOI: 10.1249/mss.ob013e3181c47b65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Previous studies have suggested that higher levels of physical activity may lower lung cancer risk; however, few prospective studies have evaluated lung cancer mortality in relation to cardiorespiratory fitness (CRF), an objective marker of recent physical activity habits. METHODS Thirty-eight thousand men, aged 20-84 yr, without history of cancer, received a preventive medical examination at the Cooper Clinic in Dallas, Texas, between 1974 and 2002. CRF was quantified as maximal treadmill exercise test duration and was grouped for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). RESULTS A total of 232 lung cancer deaths occurred during follow-up (mean = 17 yr). After adjustment for age, examination year, body mass index, smoking, drinking, physical activity, and family history of cancer, hazard ratios (95% confidence intervals) for lung cancer deaths across low, moderate, and high CRF categories were 1.0, 0.48 (0.35-0.67), and 0.43 (0.28-0.65), respectively. There was an inverse association between CRF and lung cancer mortality in former (P for trend = 0.005) and current smokers (P for trend < 0.001) but not in never smokers (trend P = 0.14). Joint analysis of smoking and fitness status revealed a significant 12-fold higher risk of death in current smokers (hazard ratio = 11.9, 95% confidence interval = 6.0-23.6) with low CRF as compared with never smokers who had high CRF. CONCLUSIONS Although the potential for some residual confounding by smoking could not be eliminated, these data suggest that CRF is inversely associated with lung cancer mortality in men. Continued study of CRF in relation to lung cancer, particularly among smokers, may further our understanding of disease etiology and reveal additional strategies for reducing its burden.
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Affiliation(s)
- Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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34
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Wiggins MS, Simonavice EM. Cancer prevention, aerobic capacity, and physical functioning in survivors related to physical activity: a recent review. Cancer Manag Res 2010; 2:157-64. [PMID: 21188106 PMCID: PMC3004575 DOI: 10.2147/cmar.s7461] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Indexed: 11/23/2022] Open
Abstract
According to recent published reports, over 12 million new cases of cancer were estimated worldwide for 2007. Estimates from 2008 predict that cancer will account for 22.8% of all deaths in the US. Another report stated 50% to 75% of cancer deaths in the US are related to smoking, poor dietary choices, and physical inactivity. A 2004 report indicated obesity and/or a sedentary lifestyle increases the risk of developing several types of cancer. Conversely, several large-scale cohort studies point to the positive relationship between physical activity and a reduction in cancer risk. In addition, research over the last few years has clearly shown cardiorespiratory benefits, increases in quality of life (QOL), and increases in physical functioning for cancer survivors who engage in exercise programs. Thus, the purpose of this review is to highlight three areas related to cancer and physical activity. First, information concerning the prevention of cancer through physical activity is addressed. Second, recent studies identifying changes in volume of oxygen uptake (VO(2)) and/or cardiorespiratory functioning involving exercise with cancer survivors is presented. Third, studies identifying changes in cancer survivors' physical functional capacity and QOL are presented. Finally, a summary of the review is offered.
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Affiliation(s)
- Matthew S Wiggins
- Department of Kinesiology, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
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35
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Sui X, Lee DC, Matthews CE, Adams SA, Hébert JR, Church TS, Lee CD, Blair SN. Influence of cardiorespiratory fitness on lung cancer mortality. Med Sci Sports Exerc 2010; 42:872-8. [PMID: 19996990 PMCID: PMC2859116 DOI: 10.1249/mss.0b013e3181c47b65] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Previous studies have suggested that higher levels of physical activity may lower lung cancer risk; however, few prospective studies have evaluated lung cancer mortality in relation to cardiorespiratory fitness (CRF), an objective marker of recent physical activity habits. METHODS Thirty-eight thousand men, aged 20-84 yr, without history of cancer, received a preventive medical examination at the Cooper Clinic in Dallas, Texas, between 1974 and 2002. CRF was quantified as maximal treadmill exercise test duration and was grouped for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). RESULTS A total of 232 lung cancer deaths occurred during follow-up (mean = 17 yr). After adjustment for age, examination year, body mass index, smoking, drinking, physical activity, and family history of cancer, hazard ratios (95% confidence intervals) for lung cancer deaths across low, moderate, and high CRF categories were 1.0, 0.48 (0.35-0.67), and 0.43 (0.28-0.65), respectively. There was an inverse association between CRF and lung cancer mortality in former (P for trend = 0.005) and current smokers (P for trend < 0.001) but not in never smokers (trend P = 0.14). Joint analysis of smoking and fitness status revealed a significant 12-fold higher risk of death in current smokers (hazard ratio = 11.9, 95% confidence interval = 6.0-23.6) with low CRF as compared with never smokers who had high CRF. CONCLUSIONS Although the potential for some residual confounding by smoking could not be eliminated, these data suggest that CRF is inversely associated with lung cancer mortality in men. Continued study of CRF in relation to lung cancer, particularly among smokers, may further our understanding of disease etiology and reveal additional strategies for reducing its burden.
