Cao Mingzhe, Huang Yuanbo, Zhou Yuan, Wang Haolin, Zhang Jing
School of Physical Education, Shaanxi Normal University, No. 620 West Chang'an Avenue, Xi'an, 710119, China.
School of Psychology, Shaanxi Normal University, Xi'an Shaanxi, 710062, China.
BMC Womens Health. 2025 Jul 3;25(1):300. doi: 10.1186/s12905-025-03848-3.
Previous evidence has unveiled that physical activity (PA) may affect gynecologic cancer (GC). However, existing research findings remain inconsistent. Hence, this comprehensive meta-analysis was to quantify updated evidence on the association between PA and GC risk.
A meta-analysis of prospective cohort studies was conducted to evaluate the association between PA and GC risk, including endometrial cancer (EC), ovarian cancer (OC), and cervical cancer (CC). PubMed, Web of Science, and Embase were searched for relevant studies until May 13, 2025. Case-control and cross-sectional studies were excluded to reduce bias and improve causal inference. Study quality was appraised via the Newcastle-Ottawa Scale. The relative risks (RRs) along with 95% confidence intervals (CIs) were pooled through a random-effects model. Heterogeneity was judged with the Q and I² statistics, and publication bias was tested through funnel plot analysis and Egger's regression test.
71 risk estimates were summarized in 36 studies. Individuals participating in moderate PA had a lower risk of EC than those in low PA (RR = 0.94, 95% CI: 0.89-0.99, P = 0.024), while those in high PA exhibited an even lower EC risk (RR = 0.82, 95% CI: 0.76-0.89, P < 0.001). Besides, moderate PA (RR = 1.04, 95% CI: 0.97-1.10, P = 0.263) and high PA levels (RR = 1.04, 95% CI: 0.92-1.18, P = 0.488) were not associated with OC risk. For CC, only two studies were available; one assessed moderate PA and the other assessed high PA. Moderate PA was not associated with CC risk (RR = 1.06, 95% CI: 0.90-1.25), and high PA also showed no significant association with CC risk (RR = 0.77, 95% CI: 0.50-1.18).
High PA is associated with a reduced risk of EC, while no significant association was found for OC. Evidence for CC remains limited and inconsistent. These findings support current PA guidelines for cancer prevention but should be interpreted with caution due to study heterogeneity and limited data. Further prospective studies are needed to clarify these associations, particularly for OC and CC.
先前的证据表明，身体活动（PA）可能会影响妇科癌症（GC）。然而，现有的研究结果仍不一致。因此，本项综合荟萃分析旨在量化PA与GC风险之间关联的最新证据。
进行了一项前瞻性队列研究的荟萃分析，以评估PA与GC风险之间的关联，包括子宫内膜癌（EC）、卵巢癌（OC）和宫颈癌（CC）。检索了PubMed、科学网和Embase数据库以查找相关研究，直至2025年5月13日。排除病例对照研究和横断面研究以减少偏差并改善因果推断。通过纽卡斯尔-渥太华量表评估研究质量。通过随机效应模型汇总相对风险（RRs）及其95%置信区间（CIs）。用Q和I²统计量判断异质性，并通过漏斗图分析和Egger回归检验检测发表偏倚。
36项研究总结了71个风险估计值。参与中度PA的个体患EC的风险低于低度PA的个体（RR = 0.94，95% CI：0.89 - 0.99，P = 0.024），而高度PA的个体患EC的风险更低（RR = 0.82，95% CI：0.76 - 0.89，P < 0.001）。此外，中度PA（RR = 1.04，95% CI：0.97 - 1.10，P = 0.263）和高度PA水平（RR = 1.04，95% CI：0.92 - 1.18，P = 0.488）与OC风险无关。对于CC，仅有两项研究；一项评估了中度PA，另一项评估了高度PA。中度PA与CC风险无关（RR = 1.06，95% CI：0.90 - 1.25），高度PA与CC风险也无显著关联（RR = 0.77，95% CI：0.50 - 1.18）。
高度PA与降低EC风险相关，而与OC风险无显著关联。CC的证据仍然有限且不一致。这些发现支持当前关于癌症预防的PA指南，但由于研究异质性和数据有限，应谨慎解释。需要进一步的前瞻性研究来阐明这些关联，特别是对于OC和CC。
