Association between Physical Activity and Risk of Hepatobiliary Cancers: A Multinational Cohort Study

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  • Sebastian E Baumeister, Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Augsburg, Germany; Institute for Community Medicine, University Medicine Greifswald, Germany. Electronic address: s.baumeister@unika-t.de., Tyskland
  • Sabrina Schlesinger, Junior Research Group Systematic Reviews, Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany., Tyskland
  • Krasimira Aleksandrova, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany., Tyskland
  • Carmen Jochem, Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany., Tyskland
  • Mazda Jenab, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Marc J Gunter, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Kim Overvad
  • Anne Tjønneland, Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Danmark
  • Marie-Christine Boutron-Ruault, Inserm, Centre de Recherche en Epidémiologie et Santé des Populations (CESP, U1018), Université Paris-Saclay, Université Paris-Sud, UVSQ, Institut Gustave Roussy, Villejuif, France., Frankrig
  • Franck Carbonnel, Institut Gustave Roussy, Villejuif, France; Department of Gastroenterology, Bicêtre University Hospital, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France., Frankrig
  • Agnès Fournier, Inserm, Centre de Recherche en Epidémiologie et Santé des Populations (CESP, U1018), Université Paris-Saclay, Université Paris-Sud, UVSQ, Institut Gustave Roussy, Villejuif, France., Frankrig
  • Tilman Kühn, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany., Tyskland
  • Rudolf Kaaks, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany., Tyskland
  • Tobias Pischon, Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany., Tyskland
  • Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany., Tyskland
  • Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece; WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece., Grækenland
  • Christina Bamia, Hellenic Health Foundation, Athens, Greece; WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece., Grækenland
  • Carlo La Vecchia, Hellenic Health Foundation, Athens, Greece; Dept. of Clinical Sciences and Community Health, Università degli Studi di Milano, Italy., Italien
  • Giovanna Masala, Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy., Italien
  • Salvatore Panico, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy., Italien
  • Francesca Fasanelli, Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy., Italien
  • Rosario Tumino, Civic-M.P. Arezzo Hospital, Italien
  • Sara Grioni, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, Milano, Italy., Italien
  • Bas Bueno de Mesquita, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands., Holland
  • Roel Vermeulen, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands; Julius Centre for Public Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands., Holland
  • Anne M May, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands., Holland
  • Kristin B Borch, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway, Norge
  • Sunday O Oyeyemi, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway, Norge
  • Eva Ardanaz, Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain., Spanien
  • Miguel Rodríguez-Barranco, Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Spain., Spanien
  • María Dolores Chirlaque López, Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Spain; CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain., Spanien
  • Mireia Felez-Nobrega, Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Spanien
  • Emily Sonestedt, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden., Sverige
  • Bodil Ohlsson, Department of Internal Medicine, Skåne University Hospital, Lund University, SE-205 92 Malmö, Sweden., Sverige
  • Oskar Hemmingsson, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden., Sverige
  • Mårten Werner, Department of Public Health and Clinical Medicine/Occupational & Environmental Medicine, Umeå University, Umeå, Sweden., Sverige
  • Aurora Perez-Cornago, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece., Storbritannien
  • Pietro Ferrari, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Magdalena Stepien, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Heinz Freisling, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Konstantinos K Tsilidis, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece., Grækenland
  • Heather Ward, Department of Epidemiology and Biostatistics, Imperial College London, London, England., Storbritannien
  • Elio Riboli, Department of Epidemiology and Biostatistics, Imperial College London, London, England., Storbritannien
  • Elisabete Weiderpass, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland., Norge
  • Michael F Leitzmann, Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany., Tyskland

Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (e.g. due to hepatitis virus infection). Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95% CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC. Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.

OriginalsprogEngelsk
BogserieJournal of Hepatology
Vol/bind70
Nummer5
Sider (fra-til)885-892
Antal sider8
ISSN0169-5185
DOI
StatusUdgivet - maj 2019

Bibliografisk note

Copyright © 2018. Published by Elsevier B.V.

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