|
日常生活中缺乏體力活動(dòng)的人群十分常見，在美國大約有51%的人群缺乏體力活動(dòng)，而全球大約有31%的人群都沒有達(dá)到推薦的體力活動(dòng)水平；與體力活動(dòng)相關(guān)的任何癌癥風(fēng)險(xiǎn)降低，都對公眾健康和癌癥預(yù)防至關(guān)重要。 2016年5月16日，《美國醫(yī)學(xué)會雜志·內(nèi)科學(xué)分冊》在線發(fā)表了美國、瑞典、挪威、芬蘭、法國、英國的研究報(bào)告，發(fā)現(xiàn)高水平休閑體育活動(dòng)與乳腺癌等13種不同癌癥發(fā)病風(fēng)險(xiǎn)降低直接相關(guān)。 該研究對1987～2004年12項(xiàng)美國和歐洲自我報(bào)告體力活動(dòng)參與者數(shù)據(jù)進(jìn)行匯總，隨后分析了參與者體力活動(dòng)和26種癌癥發(fā)生率之間的相關(guān)性。該研究包括了144萬位參與者（中位年齡59歲，范圍：19～98歲，女性占57%），其中在11年隨訪過程中被診斷為癌癥186932例。 相比低水平體力活動(dòng)而言，高水平體力活動(dòng)可以促進(jìn)26種癌癥中的13種風(fēng)險(xiǎn)降低，包括食管腺癌（風(fēng)險(xiǎn)降低42%）、肝癌（27%）、肺癌（26%）、腎癌（23%）、賁門癌（22%）、子宮內(nèi)膜癌（21%）、髓樣白血?。?0%）、骨髓瘤（17%）、結(jié)腸癌（16%）、頭頸癌（15%）、直腸癌（13%）、結(jié)腸癌（13%）、乳腺癌（10%）；體力活動(dòng)水平增加與各種癌癥風(fēng)險(xiǎn)降低之間的相關(guān)性，與個(gè)體身材和吸煙史并不相關(guān)；總而言之，高水平體力活動(dòng)會降低個(gè)體平均7%的患癌風(fēng)險(xiǎn)。 但是，體力活動(dòng)會增加個(gè)體5%的前列腺癌風(fēng)險(xiǎn)以及27%的惡性黑色素瘤風(fēng)險(xiǎn)，這種相關(guān)性在美國太陽紫外輻射較強(qiáng)地區(qū)尤為明顯，而在太陽紫外輻射水平較低的地區(qū)并無上述相關(guān)性。 該研究的最大限制在于無法完全闡明飲食、吸煙以及其他因素如何影響研究結(jié)果，同時(shí)該研究還利用了參與者自我體力活動(dòng)報(bào)告數(shù)據(jù)，這些自我報(bào)告數(shù)據(jù)或許會存在一定偏差。 美國埃默里大學(xué)、北卡羅來納大學(xué)的流行病學(xué)專家對此在線發(fā)表評論，認(rèn)為當(dāng)前相關(guān)研究結(jié)果也認(rèn)同體力活動(dòng)可以作為全球性預(yù)防癌癥以及降低癌癥風(fēng)險(xiǎn)的黃金法則，業(yè)余時(shí)間體力活動(dòng)或許可以作為一種可能降低癌癥個(gè)體風(fēng)險(xiǎn)的策略，當(dāng)然后期還需要進(jìn)行大量深入研究揭示體力活動(dòng)與癌癥之間相關(guān)性背后可能的分子機(jī)制。 JAMA Intern Med. 2016 May 16. [Epub ahead of print] Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. Steven C. Moore; I-Min Lee; Elisabete Weiderpass; Peter T. Campbell; Joshua N. Sampson; Cari M. Kitahara; Sarah K. Keadle; Hannah Arem; Amy Berrington de Gonzalez; Patricia Hartge; Hans-Olov Adami; Cindy K. Blair; Kristin B. Borch; Eric Boyd; David P. Check; Agnès Fournier; Neal D. Freedman; Marc Gunter; Mattias Johannson; Kay-Tee Khaw; Martha S. Linet; Nicola Orsini; Yikyung Park; Elio Riboli; Kim Robien; Catherine Schairer; Howard Sesso; Michael Spriggs; Roy Van Dusen; Alicja Wolk; Charles E. Matthews; Alpa V. Patel.
