Prospective study of physical activity and risk of primary adenocarcinomas of the oesophagus and stomach in the EPIC (European Prospective Investigation into Cancer and nutrition) cohort.
Huerta JM., Navarro C., Chirlaque MD., Tormo MJ., Steindorf K., Buckland G., Carneiro F., Johnsen NF., Overvad K., Stegger J., Tjønneland A., Boutron-Ruault MC., Clavel-Chapelon F., Morois S., Boeing H., Kaaks R., Rohrmann S., Vigl M., Lagiou P., Trichopoulos D., Trichopoulou A., Bas Bueno-de-Mesquita H., Monninkhof EM., Numans ME., Peeters PH., Mattiello A., Pala V., Palli D., Tumino R., Vineis P., Agudo A., Ardanaz E., Arriola L., Molina-Montes E., Rodríguez L., Lindkvist B., Manjer J., Stenling R., Lund E., Crowe FL., Key TJ., Khaw KT., Wareham NJ., Jenab M., Norat T., Romaguera D., Riboli E., González CA.
OBJECTIVE: To analyse the association between types of physical activity (occupational, recreational and household, vigorous and overall) and risk of primary oesophageal (OAC) or gastric adenocarcinoma (GAC). METHODS: From nine European countries, 420,449 participants were recruited between 1991 and 2000 and followed-up for a mean of 8.8 years to register incident GAC and OAC. Information on physical activity (PA), diet, lifestyle and health-related variables was obtained at baseline. Helicobacter pylori infection status was considered in a subset of 1,211 participants. Analyses were repeated by tumour site (cardia/non-cardia) and histological type (intestinal/diffuse). RESULTS: During the follow-up, 410 GAC and 80 OAC occurred. A lower risk of overall and non-cardia GAC was found for increasing levels of a PA index which combined occupational PA with weekly time spent in sports and cycling. The hazard ratio (HR) of GAC was 0.69, 95% CI: 0.50-0.94, for the comparison between active and inactive participants according to the PA index (HR = 0.44, 95% CI:0.26-0.74, for non-cardia GAC). No effect was found for cardia tumours or histological subtypes of GAC. PA of any kind was not associated with OAC. CONCLUSIONS: Overall and distal (non-cardia) gastric tumours were inversely associated with time spent on cycling and sports and a total PA index. No association was found for any type of PA and risk of cardia cancers of the stomach.