Cannioto Rikki A, Moysich Kirsten B
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
Gynecol Oncol. 2015 Jun;137(3):559-73. doi: 10.1016/j.ygyno.2015.03.016. Epub 2015 Mar 20.
Despite the publication of two dozen observational epidemiological studies investigating the association between recreational physical activity (RPA) and epithelial ovarian cancer (EOC) risk and survival over the past two decades, taken collectively, data from retrospective and prospective studies are mixed and remain inconclusive.
Our primary purpose was to conduct a careful review and summary of the epidemiological literature depicting the association between EOC and RPA in the framework of identifying factors which may be impeding our ability to observe consistent associations in the literature. Secondly, in the backdrop of the more broad scientific evidence regarding the benefits of RPA, we provide a summary of guidelines for practitioners to utilize in the context of exercise prescription for cancer patients, including a discussion of special considerations and contraindications to exercise which are unique to EOC patients and survivors.
We performed a comprehensive literature search via PubMed to identify epidemiologic investigations focused on the association between RPA and EOC. To be included in the review, studies had to assess RPA independently of occupational or household activities.
In total, 26 studies were identified for inclusion. Evidence of a protective effect of RPA relative to EOC risk is more consistent among-case control studies, with the majority of studies demonstrating significant risk reductions between 30 and 60% among the most active women. Among cohort studies, half yielded no significant associations, while the remaining studies provided mixed evidence of an association.
Given the limitations identified in the current body of literature, practitioners should not rely on inconclusive evidence to dissuade women from participating in moderate or vigorous RPA. Rather, emphasis should be placed on the greater body of scientific evidence which has demonstrated that RPA results in a plethora of health benefits that can be achieved in all populations, including those with cancer.
尽管在过去二十年里发表了二十多项观察性流行病学研究，调查休闲体育活动（RPA）与上皮性卵巢癌（EOC）风险及生存率之间的关联，但总体而言，回顾性研究和前瞻性研究的数据参差不齐，尚无定论。
我们的主要目的是仔细回顾和总结流行病学文献，描述EOC与RPA之间的关联，同时找出可能阻碍我们在文献中观察到一致关联的因素。其次，鉴于关于RPA益处的更广泛科学证据，我们总结了从业者在为癌症患者制定运动处方时可采用的指南，包括讨论EOC患者及幸存者运动时的特殊注意事项和禁忌。
我们通过PubMed进行了全面的文献检索，以确定聚焦于RPA与EOC关联的流行病学调查。纳入综述的研究必须独立于职业或家庭活动来评估RPA。
总共确定了26项研究纳入。RPA对EOC风险具有保护作用的证据在病例对照研究中更为一致，大多数研究表明，最活跃的女性中风险显著降低30%至60%。在队列研究中，一半没有得出显著关联，而其余研究提供了混合的关联证据。
鉴于当前文献中发现的局限性，从业者不应依赖不确定的证据来劝阻女性参与中度或剧烈的RPA。相反，应强调更多的科学证据，这些证据表明RPA能带来大量健康益处，所有人群都能实现，包括癌症患者。