Importance: Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood. Objective: To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking. Design, Setting, and Participants: We pooled data from 12 prospective US and European cohorts with self-reported physical activity (baseline 1987-2004). We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals for associations of leisure-time physical activity with incidence of 26 types of cancer. Leisure-time physical activity levels were modeled as cohort-specific percentiles on a continuous basis and cohort-specific results were synthesized by random-effects meta-analysis. Hazard ratios for high vs low levels of activity are based on a comparison of risk at the 90th vs 10th percentiles of activity. The data analysis was performed from January 1, 2014, to June 1, 2015. Exposures: Leisure-time physical activity of a moderate to vigorous intensity. Main Outcomes and Measures: Incident cancer during follow-up. Results: A total of 1.44 million participants (median [range] age, 59 [19-98] years; 57% female) and 186,932 cancers were included. High vs low levels of leisure-time physical activity were associated with lower risks of 13 cancers: esophageal adenocarcinoma (HR 0.58, 95% CI 0.37-0.89), liver (HR 0.73, 95% CI 0.55-0.98), lung (HR 0.74, 95% CI 0.71-0.77), kidney (HR 0.77, 95% CI 0.70-0.85), gastric cardia (HR 0.78, 95% CI 0.64-0.95), endometrial (HR 0.79, 95% CI 0.68-0.92), myeloid leukemia (HR 0.80, 95% CI 0.70-0.92), myeloma (HR 0.83, 95% CI 0.72-0.95), colon (HR 0.84, 95% CI 0.77-0.91), head and neck (HR 0.85, 95% CI 0.78-0.93), rectal (HR 0.87, 95% CI 0.80-0.95), bladder (HR 0.87, 95% CI 0.82-0.92), and breast (HR 0.90, 95% CI 0.87-0.93). Body mass index adjustment modestly attenuated associations for several cancers, but 10 of 13 inverse associations remained statistically significant after this adjustment. Leisure-time physical activity was associated with higher risks of malignant melanoma (HR 1.27, 95% CI 1.16-1.40) and prostate cancer (HR 1.05, 95% CI 1.03-1.08). Associations were generally similar between overweight/obese and normal-weight individuals. Smoking status modified the association for lung cancer but not other smoking-related cancers. Conclusions and Relevance: Leisure-time physical activity was associated with lower risks of many cancer types. Health care professionals counseling inactive adults should emphasize that most of these associations were evident regardless of body size or smoking history, supporting broad generalizability of findings. DOI: 10.1001/jamainternmed.2016.1548 JAMA Intern Med. 2016 May 16. [Epub ahead of print] The Promise of Leisure-Time Physical Activity to Reduce Risk of Cancer Development. Lauren E. McCullough; Kathleen M. McClain; Marilie D. Gammon.
Cancer is among the leading causes of morbidity and mortality worldwide, with 14.1 million new cancer cases and 8.2 million cancer-related deaths in 2012. By 2030 the global cancer burden is expected to double, with 21.7 million new cases and 13.2 million cancer deaths projected due to demographic changes alone. These estimates will likely be compounded by the trend toward unhealthy lifestyle behaviors (eg, smoking and poor diet), particularly in emerging economies. Given that large increases in cancer incidence and mortality are expected to occur in developing countries where economic resources for secondary and tertiary care are low, primary preventive strategies for cancer risk reduction could help to decrease the worldwide cancer burden. DOI: 10.1001/jamainternmed.2016.1521
|
|
|
