Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.
Int J Cancer. 2020 Apr 1;146(7):1800-1809. doi: 10.1002/ijc.32513. Epub 2019 Jul 1.
Results of epidemiologic studies of physical activity and ovarian cancer risk are inconsistent. Few have attempted to measure physical activity over the lifetime or in specific age windows, which may better capture etiologically relevant exposures. We examined participation in moderate-to-vigorous recreational physical activity (MVPA) in relation to ovarian cancer risk. In a population-based case-control study conducted in Montreal, Canada from 2011 to 2016 (485 cases and 887 controls), information was collected on lifetime participation in various recreational physical activities, which was used to estimate MVPA for each participant. MVPA was represented as average energy expenditure over the lifetime and in specific age-periods in units of metabolic equivalents (METs)-hours per week. Odds ratios (OR) and 95% confidence intervals (CI) for the relation between average MVPA and ovarian cancer risk were estimated using multivariable logistic regression models. Confounding was assessed using directed acyclic graphs combined with a change-in-estimate approach. The adjusted OR (95% CI) for each 28.5 MET-hr/week increment of lifetime recreational MVPA was 1.11 (0.99-1.24) for ovarian cancer overall. ORs for individual age-periods were weaker. When examined by menopausal status, the OR (95% CI) for lifetime MVPA was 1.21 (1.00-1.45) for those diagnosed before menopause and 1.04 (0.89-1.21) for those diagnosed postmenopausally. The suggestive positive associations were stronger for invasive ovarian cancers and more specifically for high-grade serous carcinomas. These results do not support a reduced ovarian cancer risk associated with MVPA.
体力活动与卵巢癌风险的流行病学研究结果不一致。很少有人试图测量一生中或特定年龄窗口内的体力活动，这可能更好地捕捉到与病因相关的暴露。我们研究了中度至剧烈的娱乐性体力活动（MVPA）与卵巢癌风险的关系。在 2011 年至 2016 年期间在加拿大蒙特利尔进行的一项基于人群的病例对照研究中（485 例病例和 887 例对照），收集了关于一生中参与各种娱乐性体力活动的信息，用于估计每位参与者的 MVPA。MVPA 以一生中的平均能量消耗和特定年龄时期的能量消耗来表示，单位为代谢当量（MET）小时/周。使用多变量逻辑回归模型估计平均 MVPA 与卵巢癌风险之间的关系的比值比（OR）和 95%置信区间（CI）。使用有向无环图（DAG）结合估计变化方法评估混杂。一生中娱乐性 MVPA 每增加 28.5MET-hr/周，卵巢癌的总体调整后 OR（95%CI）为 1.11（0.99-1.24）。个别年龄时期的 OR 较弱。按绝经状态检查时，绝经前诊断的病例的终生 MVPA 的 OR（95%CI）为 1.21（1.00-1.45），而绝经后诊断的病例的 OR 为 1.04（0.89-1.21）。这些提示阳性关联在侵袭性卵巢癌中更强，特别是在高级别浆液性癌中更强。这些结果不支持与 MVPA 相关的卵巢癌风险降低。
