Abstract
BackgroundThe incidence of esophageal and gastric cancer has been increasing rapidly worldwide in recent years, although the reason for this increase is unclear. Here, a statistical synthesis of studies that evaluated the association between physical activity, a well-known protecting factor against death and other chronic diseases, and the risk of esophageal and gastric cancer was performed.MethodsPotentially suitable studies were identified using Medline and Embase. The reference lists of all included articles and those of several recent reviews were searched manually. Studies were included if they (1) were published as case-control or cohort studies evaluating the association between physical activity and risk of esophageal or gastric cancer; and (2) reported point estimates (i.e., risk ratios, odds ratios) and measures of variability (i.e., 95% confidence intervals [CIs]) for physical activity and risk of esophageal or gastric cancer.ResultsFifteen studies were identified (7 cohorts, 8 case-controls; 984 esophageal and 7,087 gastric cancers). Collectively, they indicated that the risk of gastric cancer was 13% lower among the most physically active people than among the least active people (RR = 0.87, 95% confidence interval [CI] = 0.78 to 0.97) and that of esophageal cancer was 27% lower (RR = 0.73, 95% CI = 0.56 to 0.97).ConclusionsPooled results from observational studies support a protective effect of physical activity against both esophageal and gastric cancer.
Highlights
The incidence of esophageal and gastric cancer has been increasing rapidly worldwide in recent years, the reason for this increase is unclear
The core search consisted of terms related to physical activity (‘‘exercise,’’ ‘‘physical activity,’’ ‘‘walking,’’ and ‘‘motor activity,’’) These were combined with specific terms for cancer sites of interest (‘‘stomach,’’ ‘‘gastric,’’ ‘‘cardia,’’ ‘‘esophagus,’’ and ‘‘esophageal’’) and with descriptions of cancer (‘‘cancer,’’ ‘‘neoplasm,’’ and ‘‘carcinoma’’)
The summary relative risk of the main results from the 15 studies indicated that the risk of gastric cancer was 13% lower among the most physically active people compared that among the least active people (RR = 0.87, 95% CI = 0.78 to 0.97). (Figure S2)There was moderate heterogeneity (I2 = 49.8%, P = .012)
Summary
The incidence of esophageal and gastric cancer has been increasing rapidly worldwide in recent years, the reason for this increase is unclear. Gastric cancer (GC) is the fourth most common type of cancer and esophageal cancer (EC) is the sixth [1,2,3]. The mortality from these cancers is high and the response to treatments during advanced stages is poor, suggesting that an effective means of reducing mortality would be through early intervention of modifiable risk factors [4,5,6]. A statistical synthesis of studies that evaluated the association between physical activity, a well-known protecting factor against death and other chronic diseases, and the risk of esophageal and gastric cancer was performed
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