Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand.
Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Oxford, UK.
Environ Health. 2024 Apr 13;23(1):39. doi: 10.1186/s12940-024-01081-3.
Physical inactivity is a global public health problem. A practical solution would be to build physical activity into the daily routine by using active modes of transport. Choice of transport mode can influence cancer risk through their effects on levels of physical activity, sedentary time, and environmental pollution. This review synthesizes existing evidence on the associations of specific transport modes with risks of site-specific cancers.
Relevant literature was searched in PubMed, Embase, and Scopus from 1914 to 17th February 2023. For cancer sites with effect measures available for a specific transport mode from two or more studies, random effects meta-analyses were performed to pool relative risks (RR) comparing the highest vs. lowest activity group as well as per 10 Metabolic Equivalent of Task (MET) hour increment in transport-related physical activity per week (∼150 min of walking or 90 min of cycling).
27 eligible studies (11 cohort, 15 case-control, and 1 case-cohort) were identified, which reported the associations of transport modes with 10 site-specific cancers. In the meta-analysis, 10 MET hour increment in transport-related physical activity per week was associated with a reduction in risk for endometrial cancer (RR: 0.91, 95% CI: 0.83-0.997), colorectal cancer (RR: 0.95, 95% CI: 0.91-0.99) and breast cancer (RR: 0.99, 95% CI: 0.89-0.996). The highest level of walking only or walking and cycling combined modes, compared to the lowest level, were significantly associated with a 12% and 30% reduced risk of breast and endometrial cancers respectively. Cycling, compared to motorized modes, was associated with a lower risk of overall cancer incidence and mortality.
Active transport appears to reduce cancer risk, but evidence for cancer sites other than colorectum, breast, and endometrium is currently limited.
身体活动不足是一个全球性的公共卫生问题。一个切实可行的解决方案是将身体活动融入日常生活，采用积极的交通方式。交通方式的选择可以通过影响身体活动水平、久坐时间和环境污染来影响癌症风险。本综述综合了现有证据，探讨了特定交通方式与特定部位癌症风险之间的关联。
从 1914 年至 2023 年 2 月 17 日，在 PubMed、Embase 和 Scopus 中搜索相关文献。对于有特定交通方式的癌症部位，若有两个或更多研究提供了效应量，我们将进行随机效应荟萃分析，以比较最高与最低活动组之间的相对风险（RR），以及每周每增加 10 代谢当量任务（MET）小时的交通相关体力活动（约 150 分钟步行或 90 分钟骑自行车）。
共纳入 27 项符合条件的研究（11 项队列研究、15 项病例对照研究和 1 项病例-队列研究），这些研究报告了交通方式与 10 种特定部位癌症的关联。荟萃分析显示，每周每增加 10 MET 小时的交通相关体力活动与子宫内膜癌（RR：0.91，95%CI：0.83-0.997）、结直肠癌（RR：0.95，95%CI：0.91-0.99）和乳腺癌（RR：0.99，95%CI：0.89-0.996）的风险降低相关。与最低水平相比，最高水平的仅步行或步行和骑自行车相结合的模式与乳腺癌和子宫内膜癌风险分别降低 12%和 30%显著相关。与机动模式相比，骑自行车与总体癌症发病率和死亡率降低相关。
积极的交通方式似乎可以降低癌症风险，但目前关于结直肠、乳房和子宫内膜以外的癌症部位的证据有限。
