Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
Department of Internal Medicine II-Gastroenterology, University Hospital Munich, Munich, Germany.
Eur J Epidemiol. 2022 May;37(5):447-460. doi: 10.1007/s10654-022-00873-6. Epub 2022 May 25.
Several systematic reviews and meta-analyses have summarized the association between sedentary behavior (SB) and cancer. However, the level of evidence and the potential for risk of bias remains unclear. This umbrella review summarized the current data on SB in relation to cancer incidence and mortality, with a particular emphasis on assessing the risk of bias. We searched PubMed, Web of Science and Cochrane Database for systematic reviews and meta-analyses on the association between SB and cancer incidence and mortality. We also searched for recent observational studies not yet included in existing meta-analyses. We re-calculated summary risk estimates for cancer incidence and mortality using random effects models. We included 14 meta-analyses covering 17 different cancer sites from 77 original studies. We found that high SB levels increase the risk for developing ovarian, endometrial, colon, breast, prostate, and rectal cancers, with relative risks of 1.29 (95% confidence interval (CI) = 1.08-1.56), 1.29 (95% CI = 1.16-1.45), 1.25 (95% CI = 1.16-1.33), 1.08 (95% CI = 1.04-1.11), 1.08 (95% CI = 1.00-1.17), and 1.07 (95% CI = 1.01-1.12), respectively. Also, we found an increased risk of cancer mortality of 1.18 (95% CI = 1.09-1.26). Most associations between SB and specific cancer sites were supported by a "suggestive" level of evidence. High levels of SB are associated with increased risk of several types of cancer and increased cancer mortality risk.
几项系统评价和荟萃分析总结了久坐行为(SB)与癌症之间的关联。然而,证据水平和潜在的偏倚风险仍然不清楚。本伞式综述总结了目前关于 SB 与癌症发病率和死亡率之间关系的现有数据,特别强调了评估偏倚风险的情况。我们在 PubMed、Web of Science 和 Cochrane Database 中搜索了关于 SB 与癌症发病率和死亡率之间关联的系统评价和荟萃分析,并搜索了尚未包含在现有荟萃分析中的最新观察性研究。我们使用随机效应模型重新计算了癌症发病率和死亡率的综合风险估计值。我们纳入了 14 项荟萃分析,涵盖了来自 77 项原始研究的 17 个不同癌症部位。我们发现,高 SB 水平会增加卵巢癌、子宫内膜癌、结肠癌、乳腺癌、前列腺癌和直肠癌的发病风险,相对风险分别为 1.29(95%置信区间(CI)=1.08-1.56)、1.29(95% CI=1.16-1.45)、1.25(95% CI=1.16-1.33)、1.08(95% CI=1.04-1.11)、1.08(95% CI=1.00-1.17)和 1.07(95% CI=1.01-1.12)。此外,我们还发现癌症死亡率的风险增加了 1.18(95% CI=1.09-1.26)。SB 与特定癌症部位之间的大多数关联都得到了“提示性”证据水平的支持。高水平的 SB 与几种类型的癌症风险增加和癌症死亡率风险增加有关。
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