Kitson Sarah J, Aurangzeb Olivia, Parvaiz Jawaria, Lophatananon Artitaya, Muir Kenneth R, Crosbie Emma J
Gynaecological Oncology Research Group, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, United Kingdom.
Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
Cancer Prev Res (Phila). 2022 Sep 1;15(9):605-621. doi: 10.1158/1940-6207.CAPR-22-0129.
Endometrial cancer incidence is rising, with 435,000 global cases in 2019. An effective, low-cost primary prevention strategy is required to reduce disease burden. Obesity, insulin resistance, and inflammation contribute to endometrial carcinogenesis and physical activity targets these pathways. This study sought to quantify the amount of physical activity required to impact upon endometrial cancer risk. Physical activity data from 222,031 female participants with an intact uterus in the UK Biobank study were analyzed using a multivariable Cox proportional hazards model. A systematic review of the literature was performed, searching CENTRAL, Embase, and MEDLINE databases up to April 19, 2021. Studies including participants with and without endometrial cancer investigating the effect of physical activity measured in MET-hours/week (MET-h/week) on disease risk were included. Two reviewers independently selected studies, extracted data, and evaluated the risk of bias. Within the UK Biobank, each 1 MET-h/week increase in total physical activity was associated with a 0.2% [95% confidence interval (CI), 0.1-0.4; P = 0.020] reduction in endometrial cancer risk, equating to a 10.4% reduction if performing 50 MET-h/week or 7 hours of jogging per week. Eleven cohort and 12 case-control studies were identified in the systematic review, including 821,599 participants. One study reported a nonsignificant effect of 1 MET-h/week increases in physical activity on endometrial cancer risk (OR, 1.00; 95% CI, 0.99-1.00). Eight studies found significant reductions in disease risk of 15%-53%, but only in the most physically active individuals. Physical activity reduces endometrial cancer risk, but the effect size appears small. Regular vigorous activity should be encouraged to maximize the health benefit observed.
Effective, low-cost primary prevention strategies are urgently needed to tackle the rapid global increase in endometrial cancer. We sought to quantify the effect of physical activity on endometrial cancer risk, noting a linear inverse relationship influenced by body mass index. The most beneficial type and amount of activity remain unclear.
子宫内膜癌的发病率正在上升，2019年全球有43.5万例病例。需要一种有效、低成本的一级预防策略来减轻疾病负担。肥胖、胰岛素抵抗和炎症会导致子宫内膜癌发生，而体育活动针对这些途径发挥作用。本研究旨在量化影响子宫内膜癌风险所需的体育活动量。在英国生物银行研究中，使用多变量Cox比例风险模型分析了222031名子宫完整的女性参与者的体育活动数据。对文献进行了系统回顾，检索了截至2021年4月19日的CENTRAL、Embase和MEDLINE数据库。纳入了包括有和没有子宫内膜癌的参与者的研究，这些研究调查了以每周代谢当量小时数（MET-h/周）衡量的体育活动对疾病风险的影响。两名评审员独立选择研究、提取数据并评估偏倚风险。在英国生物银行中，总体育活动每增加1 MET-h/周，子宫内膜癌风险降低0.2%[95%置信区间（CI），0.1-0.4；P = 0.020]，如果每周进行50 MET-h/周或每周慢跑7小时，则相当于降低10.4%。在系统回顾中确定了11项队列研究和12项病例对照研究，包括821599名参与者。一项研究报告称，体育活动每周增加1 MET-h对子宫内膜癌风险的影响不显著（OR，1.00；95%CI，0.99-1.00）。八项研究发现疾病风险显著降低15%-53%，但仅在体育活动量最大的个体中。体育活动可降低子宫内膜癌风险，但效应大小似乎较小。应鼓励定期进行剧烈活动，以最大限度地提高观察到的健康益处。
迫切需要有效、低成本的一级预防策略来应对全球范围内子宫内膜癌的快速增长。我们试图量化体育活动对子宫内膜癌风险的影响，注意到存在受体重指数影响的线性反比关系。最有益的活动类型和量仍不清楚。