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Affiliation(s)
- Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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36
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Menvielle G, Boshuizen H, Kunst AE, Vineis P, Dalton SO, Bergmann M, Hermann S, Veglia F, Ferrari P, Overvad K, Raaschou-Nielsen O, Tjønneland A, Kaaks R, Linseisen J, Palli D, Krogh V, Tumino R, Rodriguez L, Agudo A, Sánchez MJ, Arozena JMA, Cirera L, Ardanaz E, Bingham S, Khaw KT, Boffetta P, Duell E, Slimani N, Gallo V, Riboli E, Bueno-De-Mesquita HB. Occupational exposures contribute to educational inequalities in lung cancer incidence among men: Evidence from the EPIC prospective cohort study. Int J Cancer 2010; 126:1928-1935. [PMID: 19810107 PMCID: PMC2873305 DOI: 10.1002/ijc.24924] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The aim of this study is to investigate to what extent occupational exposures may explain socioeconomic inequalities in lung cancer incidence after adjusting for smoking and dietary factors. Analyses were based on a subsample of the European Prospective Investigation into Cancer and Nutrition (EPIC study), a prospective cohort. The analyses included 703 incident lung cancer cases among men in Denmark, the United Kingdom, Germany, Italy, Spain and Greece. The socioeconomic position was measured using the highest level of education. The estimates of relative indices of inequality (RII) were computed with Cox regression models. We first adjusted for smoking (with detailed information on duration and quantity) and dietary factors (fruits and vegetables consumption) and then for occupational exposures. The exposure to three carcinogens [asbestos, heavy metals and polycyclic aromatic hydrocarbons (PAH)] was analyzed. The occupational exposures explained 14% of the socioeconomic inequalities remaining after adjustment for smoking and fruits and vegetables consumption. The inequalities remained nevertheless statistically significant. The RII decreased from 1.87 (95% CI: 1.36-2.56) to 1.75 (1.27-2.41). The decrease was more pronounced when adjusting for asbestos than for heavy metals or PAH. Analyses by birth cohort suggested an effect of occupational exposures among older men, while due to small number of endpoints, no conclusion could be drawn about the role of occupational exposures in educational inequalities among younger men. Our study revealed that the impact of occupational exposures on socioeconomic inequalities in cancer incidence, rarely studied until now, exists while of modest magnitude.
