期刊
JOURNAL OF HEPATOLOGY
卷 70, 期 5, 页码 885-892出版社
ELSEVIER
DOI: 10.1016/j.jhep.2018.12.014
关键词
Hepatobiliary cancer; Hepatocellular carcinoma; Liver cancer; Physical activity
资金
- French National Cancer Institute (L'Institut National du Cancer
- INCA) [2009-139]
- European Commission (DG-SANCO)
- International Agency for Research on Cancer
- Danish Cancer Society (Denmark)
- Ligue Contre le Cancer (France)
- Institut Gustave Roussy (France)
- Mutuelle Generale de l'Education Nationale (France)
- Institut National de la Sante et de la Recherche Medicale (INSERM) (France)
- Deutsche Krebshilfe (Germany)
- Deutsches Krebsforschungszentrum (Germany)
- Federal Ministry of Education and Research (Germany)
- Hellenic Health Foundation (Greece)
- Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy
- National Research Council (Italy)
- Dutch Ministry of Public Health, Welfare and Sports (VWS)
- Netherlands Cancer Registry (NKR)
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Neder-land)
- World Cancer Research Fund (WCRF)
- Statistics Netherlands (The Netherlands)
- Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway)
- Health Research Fund (FIS) (Spain) [PI13/00061]
- Regional Government of Andalucia (Spain)
- Regional Government of Asturias (Spain)
- Regional Government of Basque Country (Spain)
- Regional Government of Murcia (Spain) [6236]
- Regional Government of Navarra (Spain)
- ISCIII RETIC (Spain) [RD06/0020]
- Swedish Cancer Society (Sweden)
- Swedish Scientific Council (Sweden)
- County Council of Skane (Sweden)
- County Council of Vasterbotten (Sweden)
- Cancer Research UK [14136, C570/A16491, C8221/A19170]
- Medical Research Council (United Kingdom) [1000143, MR/M012190/1]
- MRC [MR/N003284/1, G0500300] Funding Source: UKRI
Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. Weexamined 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. (C) 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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