학술논문
Observational and genetic associations between cardiorespiratory fitness and cancer: a UK Biobank and international consortia study
Document Type
Author
Watts, Eleanor L.; Gonzales, Tomas I.; Strain, Tessa; Saint-Maurice, Pedro F.; Bishop, D. Timothy; Chanock, Stephen J.; Johansson, Mattias; Keku, Temitope O.; Le Marchand, Loic; Moreno, Victor; Newcomb, Polly A.; Newton, Christina C.; Pai, Rish K.; Purdue, Mark P.; Ulrich, Cornelia M.; Smith-Byrne, Karl; van Guelpen, Bethany; Eeles, Rosalind A.; Haiman, Christopher A.; Kote-Jarai, Zsofia; Schumacher, Fredrick R.; Benlloch, Sara; Olama, Ali Amin Al; Muir, Kenneth R.; Berndt, Sonja I.; Conti, David V.; Wiklund, Fredrik; Wang, Ying; Tangen, Catherine M.; Batra, Jyotsna; Clements, Judith A.; Grönberg, Henrik; Pashayan, Nora; Schleutker, Johanna; Albanes, Demetrius; Weinstein, Stephanie J.; Wolk, Alicja; West, Catharine M. L.; Mucci, Lorelei A.; Cancel-Tassin, Géraldine; Koutros, Stella; Sørensen, Karina Dalsgaard; Grindedal, Eli Marie; Neal, David E.; Hamdy, Freddie C.; Donovan, Jenny L.; Travis, Ruth C.; Hamilton, Robert J.; Ingles, Sue Ann; Rosenstein, Barry S.; Lu, Yong-Jie; Giles, Graham G.; MacInnis, Robert J.; Kibel, Adam S.; Vega, Ana; Kogevinas, Manolis; Penney, Kathryn L.; Park, Jong Y.; Stanford, Janet L.; Cybulski, Cezary; Nordestgaard, Børge G.; Nielsen, Sune F.; Brenner, Hermann; Maier, Christiane; Kim, Jeri; John, Esther M.; Teixeira, Manuel R.; Neuhausen, Susan L.; De Ruyck, Kim; Razack, Azad; Newcomb, Lisa F.; Lessel, Davor; Kaneva, Radka; Usmani, Nawaid; Claessens, Frank; Townsend, Paul A.; Castelao, Jose Esteban; Roobol, Monique J.; Menegaux, Florence; Khaw, Kay-Tee; Cannon-Albright, Lisa; Pandha, Hardev; Thibodeau, Stephen N.; Hunter, David J.; Kraft, Peter; Blot, William J.; Riboli, Elio; Day, Felix R.; Wijndaele, Katrien; Wareham, Nicholas J.; Matthews, Charles E.; Moore, Steven C.; Brage, Soren
Source
British Journal of Cancer. 130:114-124
Subject
Language
English
ISSN
0007-0920
1532-1827
1532-1827
Abstract
Background: The association of fitness with cancer risk is not clear.Methods: We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of lung, colorectal, endometrial, breast, and prostate cancer in a subset of UK Biobank participants who completed a submaximal fitness test in 2009-12 (N = 72,572). We also investigated relationships using two-sample Mendelian randomisation (MR), odds ratios (ORs) were estimated using the inverse-variance weighted method.Results: After a median of 11 years of follow-up, 4290 cancers of interest were diagnosed. A 3.5 ml O2⋅min−1⋅kg−1 total-body mass increase in fitness (equivalent to 1 metabolic equivalent of task (MET), approximately 0.5 standard deviation (SD)) was associated with lower risks of endometrial (HR = 0.81, 95% CI: 0.73–0.89), colorectal (0.94, 0.90–0.99), and breast cancer (0.96, 0.92–0.99). In MR analyses, a 0.5 SD increase in genetically predicted O2⋅min−1⋅kg−1 fat-free mass was associated with a lower risk of breast cancer (OR = 0.92, 95% CI: 0.86–0.98). After adjusting for adiposity, both the observational and genetic associations were attenuated.Discussion: Higher fitness levels may reduce risks of endometrial, colorectal, and breast cancer, though relationships with adiposity are complex and may mediate these relationships. Increasing fitness, including via changes in body composition, may be an effective strategy for cancer prevention.