Occupational Physical Activity and Lung Cancer Risk: A Systematic Review and Meta-Analysis.

OBJECTIVE

To deliver a systematic review of the literature synthesizing data on the association of occupational physical activity with lung cancer risk in observational studies.

DESIGN

Systematic review with meta-analysis.

DATA SOURCE

A literature search was performed in the electronic databases of PubMed/Medline and Embase.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We screened peer-reviewed articles from prospective cohort and case-control studies assessing the association of occupational physical activity with lung cancer risk. A sex-specific meta-analysis assessed the association of high (compared to low/sedentary) level occupational physical activity with lung cancer risk, estimating the relative risk (RR) and odds ratio (OR) with a 95% confidence interval (CI).

RESULTS

The systematic search identified 2065 articles, among which, eight journal articles met the inclusion criteria. The meta-analysis adjusted for age, smoking status and/or intensity, with a pooled sample size of 532,282 participants (men: 219,410; women: 312,872). A random-effect model of four prospective and four case-control studies indicated that men who engage in high-level occupational physical activity had a 15% higher risk (OR 1.15, 95% CI 1.04-1.28) of lung cancer than those engaging in low/sedentary-level occupational physical activity. There was no association observed among women (OR = 1.01, 95% CI 0.77-1.34) based on three available studies (prospective cohort: n = 2; case-control: n = 1).

CONCLUSIONS

Findings from the review suggest a higher risk of lung cancer among men reporting high-level occupational physical activity. Further prospective studies incorporating rigorous measures of domain-specific physical activity, detailed smoking status and intensity, and other occupational exposures are needed to elucidate this association.

PROSPERO REGISTRATION ID

CRD42019137911.