Perrier Flavie, Ghiasvand Reza, Lergenmuller Simon, Robsahm Trude E, Green Adele C, Borch Kristin B, Sandanger Torkjel M, Weiderpass Elisabete, Rueegg Corina S, Veierød Marit B
Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway; Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
Prev Med. 2021 Dec;153:106556. doi: 10.1016/j.ypmed.2021.106556. Epub 2021 Apr 20.
Physical activity (PA) is an important factor in cancer prevention, but positive association between PA and risk of cutaneous melanoma found in recent studies may complicate this strategy. Ultraviolet radiation (UVR) exposure during outdoor PA is a plausible explanation for a positive association. We investigated the associations between PA, UVR and melanoma risk in the Norwegian Women and Cancer cohort. Overall PA was reported by 151,710 women, aged 30-75 at inclusion, using a validated 10-point-scale at enrolment and during follow-up, together with recent numbers of sunburns, indoor tanning sessions and weeks on sunbathing vacations. Seasonal outdoor walking and seasonal PAs were recorded in subsamples (n = 102,671 and n = 29,077, respectively). Logistic and Cox regression were used. Mean follow-up was 18.5 years, and 1565 invasive incident melanoma cases were diagnosed. Overall PA was inversely associated with sunburns, while positively associated with sunbathing vacations and indoor tanning. Overall PA was not associated with melanoma risk in all body sites combined (p = 0.61), but reduced risk was found in upper limb melanomas (hazard ratio (HR) = 0.70, 95% confidence interval (CI) 0.51-0.96; high versus low PA). Non-significant reduced risks were found for seasonal outdoor walking >2 h/day versus 30-60 min/day (summer HR = 0.81, 95% CI 0.66-1.00; autumn HR = 0.74, 95%CI 0.55-1.01). Seasonal PAs were not associated with melanoma risk. In conclusion, we found positive associations between overall PA and sunbathing vacations and indoor tanning, and, unlike literature, inverse association between overall PA and sunburns. Our results do not support a positive association between PA and melanoma risk in Norwegian women.
身体活动（PA）是癌症预防的一个重要因素，但近期研究发现PA与皮肤黑色素瘤风险之间的正相关可能会使这一策略变得复杂。户外PA期间的紫外线辐射（UVR）暴露是这种正相关的一个合理的解释。我们在挪威女性与癌症队列中研究了PA、UVR与黑色素瘤风险之间的关联。共有151,710名年龄在30 - 75岁之间的女性纳入研究，她们在入组时和随访期间使用经过验证的10分制报告总体PA情况，同时报告近期晒伤次数、室内晒黑疗程数以及日光浴度假周数。在子样本中记录了季节性户外步行和季节性PA（分别为n = 102,671和n = 29,077）。使用了逻辑回归和Cox回归。平均随访时间为18.5年，诊断出1565例侵袭性黑色素瘤病例。总体PA与晒伤呈负相关，而与日光浴度假和室内晒黑呈正相关。总体PA与所有身体部位的黑色素瘤风险无关联（p = 0.61），但在上肢黑色素瘤中发现风险降低（风险比（HR）= 0.70，95%置信区间（CI）0.51 - 0.96；高PA与低PA相比）。与每天户外步行30 - 60分钟相比，每天户外步行超过2小时（夏季HR = 0.81，95% CI 0.66 - 1.00；秋季HR = 0.74，95% CI = 0.55 - 1.01），黑色素瘤风险有非显著性降低。季节性PA与黑色素瘤风险无关联。总之，我们发现总体PA与日光浴度假和室内晒黑之间存在正相关，并且与文献不同的是，总体PA与晒伤之间存在负相关。我们的结果不支持挪威女性中PA与黑色素瘤风险之间存在正相关。
