Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany.
Department of Urology, Caritas St. Josef Hospital, University of Regensburg, Germany.
Cancer Prev Res (Phila). 2019 Oct;12(10):675-688. doi: 10.1158/1940-6207.CAPR-19-0271. Epub 2019 Jul 30.
Prostate cancer is the second most common cancer in men worldwide, and sedentary behavior is widespread, yet reviews and meta-analyses summarizing the role of sedentary behavior as a potential risk factor for prostate cancer are scarce. We searched PubMed, Web of Science, and Cochrane databases for relevant articles up to January 2019. We pooled maximally adjusted risk estimates in a random effects model and performed meta-regression meta-analysis, assessed heterogeneity and publication bias using , funnel plots, and Egger and Begg tests, and conducted sensitivity analyses and influence diagnostics. Data from 12 prospective cohort studies including a total of 30,810 prostate cancer cases were analyzed. We found no statistically significant association between high versus low sedentary behavior and prostate cancer incidence [RR = 1.07; 95% confidence interval (CI), 0.99-1.16; 0.10]. We noted that adjustment for body mass index (BMI) modified the relation of sedentary behavior to prostate cancer, particularly aggressive cancer. Sedentary behavior was related to a statistically significant increased risk of aggressive prostate cancer in analyses not adjusted for BMI (RR = 1.21; 95% CI, 1.03-1.43), whereas no association was apparent in BMI-adjusted analyses (RR = 0.98; 95% CI, 0.90-1.07), and the difference between those summary risk estimates was statistically significant ( = 0.02). Sedentary behavior is not independently associated with prostate cancer. However, prolonged sedentary behavior may be related to increased risk of aggressive prostate cancer through a mechanism involving obesity. This finding represents a potentially important step toward considering sedentary behavior as a modifiable behavioral risk factor for aggressive prostate cancer.
前列腺癌是全球男性第二大常见癌症，而久坐行为普遍存在，但综述和荟萃分析总结久坐行为作为前列腺癌潜在危险因素的作用却很少。我们检索了PubMed、Web of Science 和 Cochrane 数据库，以获取截至 2019 年 1 月的相关文章。我们在随机效应模型中汇总了最大限度调整风险估计，并进行了荟萃回归荟萃分析，使用漏斗图、Egger 和 Begg 检验评估异质性和发表偏倚，并进行了敏感性分析和影响诊断。共纳入了 12 项前瞻性队列研究，包括 30810 例前列腺癌病例。我们发现高久坐行为与低久坐行为与前列腺癌发病率之间没有统计学上的显著关联[RR = 1.07；95%置信区间（CI），0.99-1.16； = 0.10]。我们注意到，调整体重指数（BMI）改变了久坐行为与前列腺癌的关系，特别是侵袭性前列腺癌。在未调整 BMI 的分析中，久坐行为与侵袭性前列腺癌的风险呈统计学显著增加相关（RR = 1.21；95%CI，1.03-1.43），而在 BMI 调整分析中则无明显关联（RR = 0.98；95%CI，0.90-1.07），并且这些汇总风险估计之间的差异具有统计学意义（ = 0.02）。久坐行为与前列腺癌独立无关。然而，长时间久坐可能通过肥胖相关机制与侵袭性前列腺癌风险增加有关。这一发现代表了将久坐行为视为侵袭性前列腺癌可改变的行为危险因素的重要一步。
