Observational and genetic associations between cardiorespiratory fitness and cancer: A UK Biobank and international consortia study
Document Type
Article
Publication Date
1-1-2024
Abstract
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. © 2023, The Author(s).
Keywords
Biological specimen banks, Breast neoplasms, Cardiorespiratory fitness, Colorectal neoplasms, Humans, Male, Risk factors, UK biobank, Article, biobank, Body mass, Breast cancer, Cancer prevention, Cancer risk, Cardiorespiratory fitness, Fat free mass, Female, Follow up, Genetic association, Genetic association study, Human, Major clinical study, Male, Malignant neoplasm, Mendelian randomization analysis, Metabolic equivalent, Obesity, Observational study, Proportional hazards model, Prostate cancer, Biobank, Breast tumor, Colorectal tumor, Genetics, Risk factor
Divisions
surgerydept
Funders
ECAC,National Institutes of Health,British Columbia Arts Council,Medical Research Council [Grant no. MC_UU_00006/1, MC_UU_00006/2, MC_UU_00006/4],National Institute for Health and Care Research,University of Cambridge
Publication Title
British Journal of Cancer
Volume
130
Issue
1
Publisher
Springer Nature