Levi F, La Vecchia C, Negri E, Franceschi S
Registre Vaudois des Tumeurs, CHUV, Lausanne, Switzerland.
Br J Cancer. 1993 Apr;67(4):846-51. doi: 10.1038/bjc.1993.155.
The relationship between various indicators of physical activity and endometrial cancer risk was analysed using data of a case-control study conducted in 1988-1991 in Switzerland and Italy on 274 histologically confirmed cases and 572 controls admitted to hospital for acute, non neoplastic, non hormone-related diseases. Using a self-rated assessment of total physical activity, there was a systematic tendency for the cases to report more frequently 'low' or 'very low' physical activity. The relative risks were similar for 'very high' or 'moderately high' physical activity, but increased in the two lowest levels, with point estimates, in various decades of age, between 1.3 and 2.3 for 'moderately low' and over 2.5 for 'very low' physical activity. Although the association was apparently stronger at older ages, all the trends in risk were significant. Allowance for major identified potential distorting factors, including body mass index and a measure of total energy intake, could explain only in part the association, and the inverse trends in risk remained statistically significant. When selected types of physical activity were analysed, no association was observed with climbing stairs or walking, but the risk estimates for the lowest level of activity was over 4 for housework, and between 1.5 and 1.9 for sport and leisure and occupational activity. Thus, the present findings suggest that a moderate or high physical activity is an indicator of reduced endometrial cancer risk, although this observation still requires epidemiologic confirmation and clearer definition from a pathogenic point of view.
利用1988 - 1991年在瑞士和意大利开展的一项病例对照研究的数据，分析了身体活动的各项指标与子宫内膜癌风险之间的关系。该研究纳入了274例经组织学确诊的病例以及572名因急性、非肿瘤性、非激素相关疾病入院的对照。通过对总体身体活动进行自评评估发现，病例组更频繁地报告“低”或“极低”的身体活动，存在一种系统性趋势。“非常高”或“中度高”身体活动水平的相对风险相似，但在两个最低水平上风险增加，在不同年龄 decade 中，“中度低”身体活动的点估计值在1.3至2.3之间，“极低”身体活动的点估计值超过2.5。尽管这种关联在老年时似乎更强，但所有风险趋势均具有统计学意义。考虑到主要确定的潜在混杂因素，包括体重指数和总能量摄入的一项指标，只能部分解释这种关联，风险的反向趋势在统计学上仍然显著。当分析特定类型的身体活动时，未观察到与爬楼梯或步行有关联，但家务活动最低水平的风险估计值超过4，运动、休闲和职业活动的风险估计值在1.5至1.9之间。因此，目前的研究结果表明，适度或高强度的身体活动是子宫内膜癌风险降低的一个指标，尽管这一观察结果仍需要流行病学证实，并从致病角度进行更清晰的定义。
