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Observational and genetic associations between cardiorespiratory fitness and cancer: a UK Biobank and international consortia study
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MD, Rockville, United States.
MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.
MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MD, Rockville, United States.
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2024 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 130, p. 114-124Article in journal (Refereed) Published
Abstract [en]

Background: The association of fitness with cancer risk is not clear.

Methods: We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of lung, colorectal, endometrial, breast, and prostate cancer in a subset of UK Biobank participants who completed a submaximal fitness test in 2009-12 (N = 72,572). We also investigated relationships using two-sample Mendelian randomisation (MR), odds ratios (ORs) were estimated using the inverse-variance weighted method.

Results: After a median of 11 years of follow-up, 4290 cancers of interest were diagnosed. A 3.5 ml O2⋅min−1⋅kg−1 total-body mass increase in fitness (equivalent to 1 metabolic equivalent of task (MET), approximately 0.5 standard deviation (SD)) was associated with lower risks of endometrial (HR = 0.81, 95% CI: 0.73–0.89), colorectal (0.94, 0.90–0.99), and breast cancer (0.96, 0.92–0.99). In MR analyses, a 0.5 SD increase in genetically predicted O2⋅min−1⋅kg−1 fat-free mass was associated with a lower risk of breast cancer (OR = 0.92, 95% CI: 0.86–0.98). After adjusting for adiposity, both the observational and genetic associations were attenuated.

Discussion: Higher fitness levels may reduce risks of endometrial, colorectal, and breast cancer, though relationships with adiposity are complex and may mediate these relationships. Increasing fitness, including via changes in body composition, may be an effective strategy for cancer prevention.

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 130, p. 114-124
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Cancer and Oncology
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URN: urn:nbn:se:umu:diva-218042DOI: 10.1038/s41416-023-02489-3ISI: 001118474500002PubMedID: 38057395Scopus ID: 2-s2.0-85178876689OAI: oai:DiVA.org:umu-218042DiVA, id: diva2:1819631
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NIH (National Institutes of Health)Available from: 2023-12-14 Created: 2023-12-14 Last updated: 2024-05-07Bibliographically approved

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van Guelpen, Bethany

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