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Affiliation(s)
- Gwenn Menvielle
- Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé
INSERM : U687IFR69Université Paris Sud - Paris XIUniversité de Versailles-Saint Quentin en YvelinesHôpital Paul Brousse 16, av Paul Vaillant Couturier 94807 VILLEJUIF,FR
- RIVM, National Institute of Public Health and Environment
National Institute of Public Health and EnvironmentBilthoven,NL
- Department of Public Health
University Medical Center RotterdamErasmus MC Rotterdam,NL
| | - Hendriek Boshuizen
- RIVM, National Institute of Public Health and Environment
National Institute of Public Health and EnvironmentBilthoven,NL
| | - Anton E. Kunst
- Department of Public Health
University Medical Center RotterdamErasmus MC Rotterdam,NL
| | - Paolo Vineis
- University of Torino and CPO-Piemonte
Università degli studi di TorinoTorino,IT
- Dept of Epidemiology and Public Health
Imperial College LondonGB
| | | | - Manuela Bergmann
- Dept of Epidemiology
German Institute of Human NutritionPostdam Rehbücke,DE
| | - Silke Hermann
- Division of Cancer Epidemiology
German Cancer Research CenterHeidelberg,DE
| | | | - Pietro Ferrari
- Nutrition and hormon group
International Agency for Research on CancerLyon,FR
| | - Kim Overvad
- Department of Epidemiology and Social Medecine
University of AarhusDK
| | | | - Anne Tjønneland
- Institute of Cancer Epidemiology
Danish Cancer SocietyCopenhague,DK
| | - Rudolf Kaaks
- Division of Cancer Epidemiology
German Cancer Research CenterHeidelberg,DE
| | - Jakob Linseisen
- Division of Cancer Epidemiology
German Cancer Research CenterHeidelberg,DE
- Institute of Epidemiology
Helmholtz Zentrum MünchenNeuherberg,DE
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit
CSPO-Scientific Institute of TuscanyFlorence,IT
| | - Vittorio Krogh
- Department of Preventive & Predictive Medicine
Italian National Center InstituteNutritional Epidemiology Unit Milan,FR
| | - Rosario Tumino
- Cancer Registry Azienda
Ospedaliera "Civile M.P. Arezzo"Ragusa,IT
| | - Laudina Rodriguez
- Public Health and Participation Directorate
Health and Health Care Service CouncilAsturias,ES
| | - Antonio Agudo
- Unit of Nutrition, Environment and Cancer
Catalan Institute of OncologyBarcelona,ES
| | - Maria-José Sánchez
- Andalusian School of Public Health
Andalusian School of Public HealthGranada,ES
- CIBER Epidemiologia y Salud Publica
CIBERESPES
| | | | - Lluis Cirera
- CIBER Epidemiologia y Salud Publica
CIBERESPES
- Department of Epidemiology
Murcia Health CouncilMurcia,ES
| | - Eva Ardanaz
- CIBER Epidemiologia y Salud Publica
CIBERESPES
- Public Health Institute of Navarra
Public Health Institute of NavarraPamplona,ES
| | - Sheila Bingham
- MRC Centrer for Nutritional Epidemiology and Cancer Prevention and Survival
University of CambridgeCambridge,GB
| | - Kay-Tee Khaw
- MRC Centrer for Nutritional Epidemiology and Cancer Prevention and Survival
University of CambridgeCambridge,GB
| | - Paolo Boffetta
- Nutrition and hormon group
International Agency for Research on CancerLyon,FR
| | - Eric Duell
- Nutrition and hormon group
International Agency for Research on CancerLyon,FR
| | - Nadia Slimani
- Nutrition and hormon group
International Agency for Research on CancerLyon,FR
| | - Valentina Gallo
- Dept of Epidemiology and Public Health
Imperial College LondonGB
| | - Elio Riboli
- Dept of Epidemiology and Public Health
Imperial College LondonGB
| | - H Bas Bueno-De-Mesquita
- RIVM, National Institute of Public Health and Environment
National Institute of Public Health and EnvironmentBilthoven,NL
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37
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Rundle A, Richie J, Steindorf K, Peluso M, Overvad K, Raaschou-Nielsen O, Clavel-Chapelon F, Linseisen JP, Boeing H, Trichopoulou A, Palli D, Krogh V, Tumino R, Panico S, Bueno-De-Mesquita HB, Peeters PH, Lund E, Gonzalez CA, Martinez C, Dorronsoro M, Barricarte A, Tormo MJ, Quiros J, Agudo A, Berglund G, Jarvholm B, Bingham S, Key TJ, Gormally E, Saracci R, Kaaks R, Riboli E, Vineis P. Physical activity and lung cancer among non-smokers: a pilot molecular epidemiological study within EPIC. Biomarkers 2010; 15:20-30. [PMID: 20050820 DOI: 10.3109/13547500903186452] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The association between physical activity, potential intermediate biomarkers and lung cancer risk was investigated in a study of 230 cases and 648 controls nested within the European Prospective Investigation of Cancer and Nutrition. Data on white blood cell aromatic-DNA adducts by (32)P-post-labelling and glutathione (GSH) in red blood cells were available from a subset of cases and controls. Compared with the first quartile, the fourth quartile of recreational physical activity was associated with a lower lung cancer risk (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.35-0.90), higher GSH levels (+1.87 micromol GSH g(-1) haemoglobin, p = 0.04) but not with the presence of high levels of adducts (OR 1.05, 95% CI 0.38-2.86). Despite being associated with recreational physical activity, in these small-scale pilot analyses GSH levels were not associated with lung cancer risk (OR 0.95, 95% CI 0.84-1.07 per unit increase in GSH levels). Household and occupational activity was not associated with lung cancer risk or biomarker levels.
