Abstract
Although physical activity (PA) is beneficial for prolonging lifespan, evidence for the protective role of PA against the development of gastric cancer (GC) is not yet well established. This study assessed the association between PA and GC risk in patients with and without Helicobacter pylori (H. pylori) infection in a Korean population. In total, 415 GC patients and 830 controls were enrolled at the National Cancer Center, Korea. The International Physical Activity Questionnaire-Short Form was used to collect PA data. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models. In the H. pylori-positive group, subjects who engaged in regular exercise showed a significantly reduced risk of GC in the entire population (OR = 0.52, 95% CI = 0.38–0.70) and in females (OR = 0.60, 95% CI = 0.21–0.64). Subjects who engaged in a high level of total PA showed a significantly reduced risk of GC relative to subjects in the lowest tertile in the fully adjusted model (OR = 0.46, 95% CI = 0.32–0.65, p-trend < 0.001). There was an inverse association between PA and GC risk in the entire population, and in the H. pylori-positive subgroup. Our data indicate the need for the promotion of all domains of PA, especially for Korean populations.
Highlights
Gastric cancer (GC) represents the fifth-most commonly diagnosed cancer and the third-leading cause of cancer-related deaths worldwide [1,2], overall GC incidence rates have been decreasing substantially in most parts of the world for decades [3,4].Recent global cancer statistics show that the estimated incidence rates of GC are markedly elevated in East Asia with values of 32.1 and 13.2 per 100,000 for men and women, respectively [1].In Korea, the age-standardized incidence rate of GC was 33.8 per 100,000 across both sexes and 49.3 and20.5 per 100,000 for men and women, respectively [5]
In the H. pylori-positive group, subjects who engaged in regular exercise showed a significantly reduced risk of GC in all study populations (OR = 0.52, 95% confidence intervals (CIs) = 0.38–0.70) and in females (OR = 0.36, 95% CI = 0.21–0.64) after adjusting for possible confounding factors
Individuals who had been histologically confirmed as early GC patients within the preceding three months at the Center for Gastric Cancer were included in the case group
Summary
Gastric cancer (GC) represents the fifth-most commonly diagnosed cancer and the third-leading cause of cancer-related deaths worldwide [1,2], overall GC incidence rates have been decreasing substantially in most parts of the world for decades [3,4].Recent global cancer statistics show that the estimated incidence rates of GC are markedly elevated in East Asia with values of 32.1 and 13.2 per 100,000 for men and women, respectively [1].In Korea, the age-standardized incidence rate of GC was 33.8 per 100,000 across both sexes and 49.3 and20.5 per 100,000 for men and women, respectively [5]. Cancers 2018, 10, 369; doi:10.3390/cancers10100369 www.mdpi.com/journal/cancers (H. pylori); male sex; lifestyle factors such as diet, tobacco smoking, and excessive alcohol drinking; family history of GC; and previous stomach surgery [7,8,9,10,11,12,13,14,15]. Of these factors, infection with H. pylori, the best-known risk factor for GC, is endemic throughout East Asia.
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