Abstract
Cardiorespiratory fitness (CRF) has a strong inverse relationship with several chronic disease outcomes, including some cancers. The association between CRF and prostate cancer is controversial. We aimed to assess the prospective association of CRF with prostate cancer risk using a cohort study and review of the literature. Cardiorespiratory fitness was assessed using a respiratory gas exchange analyser during exercise testing in 2204 cancer-free middle-aged men. Hazard ratios (HRs) with 95% confidence interval (CIs) were estimated. We corrected for within-person variability in CRF levels using repeat measurements. During a median follow-up of 24.9years, 216 prostate cancer cases occurred. The age-adjusted regression dilution ratio of CRF was 0.58 (95% CI: 0.53-0.64). The HR (95% CI) of prostate cancer per 1 standard deviation increase in CRF in age-adjusted analysis was 1.10 (0.95-1.27). The association remained consistent after further adjustment for several risk factors (HR 1.13; 95% CI 0.96-1.33). The corresponding adjusted HRs were 1.24 (95% CI: 0.87-1.77) and 1.28 (95% CI: 0.87-1.88), respectively, when comparing the extreme tertiles of CRF levels. Previous studies mostly reported no evidence of an association or an increased risk of prostate cancer in relation to high CRF. Studies reporting positive associations had short-term follow-up durations (<10years). Primary data and a review of previous studies suggest that elevated CRF is not associated with reduced prostate cancer risk. Previous findings of significant evidence of associations could be attributed to increased screening and detection as well as reverse causation bias.
Highlights
Cancer is a global health burden, being the leading cause of death worldwide at all income levels.[1]
The availability of Cardiorespiratory fitness (CRF), ascertained with the gold standard measure, within the Kuopio Ischaemic Heart Disease (KIHD) prospective study offered the opportunity to revaluate the nature and magnitude of the association between CRF and prostate cancer in greater detail than in previous studies. To put these findings into context, we reviewed the literature for previously published evidence on the associations between CRF and prostate cancer risk
The hazard ratio (HR) for prostate cancer per 1 standard deviation (SD) increase in CRF in analysis adjusted for age was 1.10, which remained consistent in analyses
Summary
Cancer is a global health burden, being the leading cause of death worldwide at all income levels.[1]. Some studies have reported an increased risk of prostate cancer with high CRF,14-17 whereas others reported a decreased risk[18] or no evidence of an association.19-22 Notably, these previous studies employed indirect methods or nonexercise algorithms for estimating CRF rather than the gold standard measure, that is CPX with VO2max measured by ventilatory expired gas analysis.[23] there are limitations associated with non-use of the gold standard measure, which include: (a) underestimation and overestimation of CRF at the top and bottom ends of the distribution, respectively,[10] and (b) a particular equation may not be suitable for all populations.[24] The availability of CRF, ascertained with the gold standard measure, within the Kuopio Ischaemic Heart Disease (KIHD) prospective study offered the opportunity to revaluate the nature and magnitude of the association between CRF and prostate cancer in greater detail than in previous studies. To put these findings into context, we reviewed the literature for previously published evidence on the associations between CRF and prostate cancer risk
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