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Affiliation(s)
- Andrew Rundle
- Columbia University Mailman School of Public Health, New York, NY, USA
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Abstract
Since lung cancer is among the cancers with the highest incidence and has the highest mortality rate of cancer worldwide, the means of reducing its impact are urgently needed. Emerging evidence shows that physical activity plays an etiological role in lung cancer risk reduction. The majority of studies support the fact that total and recreational physical activity reduces lung cancer risk by 20-30% for women and 20-50% for men, and there is evidence of a dose-response effect. The biological mechanisms operating between physical activity and lung cancer are likely complex and influenced by many factors including inherited or acquired susceptibility genes, gender, smoking, and other environmental factors. Several plausible biological factors and mechanisms have been hypothesized linking physical activity to reduced lung cancer risk including: improved pulmonary function, reduced concentrations of carcinogenic agents in the lungs, enhanced immune function, reduced inflammation, enhanced DNA repair capacity, changes in growth factor levels and possible gene-physical activity interactions. Future research should target the possible subgroup effects and the biologic mechanisms that may be involved.
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Affiliation(s)
- Aina Emaus
- Division of Cancer Etiology, Department of Population Science, City of Hope National Medical Center, Duarte, CA, USA.
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Physical activity and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Int J Cancer 2009; 125:902-8. [DOI: 10.1002/ijc.24326] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Leitzmann MF, Koebnick C, Abnet CC, Freedman ND, Park Y, Hollenbeck A, Ballard-Barbash R, Schatzkin A. Prospective study of physical activity and lung cancer by histologic type in current, former, and never smokers. Am J Epidemiol 2009; 169:542-53. [PMID: 19126591 DOI: 10.1093/aje/kwn371] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Increased physical activity has been associated with decreased lung cancer risk. However, no previous investigation has examined physical activity in relation to lung cancer histologic types by smoking status. The authors investigated these relations in the National Institutes of Health-AARP Diet and Health Study among 501,148 men and women aged 50-71 years at baseline in 1995-1996. During follow-up to 2003, 6,745 lung carcinomas occurred (14.8% small cell, 40.3% adenocarcinoma, 19.7% squamous cell, 6.1% undifferentiated large cell, 7.2% non-small cell not otherwise specified, and 11.8% carcinoma not otherwise specified). Among former smokers, the multivariate relative risks of small cell, adenocarcinoma, squamous cell, and undifferentiated large cell carcinomas comparing the highest with the lowest activity level (> or =5 times/week vs. inactive) were 0.93 (95% confidence interval (CI): 0.67, 1.28), 0.79 (95% CI: 0.67, 0.94), 0.73 (95% CI: 0.57, 0.93), and 0.61 (95% CI: 0.38, 0.98), respectively. Among current smokers, corresponding values were 0.77 (95% CI: 0.58, 1.02), 0.76 (95% CI: 0.61, 0.95), 0.85 (95% CI: 0.65, 1.11), and 1.10 (95% CI: 0.69, 1.78). In contrast, physical activity was unrelated to lung carcinoma among never smokers (P(interaction) between physical activity and smoking for total lung carcinomas = 0.002). The inverse findings among former and current smokers in combination with the null results for physical activity among never smokers may point toward residual confounding by cigarette smoking as an explanation for the relations observed.
