Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
Cancer Prev Res (Phila). 2014 Jan;7(1):12-22. doi: 10.1158/1940-6207.CAPR-13-0282. Epub 2013 Sep 18.
Physical activity may be associated with reduced risk of gastric cancer. We performed a systematic review and meta-analysis to evaluate the magnitude of the association and the quality of supporting evidence. After a comprehensive search of bibliographic databases and conference proceedings through February 2013 for observational studies that examined associations between recreational and/or occupational physical activity and gastric cancer risk, we identified 16 studies (seven cohort, nine case control) reporting 11,111 cases of gastric cancer among 1,606,760 patients. Summary adjusted-OR estimates with 95% confidence intervals (CI) were estimated using the random-effects model. Meta-analysis demonstrated that the risk of gastric cancer was 21% lower among the most physically active people as compared with the least physically active people (OR = 0.79; 95% CI, 0.71-0.87) with moderate heterogeneity among studies (I(2) = 55%). This protective effect was seen for gastric cancers in the cardia (four studies; OR = 0.80; 95% CI, 0.63-1.00) and distal stomach (five studies; OR = 0.63; 95% CI, 0.52-0.76). The effect size was significantly smaller in high-quality studies (six studies; OR = 0.86; 95% CI, 0.75-0.99), as compared with low-quality studies (10 studies; OR = 0.74; 95% CI, 0.69-0.81). The results were consistent across sex, study quality, study design, and geographic location. In conclusion, meta-analysis of published observational studies indicates that physical activity is associated with reduced risk of gastric cancer. Lifestyle interventions focusing on increasing physical activity may decrease the global burden of gastric cancer, in addition to a myriad of other health benefits.
身体活动可能与降低胃癌风险有关。我们进行了系统评价和荟萃分析，以评估这种关联的程度和支持证据的质量。通过全面搜索文献数据库和会议记录，截至 2013 年 2 月，我们共检索到 16 项观察性研究，这些研究检查了休闲和/或职业身体活动与胃癌风险之间的关系，共包括 1606760 名患者中的 11111 例胃癌病例。使用随机效应模型估算具有 95%置信区间（CI）的汇总调整后 OR 估计值。荟萃分析表明，与活动最少的人相比，活动最多的人患胃癌的风险低 21%（OR=0.79；95%CI，0.71-0.87），但研究之间存在中度异质性（I²=55%）。这种保护作用在贲门癌（四项研究；OR=0.80；95%CI，0.63-1.00）和远端胃癌（五项研究；OR=0.63；95%CI，0.52-0.76）中均可见。高质量研究（六项研究；OR=0.86；95%CI，0.75-0.99）的效应值明显小于低质量研究（十项研究；OR=0.74；95%CI，0.69-0.81）。结果在性别、研究质量、研究设计和地理位置方面都是一致的。总之，对已发表的观察性研究进行荟萃分析表明，身体活动与降低胃癌风险有关。以增加身体活动为重点的生活方式干预措施可能会除了带来无数其他健康益处外，还会降低全球胃癌负担。
