The association between physical activity and renal cancer: systematic review and meta-analysis

Behrens, Gundula; Leitzmann, Michael F.

doi:10.1038/bjc.2013.37

Cited by 113 publications

(74 citation statements)

References 54 publications

(96 reference statements)

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“…In our previous study of population attribut- able risk, sensitivity analysis of Canadian data from the CCHS showed that, by using bias-adjusted prevalence estimates based on accelerometer data from the 2008 Canadian Health Measures Survey, the total cancer burden attributable to inadequate physical activity increased from 7.9% to 10.7%. 13 In addition, in the current analysis, we excluded cancer sites for which the evidence of association is suggestive but not yet fully developed, such as the pancreas, 5 kidney 36 and liver. 37 Thus, the overall burden of cancer in Alberta associated with physical inactivity is likely to be higher than the estimates reported here.…”

Section: Limitationsmentioning

confidence: 99%

Cancer incidence attributable to inadequate physical activity in Alberta in 2012

et al. 2017

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Background: Physical inactivity has been consistently associated with increased risk of colorectal, endometrial, breast (in postmenopausal women), prostate, lung and ovarian cancers. The objective of the current analysis was to estimate the proportion and absolute number of site-specific cancer cases attributable to inadequate physical activity in Alberta in 2012. Methods:We used population attributable risks to estimate the proportion of each site-specific cancer attributable to inactivity. Relative risk estimates were obtained from the epidemiological literature, and prevalence estimates were calculated with the use of data from the Canadian Community Health Survey cycle 2.1 (2003). Respondents who acquired 1.5-2.9 kcal/kg per day and less than 1.5 kcal/kg per day of physical activity were classified as moderately active and inactive, respectively, and both levels were considered inadequate for mitigating cancer risks. We obtained age-, sex-and site-specific cancer incidence data from the Alberta Cancer Registry for 2012.Results: About 59%-75% of men and 69%-78% of women did not engage in adequate physical activity. Overall, 13.8% of cancers across all associated cancers were estimated to be attributable to inadequate physical activity, representing 7.2% of all cancers diagnosed in Alberta in 2012. Suboptimal levels of physical activity had a greater impact among women: the proportion of all associated cancers attributable to inadequate physical activity was 18.3% for women and 9.9% for men.Interpretation: A substantial proportion of cancer cases diagnosed in Alberta were estimated to be attributable to inadequate physical activity. With the high prevalence of physical inactivity among adults in the province, developing strategies to increase physical activity levels could have a notable impact on reducing future cancer burden in Alberta. AbstractResearch Research CMAJ OPENCMAJ OPEN, 5(2) E339 levels of physical activity. 11,12 However, these studies considered only colon, breast and endometrial cancers. We previously estimated that, in Canada, 5.8% and 10.2% of cancers in men and women, respectively, could be attributed to inadequate physical activity (energy expenditure < 3 kcal/kg per day). 13 The objective of this analysis was to estimate the proportion and absolute number of site-specific cancer cases attributable to inadequate physical activity in Alberta in 2012. MethodsThis paper is part of a series of exposure-specific manuscripts concerning the proportion of cancer cases attributable to modifiable lifestyle and environmental risk factors in the general population of Alberta. The methodologic framework for the series' methods has been previously described. 14 Latency periodThe cancer risk associated with inadequate physical activity is understood to be the result of past exposure to inadequate physical activity. Thus, we identified a 7-to 10-year latency period based on previous literature.13 As has been previously described, 14 we considered the theoretical latency period to be the time between i...

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Section: Limitationsmentioning

confidence: 99%

Cancer incidence attributable to inadequate physical activity in Alberta in 2012

et al. 2017

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“…A quality score developed by Monninkhof and colleagues (43) and previously used in several meta-analyses of physical activity and specific cancers (17,(43)(44)(45)(46) was applied to assess the methodological quality of the selected studies (supplementary Materials and Methods).…”

Section: Quality Assessmentmentioning

confidence: 99%

Physical Activity in Relation to Risk of Hematologic Cancers: A Systematic Review and Meta-analysis