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Affiliation(s)
- Michael F Leitzmann
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA.
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Menvielle G, Boshuizen H, Kunst AE, Dalton SO, Vineis P, Bergmann MM, Hermann S, Ferrari P, Raaschou-Nielsen O, Tjønneland A, Kaaks R, Linseisen J, Kosti M, Trichopoulou A, Dilis V, Palli D, Krogh V, Panico S, Tumino R, Büchner FL, van Gils CH, Peeters PHM, Braaten T, Gram IT, Lund E, Rodriguez L, Agudo A, Sánchez MJ, Tormo MJ, Ardanaz E, Manjer J, Wirfält E, Hallmans G, Rasmuson T, Bingham S, Khaw KT, Allen N, Key T, Boffetta P, Duell EJ, Slimani N, Gallo V, Riboli E, Bueno-de-Mesquita HB. The role of smoking and diet in explaining educational inequalities in lung cancer incidence. J Natl Cancer Inst 2009; 101:321-30. [PMID: 19244178 DOI: 10.1093/jnci/djn513] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Studies in many countries have reported higher lung cancer incidence and mortality in individuals with lower socioeconomic status. METHODS To investigate the role of smoking in these inequalities, we used data from 391,251 participants in the European Prospective Investigation into Cancer and Nutrition study, a cohort of individuals in 10 European countries. We collected information on smoking (history and quantity), fruit and vegetable consumption, and education through questionnaires at study entry and gathered data on lung cancer incidence for a mean of 8.4 years. Socioeconomic status was defined as the highest attained level of education, and participants were grouped by sex and region of residence (Northern Europe, Germany, or Southern Europe). Relative indices of inequality (RIIs) of lung cancer risk unadjusted and adjusted for smoking were estimated using Cox regression models. Additional analyses were performed by histological type. RESULTS During the study period, 939 men and 692 women developed lung cancer. Inequalities in lung cancer risk (RII(men) = 3.62, 95% confidence interval [CI] = 2.77 to 4.73, 117 vs 52 per 100,000 person-years for lowest vs highest education level; RII(women) = 2.39, 95% CI = 1.77 to 3.21, 46 vs 25 per 100,000 person-years) decreased after adjustment for smoking but remained statistically significant (RII(men) = 2.29, 95% CI = 1.75 to 3.01; RII(women) = 1.59, 95% CI = 1.18 to 2.13). Large RIIs were observed among men and women in Northern European countries and among men in Germany, but inequalities in lung cancer risk were reverse (RIIs < 1) among women in Southern European countries. Inequalities differed by histological type. Adjustment for smoking reduced inequalities similarly for all histological types and among men and women in all regions. In all analysis, further adjustment for fruit and vegetable consumption did not change the estimates. CONCLUSION Self-reported smoking consistently explains approximately 50% of the inequalities in lung cancer risk due to differences in education.
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Affiliation(s)
- Gwenn Menvielle
- The National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
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Pan SY, DesMeules M. Energy intake, physical activity, energy balance, and cancer: epidemiologic evidence. Methods Mol Biol 2009; 472:191-215. [PMID: 19107434 DOI: 10.1007/978-1-60327-492-0_8] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Energy intake, physical activity, and obesity are modifiable lifestyle factors. This chapter reviews and summarizes the epidemiologic evidence on the relation of energy intake, physical activity, and obesity to cancer. High energy intake may increase the risk of cancers of colon-rectum, prostate (especially advanced prostate cancer), and breast. However, because physical activity, body size, and metabolic efficiency are highly related to total energy intake and expenditure, it is difficult to assess the independent effect of energy intake on cancer risk. There are sufficient evidences to support a role of physical activity in preventing cancers of the colon and breast, whereas the association is stronger in men than in women for colon cancer and in postmenopausal than in premenopausal women for breast cancer. The evidence also suggests that physical activity likely reduces the risk of cancers of endometrium, lung, and prostate (to a lesser extent). On the other hand, there is little or no evidence that the risk of rectal cancer is related to physical activity, whereas the results have been inconsistent regarding the association between physical activity and the risks of cancers of pancreas, ovary and kidney. Epidemiologic studies provide sufficient evidence that obesity is a risk factor for both cancer incidence and mortality. The evidence supports strong links of obesity with the risk of cancers of the colon, rectum, breast (in postmenopausal women), endometrium, kidney (renal cell), and adenocarcinoma of the esophagus. Epidemiologic evidence also indicates that obesity is probably related to cancers of the pancreas, liver, and gallbladder, and aggressive prostate cancer, while it seems that obesity is not associated with lung cancer. The role of obesity in other cancer risks is unclear.
