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Obesity,physical activity and cancer risks: Results from the Cancer,Lifestyle and Evaluation of Risk Study (CLEAR)
Institution:1. Cancer Research Division, Cancer Council NSW, Sydney, Australia;2. Sydney School of Public Health, The University of Sydney, Sydney, Australia;3. Faculty of Medicine and Health Science, Macquarie University, Sydney, Australia;1. Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;2. School of Pharmacy, Queen’s University Belfast, Northern Ireland, United Kingdom;3. Centre of Excellence for Public Health (NI), Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;1. University of Tampere, School of Health Sciences, Tampere, Finland;2. Department of Clinical Chemistry, Helsinki University Central Hospital, Finland;3. Tampere University Hospital, Department of Urology and University of Tampere, Medical School, Tampere, Finland;4. Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands;5. Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden;6. Memorial Sloan-Kettering Cancer Centre, Department of Surgery and Department of Epidemiology and Biostatistics, New York, NY, USA;7. Finnish Cancer Registry, Helsinki, Finland;1. Cancer Prevention Institute of California, Fremont, CA, United States;2. Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA, United States;3. Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA, United States;1. College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331;2. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX 78714;1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA;2. Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
Abstract:IntroductionPhysical activity (PA) has been associated with lower risk of cardiovascular diseases, but the evidence linking PA with lower cancer risk is inconclusive. We examined the independent and interactive effects of PA and obesity using body mass index (BMI) as a proxy for obesity, on the risk of developing prostate (PC), postmenopausal breast (BC), colorectal (CRC), ovarian (OC) and uterine (UC) cancers.MethodsWe estimated odds ratios (OR) and 95% confidence intervals (CI), adjusting for cancer specific confounders, in 6831 self-reported cancer cases and 1992 self-reported cancer-free controls from the Cancer Lifestyle and Evaluation of Risk Study, using unconditional logistic regression.ResultsFor women, BMI was positively associated with UC risk; specifically, obese women (BMI ≥30 kg/m2) had nearly twice the risk of developing UC compared to women with healthy-BMI-range (<25 kg/m2) (OR = 1.99;CI:1.31–3.03). For men, BMI was also positively associated with the risk of developing any cancer type, CRC and PC. In particular, obese men had 37% (OR = 1.37;CI:1.11–1.70), 113% (OR = 2.13;CI:1.55–2.91) and 51% (OR = 1.51;CI:1.17-1.94) higher risks of developing any cancer, CRC and PC respectively, when compared to men with healthy-BMI-range (BMI<25 kg/m2).Among women, PA was inversely associated with the risks of CRC, UC and BC. In particular, the highest level of PA (versus nil activity) was associated with reduced risks of CRC (OR = 0.60;CI:0.44–0.84) and UC (OR = 0.47;CI:0.27–0.80). Reduced risks of BC were associated with low (OR = 0.66;CI:0.51–0.86) and moderate (OR = 0.72;CI:0.57–0.91) levels of PA. There was no association between PA levels and cancer risks for men.We found no evidence of an interaction between BMI and PA in the CLEAR study.ConclusionThese findings suggest that PA and obesity are independent cancer risk factors.
Keywords:Physical activity  Obesity  Body mass index  Cancer  Case-control study
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