Jochem

Leitzmann

Keimling

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Despite the existence of numerous biologic pathways potentially linking increased physical activity to decreased risk of hematologic cancers, the associations between physical activity and subtypespecific hematologic cancers have not been comprehensively quantified.Methods: We conducted a systematic review and meta-analysis of physical activity in relation to subtypespecific hematologic cancers. We summarized the data from 23 eligible studies (15 cohort and eight casecontrol studies) and estimated summary relative risks (RR) and 95% confidence intervals (CI) using randomeffects models.Results: When comparing high versus low physical activity levels, the RR for non-Hodgkin lymphoma was 0.91 (95% CI, 0.82-1.00), for Hodgkin lymphoma it was 0.86 (95% CI, 0.58-1.26), for leukemia it was 0.97 (95% CI, 0.84-1.13), and for multiple myeloma it was 0.86 (95% CI, 0.68-1.09). When focusing on subtypes of nonHodgkin lymphoma, the RR for diffuse large B-cell lymphoma was 0.95 (95% CI, 0.80-1.14) and for follicular lymphoma it was 1.01 (95% CI, 0.83-1.22). In an exploratory analysis combining all hematologic cancers, high versus low physical activity levels yielded a statistically significant RR of 0.93 (95% CI, 0.88-0.99).Conclusions: Physical activity showed statistically nonsignificant associations with risks of non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, and leukemia. These findings may not represent a true lack of associations given the variation in high versus low physical activity definitions, the quality of physical activity assessments, and the variability in hematologic cancer classification schemes in individual studies.Impact: Physical activity is unrelated to risks of subtype-specific hematologic cancers. Cancer Epidemiol Biomarkers Prev; 23(5); 833-46. Ó2014 AACR.

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“…In addition to breast cancer, meta-analysis is also adopted as a useful tool to detect the association between physical activity and other cancers like endometrial cancer [8], bladder cancer [9], gastroesophageal cancer [10][11][12], lung cancer [13], thyroid cancer [14], renal cancer [15], prostate cancer [16], pancreatic cancer [17] and colon cancer [18,19], and also mortality among breast cancer survivors [20,21]. Furthermore, physical activity has been acknowledged as one of the breast cancer primary prevention strategies that are applicable to both premenopausal women and postmenopausal women [22].…”

Section: Rebuttal Lettermentioning

confidence: 99%

Meta-analyses of etiologic studies should account for the underlying biologic mechanisms

Zhang

2015

Breast Cancer Res Treat

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We thank Neilson HK for the comments with our paper entitled ''Physical activity and risk of breast cancer: a meta-analysis of prospective studies'' [1], and our replies are as follows:First, Neilson HK suggested that all pooled estimates in subgroup analysis should be further stratified by menopausal status to avoid the potential confounding by menopausal status, especially for the subgroup analysis by body mass index (BMI). It is a pity that this suggestion could not be taken in practice because none of the included studies conducted their analysis in this way, considering the fact that the statistical power could be greatly reduced while the type 1 error greatly inflated in this way. However, several original studies involving postmenopausal women and 1 study with premenopausal provided their results by BMI, and the results are shown in the following table.As shown in the above-mentioned table, the magnitude of association between physical activity and risk of breast cancer was stronger in subjects with lower values of BMI (\25.0 kg/m 2 ) than those with BMI values of C25.0 kg/m 2 , regardless of menopausal status. Therefore, the findings are consistent with the results in our meta-analysis by BMI [\25.0 kg/m 2 : 0.72 (0.65-0.81), [25.0 kg/m 2 : 0.93 (0.83-1.05)] [1]. In addition, no between-study heterogeneity (I 2 = 0.00 %) was found in subgroup analysis by BMI, suggesting the association by BMI was consistent among the included studies regardless of menopausal status. As for adjusting for BMI as a covariates and as shown in Table 1, the results were very similar in subgroup analysis [results adjusting for BMI: 0.88 (0.85-0.91), results did not adjusting for BMI: 0.89 (0.85-0.93)], suggesting that BMI is not a major concern in this meta-analysis.Second, Neilson HK stated that ''A meta-analysis might have been done sooner were it not for what some consider to be too much heterogeneity in this field of research''. This concern was already mentioned in our meta-analysis [1] ''a wide range of definitions of physical activity have been used in previous studies as they have not uniformly assessed all types of physical activity (i.e., occupational, household, and recreational), the dose of activity (frequency, intensity, and duration), or all time periods in life when activity was performed'', and we also had conducted subgroup analysis to assess the potential influence of the above-mentioned factors, and detailed results by activity domains (occupational, non-occupational, recreational, household and walking), activity intensity (moderate and vigorous) as well as periods of life during which physical activity was performed (\25 years, 25-50 years and [50 years) are summarized in Table 1. With regards to the interpretation of heterogeneity, Neilson HK might be interested in the paper by Higgins [7], because presence of between-study heterogeneity is common in a meta-analysis summarizing the results from previous studies to improve the power to detect an association, and explore the potential sources of between-stud...

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The association between physical activity and renal cancer: systematic review and meta-analysis

Cited by 113 publications

References 54 publications

Cancer incidence attributable to inadequate physical activity in Alberta in 2012

Cancer incidence attributable to inadequate physical activity in Alberta in 2012

Physical Activity in Relation to Risk of Hematologic Cancers: A Systematic Review and Meta-analysis

Meta-analyses of etiologic studies should account for the underlying biologic mechanisms

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