Abstract
Cancer prevention efforts include modification of unhealthy lifestyle, such as smoking cessation and resisting gain in body weight. Although physical activity is inversely related to risk of several cancers, it is poorly studied whether changes in physical activity or fitness influence future cancer risk. Thus, we aimed to investigate whether changes in midlife cardiorespiratory fitness (CRF), body mass index (BMI), and smoking habits influence cancer incidence and mortality. The study cohort includes 1689 initially healthy men, aged 40‐59 years. Measurements of CRF, BMI and information on smoking habits were collected in two repeated waves, 7 years apart. Cox regression models estimated associations as hazard rates (HR) with 95% confidence intervals (CI), between midlife changes in the modifiable lifestyle factors and cancer incidence and mortality. The men were followed prospectively for more than 30 years. Compared to CRF loss (>5%), improved CRF (>5%) was associated with lower cancer incidence (HR 0.81, 95% CI 0.67‐0.98) and mortality (HR 0.70, 95% CI 0.54‐0.92), and maintaining the CRF stable yielded lower cancer incidence (HR 0.76, 95% CI 0.61‐0.95). No association was seen for BMI gain, but maintaining the BMI stable was related to lower cancer incidence (HR 0.77, 95% CI 0.60‐0.98), compared to BMI loss. Continue smoking was associated with higher cancer incidence and mortality, compared to men who stopped smoking. In particular, this study adds new knowledge about the potential preventive role of CRF in cancer development and emphasizes lifestyle modification as a highly important effort in cancer prevention.
Highlights
In 2015, 17.5 million new cancer cases were diagnosed worldwide and 8.7 million cancer deaths occurred.[1]
The role of physical activity in cancer prevention was re‐reviewed by the Continuous Update Project, managed by the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR)[7] and a large pooled analysis has emphasized an inverse relationship for 13 cancers.[8]
Lower cancer incidence was found for men who maintained a stable cardiorespiratory fitness (CRF) (24%) and those who maintained a stable body mass index (BMI) (23%), while no association was found for cancer mortality
Summary
In 2015, 17.5 million new cancer cases were diagnosed worldwide and 8.7 million cancer deaths occurred.[1] The numbers are expected to increase considerably over the decade due to population aging, population growth, and unhealthy lifestyle behaviors.[1,2] Tobacco smoking is a leading cause of cancer, related to 14 cancer sites,[2,3] while excess. | 4876 body fat, measured by body mass index (BMI), is related to 13 cancer sites.[3,4] cancer risk is shown to decrease after successful smoking cessation[2] and after intentional loss in body fat.[2,5] primary cancer prevention efforts including modification of unhealthy lifestyle factors have become an urgent health issue. Such studies will increase our knowledge about the role of physical activity as a tool in prevention of cancer diseases
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