J Phys Act Health. 2019 Dec 1;16(12):1098-1104. doi: 10.1123/jpah.2019-0245.
To assess the joint and stratified associations between cardiorespiratory fitness (CRF), incidence, and mortality from cancer in never, former, and current male smokers.
CRF (treadmill exercise test) was assessed in 4694 men (never smokers [n = 1715]; former smokers [n = 1602], 32.4 [30.5] pack-years; and current smokers [n = 1377], 40.3 [26] pack-years) aged 58.1 (17.3) years, and prospectively followed for 12.7 (7.5) years. Multivariable Cox hazard models were analyzed.
In joint analyses, where high CRF in never smokers was used as a reference, hazard ratios and 95% (confidence intervals) for cancer incidence and cancer mortality were as follows: moderate CRF 1.41 (1.0-1.9) and 3.0 (1.7-5.5) in never smokers, 1.65 (1.3-2.2) and 3.7 (2.1-6.6) in former smokers, and 1.3 (0.9-1.7) and 3.4 (1.9-6.1) in current smokers, respectively. The corresponding values for low CRF were 1.53 (1.1-2.2) and 5.1 (2.7-9.5), 1.84 (1.3-2.5) and 6.6 (3.7-11.8), and 1.5 (1.1-2.2) and 5 (2.7-9.3), respectively. In stratified analyses by smoking status, compared with low CRF, moderate and high CRF were associated with a 32% to 78% reduction in cancer mortality risk (P trend for all <.001).
Higher CRF is associated with lower risk of incidence and mortality from cancer regardless of smoking status, supporting the potential preventive benefits for public health.
评估心肺适能（CRF）与从不吸烟者、前吸烟者和当前吸烟者的癌症发病率和死亡率之间的联合和分层关联。
在 4694 名年龄为 58.1（17.3）岁的男性（从不吸烟者 [n=1715]；前吸烟者 [n=1602]，32.4[30.5]包年；和当前吸烟者 [n=1377]，40.3[26]包年）中评估 CRF（跑步机运动测试），并进行了 12.7（7.5）年的前瞻性随访。多变量 Cox 风险模型进行了分析。
在联合分析中，将从不吸烟者中的高 CRF 用作参考，从不吸烟者、前吸烟者和当前吸烟者的癌症发病率和癌症死亡率的风险比（HR）和 95%置信区间（CI）如下：中等到高 CRF 分别为 1.41（1.0-1.9）和 3.0（1.7-5.5），1.65（1.3-2.2）和 3.7（2.1-6.6），1.3（0.9-1.7）和 3.4（1.9-6.1）。低 CRF 的相应值分别为 1.53（1.1-2.2）和 5.1（2.7-9.5）、1.84（1.3-2.5）和 6.6（3.7-11.8）、1.5（1.1-2.2）和 5（2.7-9.3）。按吸烟状况进行分层分析时，与低 CRF 相比，中等到高 CRF 与癌症死亡率风险降低 32%至 78%相关（所有 P 趋势<.001）。
无论吸烟状况如何，较高的 CRF 与癌症发病率和死亡率风险降低相关，支持其对公共健康的潜在预防益处。
