Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
Department of Public Health Sciences, University of California, Davis, Davis, CA, USA.
Support Care Cancer. 2023 Nov 24;31(12):718. doi: 10.1007/s00520-023-08192-6.
To investigate the long-term effect of sitting time and physical activity after a skin cancer diagnosis.
A cohort of a nationally representative sample of skin cancer survivors (n=862) and non-cancer adults (n=13691) ≥50 years from the US National Health and Nutrition Examination Survey. Mortality data were linked through December 31, 2019.
During up to 13.2 years of follow-up (median, 6.3 years; 94,093 person-years), 207 deaths (cancer: 53) occurred in skin cancer survivors and 1970 (cancer: 414) in non-cancer adults. After adjusting for covariates and skin cancer type, being active was associated with lower risks of all-cause (HR=0.69; 95% CI: 0.47 to 1.00) and non-cancer (HR=0.59; 95% CI: 0.36 to 0.97) mortality compared to being inactive among skin cancer survivors. Meanwhile, sitting 8 h/d was associated with higher risks of all-cause (HR=1.72; 95% CI: 1.11 to 2.67) and non-cancer (HR=1.76; 95% CI: 1.07 to 2.92) mortality compared to sitting <6 h/d. In the joint analysis, inactive skin cancer survivors sitting >8 h/d had the highest mortality risks from all-cause (HR=2.26; 95% CI: 1.28 to 4.00) and non-cancer (HR=2.11; 95% CI,1.10 to 4.17). Additionally, the associations of LTPA and sitting time with all-cause and cause-specific mortality did not differ between skin cancer survivors and non-cancer adults (all P for interaction>0.05) CONCLUSION: The combination of prolonged sitting and lack of physical activity was associated with elevated risks of all-cause and non-cancer deaths among US skin cancer survivors. Skin cancer survivors could benefit from maintaining a physically active lifestyle.
研究皮肤癌诊断后久坐时间和身体活动对长期预后的影响。
本队列研究纳入了美国国家健康和营养调查（National Health and Nutrition Examination Survey，NHANES）中具有代表性的皮肤癌幸存者（n=862）和非癌症成年人（n=13691）≥50 岁的病例。通过截至 2019 年 12 月 31 日的死亡数据进行随访。
在长达 13.2 年（中位数 6.3 年；94093 人年）的随访期间，皮肤癌幸存者发生 207 例死亡（癌症死亡 53 例），非癌症成年人发生 1970 例死亡（癌症死亡 414 例）。在校正协变量和皮肤癌类型后，与不活动相比，活跃与所有原因（HR=0.69；95%CI：0.47 至 1.00）和非癌症原因（HR=0.59；95%CI：0.36 至 0.97）死亡率降低相关。同时，与每天坐 6 小时相比，每天坐 8 小时与所有原因（HR=1.72；95%CI：1.11 至 2.67）和非癌症原因（HR=1.76；95%CI：1.07 至 2.92）死亡率升高相关。在联合分析中，不活跃且每天坐 8 小时以上的皮肤癌幸存者所有原因（HR=2.26；95%CI：1.28 至 4.00）和非癌症原因（HR=2.11；95%CI，1.10 至 4.17）的死亡率最高。此外，LTPA 和久坐时间与所有原因和特定原因死亡率之间的关联在皮肤癌幸存者和非癌症成年人之间没有差异（所有 P 交互作用>0.05）。
在美国皮肤癌幸存者中，长时间久坐和缺乏身体活动与全因和非癌症死亡风险增加相关。皮肤癌幸存者可以从保持积极的生活方式中受益。
