摘要
Purpose:To assess the association between cardiorespiratory fitness(CRF)and the incidence and mortality from cancer in women,and to evaluate the potential public health implications for cancer prevention.Methods:Maximal exercise testing was performed in a pilot cohort of 184 women(59.3 ± 15.2 years)who were followed for 12.0 ± 6.9 years.Cox hazard models adjusted for established cancer risk factors and accounting for competing events were analyzed for all-type cancer incidence and mortality from cancer.Population-attributable risks and exposure impact number were determined for low CRF(<5 metabolic equivalents(METs))as a risk factor.Results:During the follow-up,11.4% of the participants were diagnosed with cancer and 3.2% died from cancer.CRF was inversely and independently associated with cancer outcomes.For every 1-metabolic equivalent increase in CRF,there was a 20% decrease in the risk of cancer incidence(hazard ratio(HR)= 0.80,95% confidence interval(CI):0.69-0.92;p=0.001)and a 26% reduction in risk of cancer mortality(HR = 0.74,95%CI:0.61-0.90;p=0.002).The population-attributable risks of low CRF were 11.6% and 14% for incidence and mortality of cancer,respectively,and the respective exposure impact numbers were 8 and 20.Conclusion:Greater CRF was independently associated with a lower risk of incidence and mortality from cancer in women.Screening for low CRF as a cancer risk factor and referring unfit individuals to a supervised exercise program could be a public health strategy for cancer prevention in middle-age women.
Purpose:To assess the association between cardiorespiratory fitness(CRF)and the incidence and mortality from cancer in women,and to evaluate the potential public health implications for cancer prevention.Methods:Maximal exercise testing was performed in a pilot cohort of 184 women(59.3 ± 15.2 years)who were followed for 12.0 ± 6.9 years.Cox hazard models adjusted for established cancer risk factors and accounting for competing events were analyzed for all-type cancer incidence and mortality from cancer.Population-attributable risks and exposure impact number were determined for low CRF(<5 metabolic equivalents(METs))as a risk factor.Results:During the follow-up,11.4% of the participants were diagnosed with cancer and 3.2% died from cancer.CRF was inversely and independently associated with cancer outcomes.For every 1-metabolic equivalent increase in CRF,there was a 20% decrease in the risk of cancer incidence(hazard ratio(HR)= 0.80,95% confidence interval(CI):0.69-0.92;p=0.001)and a 26% reduction in risk of cancer mortality(HR = 0.74,95%CI:0.61-0.90;p=0.002).The population-attributable risks of low CRF were 11.6% and 14% for incidence and mortality of cancer,respectively,and the respective exposure impact numbers were 8 and 20.Conclusion:Greater CRF was independently associated with a lower risk of incidence and mortality from cancer in women.Screening for low CRF as a cancer risk factor and referring unfit individuals to a supervised exercise program could be a public health strategy for cancer prevention in middle-age women.