Abstract
BackgroundEvidence for a protective role of physical activity against development of stomach cancer is yet inconclusive. We studied the association of domain-specific physical activity and the risk of gastric adenocarcinoma (GAC), by site and histology, in the MCC-Spain case-control study.Methods428 histologically confirmed GAC cases (67% men) including the gastro-esophageal region and 3225 controls were included. Cases were recruited in hospitals from 10 different Spanish regions, whereas population controls were randomly selected within the respective hospitals' catchment areas. A physical activity (PA) questionnaire was used to gather information on household and recreational activities, allowing estimation of PA volume (in metabolic equivalents (MET)-min/week). Participants also reported the intensity of working PA and daily sitting time. Questionnaire data on diet, lifestyles and clinical variables including Helicobacter pylori serology were available. Adjusted odds ratios (OR) of GAC were estimated for domains of physical activity, stratifying by sex, site (cardia vs. non-cardia), and Lauren classification (intestinal vs. diffuse).ResultsHousehold physical activity (HPA) showed a strong inverse association with GAC, observed for both cardia and non-cardia tumours. Risk of overall gastric cancer was 50% lower risk among participants in the highest HPA category (OR = 0.50, 95%CI: 0.38, 0.66). Recreational physical activity (RPA) was also associated with lower overall GAC risk (OR = 0.68, 95% CI: 0.52, 0.88), particularly at moderate levels of intensity such as walking (OR = 0.61, 95% CI: 0.46, 0.79). The protective effect of RPA was strongest for non-cardia tumours. Sedentary time was not related to GAC risk (p-trend = 0.392), but the potential protective effect of RPA was restricted to non-sedentary participants.ConclusionsBoth household and recreational physical activities were independently related to lower GAC risk in the MCC-Spain study.
Highlights
Regular physical activity (PA) has been shown to reduce the risk of gastric cancer in observational studies
Risk of overall gastric cancer was 50% lower risk among participants in the highest Household physical activity (HPA) category (OR = 0.50, 95%confidence intervals (CI): 0.38, 0.66)
Recreational physical activity (RPA) was associated with lower overall gastric adenocarcinoma (GAC) risk (OR = 0.68, 95% CI: 0.52, 0.88), at moderate levels of intensity such as walking (OR = 0.61, 95% CI: 0.46, 0.79)
Summary
Regular physical activity (PA) has been shown to reduce the risk of gastric cancer in observational studies. Variations in risk estimates have been reported by sex (largest effect in women) [1,2,3], body mass index (weaker association at higher BMI) [2], smoking (weaker protection in smokers) [2], or tumour location [1,2,3,5] These results are based on a limited number of observational studies, and the evidence to claim a preventive effect for PA against stomach cancer is still judged as insufficient [5,6,7,8]. We studied the association of domain-specific physical activity and the risk of gastric adenocarcinoma (GAC), by site and histology, in the MCC-Spain case-control study
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