Tran Thi Phuong Thao, Luu Ngoc Minh, Bui Thi Tra, Han Minji, Lim Min Kyung, Oh Jin-Kyoung
Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
Hanoi University of Public Health, Hanoi, Vietnam.
Eur Rev Aging Phys Act. 2023 Mar 9;20(1):4. doi: 10.1186/s11556-023-00316-5.
Physical activity (PA) changes throughout an individual's life, but the association between such changes and cancer risk seems to be overlooked in the literature. Thus, this study aimed to examine the association between the trajectories of PA frequency and cancer incidence among middle-aged Korean adults.
A total of 1,476,335 eligible participants (992,151 men and 484,184 women) aged ≥40 years from the National Health Insurance Service cohort (2002-2018) were included. Assessment of PA frequency was a self-reported measure, based on the question: "How many times per week do you perform exercise that makes you sweat?". PA frequency trajectories (i.e., trajectory classes of change in PA frequency) from 2002 to 2008 were identified using group-based trajectory modeling. Cox proportional hazards regression was used to assess the associations between the PA trajectories and cancer incidence.
Five PA frequency trajectories over 7 years were identified: persistently low (men:73.5%; women:74.7%), persistently moderate (men:16.2%; women:14.6%), high-to-low (men:3.9%; women:3.7%), low-to-high (men:3.5%; women:3.8%), and persistently high (men:2.9%; women:3.3%). Compared with persistently low frequency, maintaining a high PA frequency was associated with a lower risk of all cancers (Hazard ratio (HR) = 0.92, 95%CI = 0.87-0.98) and breast cancer (HR = 0.82, 95%CI = 0.70-0.96) among women. There was a lower risk for thyroid cancer among men in the high-to-low (HR = 0.83, 95%CI = 0.71-0.98), low-to-high (HR = 0.80, 95%CI = 0.67-0.96), and high PA trajectories (HR = 0.82, 95%CI = 0.68-0.99). There was a significant association between moderate trajectory and lung cancer in men (HR = 0.88, 95%CI = 0.80-0.95), in both smoking and non-smoking men.
Long-term persistent high frequency of PA as part of the daily routine should be widely promoted and encouraged to reduce the risk for all cancer development in women.
身体活动（PA）在个体一生中会发生变化，但此类变化与癌症风险之间的关联在文献中似乎被忽视了。因此，本研究旨在探讨韩国中年成年人PA频率轨迹与癌症发病率之间的关联。
纳入了来自国民健康保险服务队列（2002 - 2018年）的1476335名年龄≥40岁的合格参与者（992151名男性和484184名女性）。PA频率评估是一项基于自我报告的测量，依据的问题是：“你每周进行多少次会让你出汗的运动？”。使用基于群组的轨迹模型确定了2002年至2008年的PA频率轨迹（即PA频率变化的轨迹类别）。采用Cox比例风险回归来评估PA轨迹与癌症发病率之间的关联。
确定了7年期间的5种PA频率轨迹：持续低频率（男性：73.5%；女性：74.7%）、持续中等频率（男性：16.2%；女性：14.6%）、高到低（男性：3.9%；女性：3.7%）、低到高（男性：3.5%；女性：3.8%）以及持续高频率（男性：2.9%；女性：3.3%）。与持续低频率相比，保持高PA频率与女性所有癌症风险较低相关（风险比（HR）=0.92，95%置信区间（CI）=0.87 - 0.98）以及乳腺癌风险较低相关（HR = 0.82，95%CI = 0.70 - 0.96）。在高到低（HR = 0.83，95%CI = 0.71 - 0.98）、低到高（HR = 0.80，95%CI = 0.67 - 0.96）以及高PA轨迹的男性中，甲状腺癌风险较低（HR = 0.82，95%CI = 0.68 - 0.99）。在男性中，中等轨迹与肺癌之间存在显著关联（HR = 0.88，95%CI = 0.80 - 0.95），在吸烟和不吸烟的男性中均如此。
应广泛推广并鼓励将长期持续的高频率PA作为日常活动的一部分，以降低女性患所有癌症的风险。
