Physical activity, physical fitness, and all-cause and cancer mortality: A prospective study of men and women

Abstract

We studied physical fitness and physical activity in relation to all-cause and cancer mortality in a cohort of 7080 women and 25,341 men examined at the Cooper Clinic in Dallas, Texas, during 1970 to 1989. Physical fitness was assessed at baseline by a maximal treadmill exercise test, while physical activity was self-reported on the attendant health habits questionnaire. Both men and women averaged about 43 years of age at baseline (range, 20 to 88 years), and they were followed for ~ 8 years on average. Through the end of 1989, the women contributed 52,982 person-years of observation and incurred 89 deaths, including 44 deaths due to cancer. The men contributed 211,996 person-years and incurred 601 deaths, with 179 due to cancer. After adjustment for baseline differences in age, examination year, cigarette habit, chronic illnesses, and electrocardiogram abnormalities, we found a strong inverse association between risk of all-cause mortality and level of physical fitness in both men and women ( P for trend < 0.001). Physically active men also were at lower risk of all-cause mortality than were sedentary ones ( P for trend = 0.01). Among women, however, self-reported physical activity was not significantly related to risk of death from all causes. The risk of mortality from cancer declined sharply across increasing levels of fitness among men ( P for trend < 0.001), whereas among women the gradient was suggestive but not significant ( P for trend = 0.07). Physically active men also were at lower risk of death from cancer than were sedentary men ( P for trend = 0.002), but among women physical activity was unrelated to cancer mortality.