Clinical Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.
BMJ Open. 2023 Jun 6;13(6):e069042. doi: 10.1136/bmjopen-2022-069042.
Sedentary behaviour is associated with increased cancer risk. We aim to assess the associations of domain-specific and total sedentary behaviour with risk of endometrial cancer, with additional attention paid to potential differences in adjustment strategy for obesity and physical activity.
A systematic review and meta-analysis was conducted in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews (PRISMA) and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology (MOOSE).
PubMed, Embase and MEDLINE databases were searched up to 28 February 2023, supplemented by grey literature searches.
Observational human studies evaluating the association between sedentary behaviour and endometrial cancer.
Two reviewers extracted data and conducted the quality assessment based on Newcastle-Ottawa Scale (NOS) independently. We used a random-effects model with inverse variance approach to pool the estimates. The extent of heterogeneity was quantified with the statistics.
Sixteen studies were included in the systematic review. Fourteen studies involving 882 686 participants were included in the meta-analysis. The pooled relative risks (RRs) for high versus low level of overall sedentary behaviour was 1.28 (95% CI: 1.14 to 1.43; =34.8%). The increased risk regarding specific domains was 1.22 (95% CI: 1.09 to 1.37; I=13.4%, n=10) for occupational domain, 1.34 (95% CI: 0.98 to 1.83; I=53.7%, n=6) for leisure-time domain and 1.55 (95% CI: 1.27 to 1.89; I=0.0%, n=2) for total sedentary behaviour. Larger pooled RRs were observed among studies with adjustment for physical activity and studies without adjustment for body mass index.
Higher levels of sedentary behaviour, total and occupational sedentary behaviour in particular, increase the risk of endometrial cancer. Future studies are needed to verify domain-specific associations based on objective quantification of sedentary behaviour, as well as the interaction of physical activity, adiposity and sedentary time on endometrial cancer.
久坐行为与癌症风险增加有关。我们旨在评估特定领域和总体久坐行为与子宫内膜癌风险的关联，并特别关注肥胖和体力活动的调整策略差异。
根据系统评价和荟萃分析的首选报告项目（PRISMA）和观察性研究荟萃分析（MOOSE）指南进行系统评价和荟萃分析。
截至 2023 年 2 月 28 日，检索了 PubMed、Embase 和 MEDLINE 数据库，并补充了灰色文献检索。
评估久坐行为与子宫内膜癌之间关联的观察性人类研究。
两名审查员独立根据纽卡斯尔-渥太华量表（NOS）提取数据并进行质量评估。我们使用随机效应模型和倒数方差方法来汇总估计值。用 统计量来衡量异质性程度。
系统评价纳入了 16 项研究。荟萃分析纳入了 14 项涉及 882686 名参与者的研究。总体久坐行为高水平与低水平相比，相对风险（RR）为 1.28（95%置信区间：1.14 至 1.43； =34.8%）。特定领域的风险增加情况如下：职业领域为 1.22（95%置信区间：1.09 至 1.37；I=13.4%，n=10），休闲时间领域为 1.34（95%置信区间：0.98 至 1.83；I=53.7%，n=6），总久坐行为领域为 1.55（95%置信区间：1.27 至 1.89；I=0.0%，n=2）。在调整体力活动和不调整体重指数的研究中，观察到更大的汇总 RR。
更高水平的久坐行为，特别是总体久坐行为和职业久坐行为，会增加子宫内膜癌的风险。需要进一步的研究来验证基于久坐行为的客观量化以及体力活动、肥胖和久坐时间对子宫内膜癌的相互作用的特定领域关联。