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Affiliation(s)
- Sai Yi Pan
- Public Health Agency of Canada, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
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Abstract
It is estimated that almost 1.5 million people in the USA are diagnosed with cancer every year. However, due to the substantial effect of modifiable lifestyle factors on the most prevalent cancers, it has been estimated that 50% of cancer is preventable. Physical activity, weight loss, and a reduction in alcohol use can strongly be recommended for the reduction of breast cancer risk. Similarly, weight loss, physical activity, and cessation of tobacco use are important behavior changes to reduce colorectal cancer risk, along with the potential benefit for the reduction of red meat consumption and the increase in folic acid intake. Smoking cessation is still the most important prevention intervention for reducing lung cancer risk, but recent evidence indicates that increasing physical activity may also be an important prevention intervention for this disease. The potential benefit of lifestyle change to reduce prostate cancer risk is growing, with recent evidence indicating the importance of a diet rich in tomato-based foods and weight loss. Also, in the cancers for which there are established lifestyle risk factors, such as physical inactivity for breast cancer and obesity for colorectal cancer, there is emerging information on the role that genetics plays in interacting with these factors, as well as the interaction of combinations of lifestyle factors. Integration of genetic information into lifestyle factors can help to clarify the causal relationships between lifestyle and genetic factors and assist in better identifying cancer risk, ultimately leading to better-informed choices about effective methods to enhance health and prevent cancer.
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Affiliation(s)
- Yvonne M Coyle
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
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Sprague BL, Trentham-Dietz A, Klein BEK, Klein R, Cruickshanks KJ, Lee KE, Hampton JM. Physical activity, white blood cell count, and lung cancer risk in a prospective cohort study. Cancer Epidemiol Biomarkers Prev 2008; 17:2714-22. [PMID: 18843014 DOI: 10.1158/1055-9965.epi-08-0042] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous studies have suggested that physical activity may lower lung cancer risk. The association of physical activity with reduced chronic inflammation provides a potential mechanism, yet few studies have directly related inflammatory markers to cancer incidence. The relation among physical activity, inflammation, and lung cancer risk was evaluated in a prospective cohort of 4,831 subjects, 43 to 86 years of age, in Beaver Dam, Wisconsin. A total physical activity index was created by summing up kilocalories per week from sweat-inducing physical activities, city blocks walked, and flights of stairs climbed. Two inflammatory markers, WBC count and serum albumin, were measured at the baseline examination. During an average of 12.8 years of follow-up, 134 incident cases of lung cancer were diagnosed. After multivariable adjustment, participants in the highest tertile of total physical activity index had a 45% reduction in lung cancer risk compared with those in the lowest tertile (hazard ratio, 0.55; 95% confidence interval, 0.35-0.86). Participants with WBC counts in the upper tertile (>or=8 x 10(3)/microL) were 2.81 (95% confidence interval, 1.58-5.01) times as likely to develop lung cancer as those with counts in the lowest tertile (<6.4 x 10(3)/microL). Serum albumin was not related to lung cancer risk. There was no evidence that inflammation mediated the association between physical activity and lung cancer risk, as the physical activity risk estimates were essentially unchanged after adjustment for WBC count. Although the potential for residual confounding by smoking could not be eliminated, these data suggest that physical activity and WBC count are independent risk factors for lung cancer.
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Affiliation(s)
- Brian L Sprague
- Departments of Population Health Sciences, University of Wisconsin, 610 Walnut Street, Madison WI 53726, USA
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