Cannioto Rikki, Etter John Lewis, LaMonte Michael J, Ray Andrew D, Joseph Janine M, Al Qassim Emad, Eng Kevin H, Moysich Kirsten B
Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, New York 14263, United States of America.
Department of Epidemiology and Environmental Health, University at Buffalo, 273 Farber Hall, Buffalo, New York 14214, United States of America.
Cancer Treat Res Commun. 2018;14:37-45. doi: 10.1016/j.ctarc.2018.01.001.
Investigations of the independent associations of physical inactivity with cancer endpoints have been mounting in the epidemiological literature, in part due to the high prevalence of physical inactivity among cancer patients and to evidence that inactivity associates with carcinogenesis via pathways independent of obesity. Yet, physical inactivity is not currently recognized as a well-established risk or prognostic factor for lung cancer. As such, we examined the associations of lifetime physical inactivity with lung cancer risk and mortality in a hospital-based, case-control study.
The analyses included data from 660 lung cancer patients and 1335 matched cancer-free controls. Multivariable logistic regression analyses were utilized to assess the association between lifetime physical inactivity and lung cancer risk, and Cox proportional hazards models were utilized to estimate the association between lifetime physical inactivity and mortality among lung cancer cases. We observed a significant positive association between lifetime physical inactivity and lung cancer risk: [Odds ratio (OR)=2.23, 95% confidence interval (CI): 1.77-2.81]; the association remained significant among never smokers (OR=3.00, 95% CI:1.33-6.78) and non-smokers (OR=2.33, 95% CI: 1.79-3.02). We also observed a significant positive association between lifetime physical inactivity and lung cancer mortality [Hazard ratio (HR)=1.40, 95% CI: 1.14-1.71]; the association remained significant in non-smokers (HR=1.51, 95% CI: 1.16-1.95).
DISCUSSION/CONCLUSION: These data add to the body of evidence suggesting that physical inactivity is an independent risk and prognostic factor for cancer. Additional research utilizing prospectively collected data is needed to substantiate the current findings.
流行病学文献中,关于身体活动不足与癌症终点事件之间独立关联的研究日益增多,部分原因在于癌症患者中身体活动不足的比例很高,以及有证据表明身体活动不足通过独立于肥胖的途径与致癌作用相关。然而,目前身体活动不足尚未被公认为肺癌的确立风险因素或预后因素。因此,我们在一项基于医院的病例对照研究中,研究了终生身体活动不足与肺癌风险及死亡率之间的关联。
分析纳入了660例肺癌患者和1335例匹配的无癌对照的数据。采用多变量逻辑回归分析评估终生身体活动不足与肺癌风险之间的关联,采用Cox比例风险模型估计终生身体活动不足与肺癌病例死亡率之间的关联。我们观察到终生身体活动不足与肺癌风险之间存在显著正相关:[比值比(OR)=2.23,95%置信区间(CI):1.77 - 2.81];在从不吸烟者(OR = 3.00,95% CI:1.33 - 6.78)和非吸烟者(OR = 2.33,95% CI:1.79 - 3.02)中,该关联仍然显著。我们还观察到终生身体活动不足与肺癌死亡率之间存在显著正相关[风险比(HR)=1.40,95% CI:1.14 - 1.71];在非吸烟者中该关联仍然显著(HR = 1.51,95% CI:1.16 - 1.95)。
讨论/结论:这些数据进一步证明,身体活动不足是癌症的独立风险因素和预后因素。需要利用前瞻性收集的数据进行更多研究,以证实当前的发现。