Dong Xiaosheng, Ding Meng, Yi Nuo, Hou Xiao, Zhou Chengchao, Yi Xiangren
Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.
Support Care Cancer. 2025 Apr 2;33(4):342. doi: 10.1007/s00520-025-09288-x.
The purpose of this study was to examine a dose-response association between aerobic physical activity (APA) and muscle-strengthening exercise (MSE) and their combinations with cancer mortality.
The final 575,439 participants involved in this study were derived from 1997 to 2018 longitudinal follow-up data collected in the National Health Interview Survey (NHIS). The APA and MSE were requested via self-reported questionnaires. These records are linked to the National Death Index and classified as cancer deaths based on the International Classification of Diseases (ICD-10). Statistical analysis was performed by Wilcoxon rank-sum test, chi-square test, and the Cox proportional hazards models.
After adjusting for all covariates, the results demonstrated that the cancer mortality risk for cancer survivors decreased by 23.2%, 35.8%, 42.5%, and 46.7% for those engaging in 0-7.4 MET hours/week, 7.5-14.9 MET hours/week, 15-29.9 MET hours/week, and 30 + MET hours/week, respectively. For non-cancer patients, the cancer mortality risk decreased by 6.9%, 11.9%, 15.1%, and 16.7%. Furthermore, the results showed that the cancer mortality risk for cancer survivors decreased by 34.9%, 30.2%, 32.3%, and 10% for those engaging in 2-3 times/week, 4-5 times/week, 6-7 times/week, and 8 + times/week. For non-cancer patients, the cancer mortality risk decreased by 17.4%, 23.7%, 9.5%, and 10.6%. Among non-cancer patients with insufficient MSE, there was no significant negative correlation between APA and cancer mortality.
The optimal dose response in reducing the risk of cancer mortality may occur at higher levels of APA with MSE 4-5 times/week and 2-3 times/week for primary and secondary prevention. In addition, primary prevention derives a greater advantage from MSE, and a protocol of APA should be emphasized in secondary prevention.
本研究旨在探讨有氧运动（APA）和肌肉强化运动（MSE）及其组合与癌症死亡率之间的剂量反应关系。
本研究的最终575439名参与者来自1997年至2018年在美国国家健康访谈调查（NHIS）中收集的纵向随访数据。通过自我报告问卷询问APA和MSE情况。这些记录与国家死亡指数相关联，并根据国际疾病分类（ICD - 10）归类为癌症死亡。采用Wilcoxon秩和检验、卡方检验和Cox比例风险模型进行统计分析。
在调整所有协变量后，结果表明，对于癌症幸存者，每周进行0 - 7.4梅脱小时、7.5 - 14.9梅脱小时、15 - 29.9梅脱小时和30 +梅脱小时的人，癌症死亡风险分别降低了23.2%、35.8%、42.5%和46.7%。对于非癌症患者，癌症死亡风险分别降低了6.9%、11.9%、15.1%和16.7%。此外，结果显示，对于癌症幸存者，每周进行运动2 - 3次、4 - 至5次、6 - 7次和8次以上的人，癌症死亡风险分别降低了34.9%、30.2%、32.3%和10%。对于非癌症患者，癌症死亡风险分别降低了17.4%、23.7%、9.5%和10.6%。在MSE不足的非癌症患者中，APA与癌症死亡率之间无显著负相关。
在一级和二级预防中，每周进行4 - 5次和2 - 3次MSE且处于较高水平的APA可能会出现降低癌症死亡风险的最佳剂量反应。此外，一级预防从MSE中获益更大，二级预防应强调APA方案。
