Article

Past and present physical activity and endometrial cancer risk

Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20892.
British Journal of Cancer (Impact Factor: 4.82). 10/1993; 68(3):584-9. DOI: 10.1038/bjc.1993.390
Source: PubMed

ABSTRACT We examined the relation between physical activity and endometrial cancer using data from a multicentre case-control study involving 405 endometrial cancer cases and 297 population controls. Estimates of recreational (i.e. active sport, walks and hikes) and nonrecreational activity (i.e. house cleaning, climbing stairs and walking or standing on the job) were obtained using interview information. After adjustment for age, study area, education, parity, years of use of oral contraceptives, years of use of menopausal oestrogens and cigarette smoking, recent recreational inactivity was associated with increased risk (RR = 1.9 for lowest vs highest tertile). Similarly, recent nonrecreational inactivity was associated with increased risk (RR = 2.2 for lowest vs highest tertile). Further adjustment for body mass and nonrecreational activity attenuated the association between risk and recent recreational inactivity (RR = 1.2; 95% CL = 0.7-2.0) but adjustment for body mass and recreational activity did not alter the association between risk and recent nonrecreational inactivity (RR = 2.0; 95% CL = 1.2-3.1). To evaluate the relation between risk and sustained inactivity, we simultaneously examined activity levels at three periods (RR i.e. age 20-29, age 30-39 and recently) in women age 50 and older. After adjustment for potential confounders and body mass, risk was elevated among women who were always recreationally inactive (RR = 1.5 for always active vs always inactive) and among women who were always nonrecreationally inactive (RR = 1.6 for always active vs always inactive). This study suggests that physically inactive women may be at increased risk of endometrial cancer because they are more likely to be overweight or obese. Our data also suggest that inactivity per se may be associated with an increased risk of endometrial cancer. However, we cannot rule out the possibility that our results, particularly those for nonrecreational activity, reflect unmeasured confounding factors. Future studies should attempt to obtain more detailed assessments of physical activity, including the intensity with which an individual engaged in an activity and the actual time involved in exertion.

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    • "To date, studies of different designs have examined the relationship between physical activity and endometrial cancer risk, including linkage (Pukkala et al, 1993; Zheng et al, 1993), prospective cohort (Moradi et al, 1998; Terry et al, 1999; Moradi et al, 2000; Colbert et al, 2003; Furberg and Thune, 2003; Schouten et al, 2004; Friberg et al, 2006; Friedenreich et al, 2007; Patel et al, 2008; Conroy et al, 2009; Gierach et al, 2009), population-based case–control (Shu et al, 1993; Sturgeon et al, 1993; Goodman et al, 1997; Olson et al, 1997; Littman et al, 2001; Matthews et al, 2005; John et al, 2010) and hospital-based case–control (Dosemeci et al, 1993; Levi et al, 1993; Hirose et al, 1996; Kalandidi et al, 1996; Troisi et al, 1997; Salazar-Martinez et al, 2000; Tavani et al, 2009) studies. However the type, time points and intensity of physical activity have varied across these studies. "
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    ABSTRACT: Background: Physical activity may be associated with decreasing endometrial cancer risk; it remains unclear whether the association is modified by body size. Methods: Among 93 888 eligible California Teachers Study participants, 976 were diagnosed with incident endometrial cancer between 1995–1996 and 2007. Cox proportional hazards regression methods were used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for endometrial cancer associated with long-term (high school through age 54 years) and baseline (3 years prior to joining the cohort) strenuous and moderate recreational physical activity, overall and by body size. Results: Increased baseline strenuous recreational physical activity was associated with decreased endometrial cancer risk (Ptrend=0.006) with approximately 25% lower risk among women exercising >3 h per week per year than among those exercising <1/2 h per week per year (RR, 0.76; 95% CI, 0.63–0.92). This inverse association was observed among overweight/obese women (body mass index ≥25 kg m−2; Ptrend=0.006), but not among thinner women (Ptrend=0.12). Baseline moderate activity was associated with lower risk among overweight/obese women. Conclusion: Increasing physical activity, particularly strenuous activity, may be a lifestyle change that overweight and obese women can implement to reduce their endometrial cancer risk.
    British Journal of Cancer 07/2013; 109(3). DOI:10.1038/bjc.2013.61 · 4.82 Impact Factor
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    • "Physical activity has many health benefits, including reduced obesity (Goran, Reynolds, & Lindquist, 1999; Bergman, Ader, Huecking, & Van Citters, 2002); reduced risk for cardiovascular disease (McTiernan, Ulrich, Slate, & Potter, 1998), osteoporosis (Stallings, 1997; Lysen & Walker, 1997), and type 2 diabetes (Diabetes Prevention Program Research Group, 2002); the reduction of breast cancer risk by as much as 40% (McTiernan et al., 2003; A. Patel & Bernstein, 2006; Thune, Brenn, Lund, & Gaard, 1997; Verloop, Rookus, van der Kooy, & van Leeuwen, 2000); reduction of risk for many other cancers, including colon (Slattery et al., 1997; Wu, Paganini-Hill, Ross, & Henderson, 1987) and endometrial cancer (Friedenreich & Orenstein, 2002; Sturgeon et al., 1993); and improved mental health and well-being (Suitor & Kraak, 2007). Measurement of physical activity levels can thus inform medical decisions, decisions pertaining to an individual's exercise needs, competing programmatic interventions, and the management of public facilities. "
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    • "None of the previous studies had a comprehensive measure of lifetime total activity. Eight studies [14, 21, 24, 25, 28, 30–32] measured usual lifetime occupational activity or some aspect of recreational activity over lifetime rather than using current activity as a proxy for lifetime activity. Hence, the results of this study cannot be directly compared to any previous investigation. "
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    ABSTRACT: A population-based case–control study of physical activity and endometrial cancer risk was conducted in Alberta between 2002 and 2006. Incident, histologically confirmed cases of endometrial cancer (n = 542) were frequency age-matched to controls (n = 1,032). The Lifetime Total Physical Activity Questionnaire was used to measure occupational, household, and recreational activity levels. Multivariable logistic regression analyses were conducted. Total lifetime physical activity reduced endometrial cancer risk (odds ratio [OR] for >129 vs. <82 MET-h/week/year = 0.86, 95% confidence interval [95% CI]: 0.63, 1.18). By type of activity, the risks were significantly decreased for greater recreational activity (OR = 0.64, 95% CI: 0.47, 0.87), but not for household activity (OR = 1.09, 95% CI: 0.75, 1.58) and/or occupational activity (OR = 0.90, 95% CI: 0.67, 1.20) when comparing the highest to lowest quartiles. For activity performed at different biologically defined life periods, some indication of reduced risks with activity done between menarche and full-term pregnancy and after menarche was observed. When examining the activity by intensity of activity (i.e., light <3, moderate 3–6, and vigorous >6 METs), light activity slightly decreased endometrial cancer risk (OR = 0.68, 95% CI: 0.48, 0.97) but no association with moderate or vigorous intensity activity was found. Endometrial cancer risk was increased with sedentary occupational activity by 28% (95 CI%: 0.89, 1.83) for >11.3 h/week/year versus ≤2.4 h/week/year or by 11% for every 5 h/week/year spent in sedentary behavior. This study provides evidence for a decreased risk between lifetime physical activity and endometrial cancer risk and a possible increased risk associated with sedentary behavior. Electronic supplementary material The online version of this article (doi:10.1007/s10552-010-9538-1) contains supplementary material, which is available to authorized users.
    Cancer Causes and Control 03/2010; 21(7):1105-16. DOI:10.1007/s10552-010-9538-1 · 2.96 Impact Factor
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