Cannioto Rikki A, Dighe Shruti, Mahoney Martin C, Moysich Kirsten B, Sen Arindam, Hulme Karen, McCann Susan E, Ambrosone Christine B
Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
Cancer Causes Control. 2019 Jan;30(1):1-12. doi: 10.1007/s10552-018-1101-5. Epub 2018 Nov 28.
The association of recreational physical activity (RPA) with mortality is well established only for breast and colon cancers and few studies have evaluated relationships for exercising before and after diagnosis, across multiple disease sites. We examined the joint associations of pre- and post- diagnosis RPA with mortality in a cohort of 5,807 patients enrolled in the Data Bank and BioRepository at Roswell Park.
Patients were classified into one of four activity categories (habitually active, increased activity after diagnosis, decreased activity after diagnosis, habitually inactive). Cox proportional hazards models were used to estimate the associations of activity status with mortality.
In comparison to patients who were habitually inactive, habitually active patients experienced a 39% decreased hazard of all-cause mortality (HR = 0.61, 95% CI 0.54-0.69) and a 36% decreased hazard of cancer-specific mortality (HR = 0.64, 95% CI 0.56-0.73). Previously inactive patients who began exercising after diagnosis experienced a 28% decreased hazard of all-cause (HR = 0.72, 95% CI 0.59-0.89) and cancer-specific mortality (HR = 0.72, 95% CI 0.57-0.91) in comparison to patients who remained inactive. Patients engaging in 3-4 sessions/week experienced the greatest survival advantages, but 1-2 sessions/week also yielded significant survival advantages in comparison to inactivity.
Low-to-moderate frequency pre- and post-diagnosis RPA was associated with significantly decreased mortality in patients diagnosed with a variety of malignancies. These observations solidify the clinical and public health importance of the message that some regular activity is better than inactivity, which is particularly encouraging, given that cancer survivors can be overwhelmed by current daily physical activity recommendations.
仅乳腺癌和结肠癌的休闲体育活动(RPA)与死亡率之间的关联已得到充分证实,很少有研究评估在多个疾病部位诊断前后进行运动的关系。我们在罗斯威尔公园数据银行和生物样本库登记的5807名患者队列中,研究了诊断前后RPA与死亡率的联合关联。
患者被分为四个活动类别之一(习惯性活跃、诊断后活动增加、诊断后活动减少、习惯性不活跃)。使用Cox比例风险模型估计活动状态与死亡率的关联。
与习惯性不活跃的患者相比,习惯性活跃的患者全因死亡率风险降低39%(HR = 0.61,95%CI 0.54 - 0.69),癌症特异性死亡率风险降低36%(HR = 0.64,95%CI 0.56 - 0.73)。与仍不活动的患者相比,诊断前不活动但诊断后开始运动的患者全因死亡率(HR = 0.72,95%CI 0.59 - 0.89)和癌症特异性死亡率(HR = 0.72,95%CI 0.57 - 0.91)风险降低28%。每周进行3 - 4次运动的患者生存优势最大,但与不运动相比,每周1 - 2次运动也产生了显著的生存优势。
诊断前后低至中等频率的RPA与多种恶性肿瘤患者死亡率显著降低相关。这些观察结果强化了这样一个信息的临床和公共卫生重要性,即一些规律的活动总比不活动好,鉴于癌症幸存者可能被当前的日常体育活动建议压垮,这尤其令人鼓舞。