Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America.
PLoS One. 2013 Dec 19;8(12):e84805. doi: 10.1371/journal.pone.0084805. eCollection 2013.
Body mass index is known to be positively associated with an increased risk of adenocarcinomas of the esophagus, yet there is there limited evidence on whether physical activity or sedentary behavior affects risk of histology- and site-specific upper gastrointestinal cancers. We used the NIH-AARP Diet and Health Study to assess these exposures in relation to esophageal adenocarcinoma (EA), esophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma (GCA), and gastric non-cardia adenocarcinoma (GNCA).
Self-administered questionnaires were used to elicit physical activity and sedentary behavior exposures at various age periods. Cohort members were followed via linkage to the US Postal Service National Change of Address database, the Social Security Administration Death Master File, and the National Death Index. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 percent confidence intervals (95%CI).
During 4.8 million person years, there were a total of 215 incident ESCCs, 631 EAs, 453 GCAs, and 501 GNCAs for analysis. Strenuous physical activity in the last 12 months (HR(>5 times/week vs. never)=0.58, 95%CI: 0.39, 0.88) and typical physical activity and sports during ages 15-18 years (p for trend=0.01) were each inversely associated with GNCA risk. Increased sedentary behavior was inversely associated with EA (HR(5-6 hrs/day vs. <1 hr)=0.57, 95%CI: 0.36, 0.92). There was no evidence that BMI was a confounder or effect modifier of any relationship. After adjustment for multiple testing, none of these results were deemed to be statistically significant at p<0.05.
We find evidence for an inverse association between physical activity and GNCA risk. Associations between body mass index and adenocarcinomas of the esophagus do not appear to be related to physical activity and sedentary behavior.
体重指数与食管腺癌风险的增加呈正相关，但关于体力活动或久坐行为是否影响组织学和部位特异性上消化道癌症的风险，证据有限。我们使用 NIH-AARP 饮食与健康研究来评估这些暴露与食管腺癌（EA）、食管鳞状细胞癌（ESCC）、胃贲门腺癌（GCA）和胃非贲门腺癌（GNCA）的关系。
自我管理问卷用于在不同年龄阶段获取体力活动和久坐行为的暴露情况。通过与美国邮政总局全国地址变更数据库、社会保障管理局死亡主文件和国家死亡指数的链接，对队列成员进行随访。使用 Cox 比例风险回归模型估计风险比（HR）和 95%置信区间（95%CI）。
在 480 万人年的随访期间，共发生了 215 例 ESCC、631 例 EA、453 例 GCA 和 501 例 GNCA。最近 12 个月的剧烈体力活动（每周>5 次与从不）（HR（>5 次/周比从不）=0.58，95%CI：0.39，0.88）和 15-18 岁时的典型体力活动和运动（趋势检验的 p 值=0.01）与 GNCA 风险呈负相关。久坐行为增加与 EA 呈负相关（每天 5-6 小时与<1 小时）（HR（5-6 小时/天比<1 小时）=0.57，95%CI：0.36，0.92）。没有证据表明 BMI 是任何关系的混杂因素或效应修饰剂。在进行多次测试调整后，这些结果均未达到统计学显著水平（p<0.05）。
我们发现体力活动与 GNCA 风险之间存在负相关。体重指数与食管腺癌之间的关联似乎与体力活动和久坐行为无关。
