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ORIGINAL ARTICLE  EPIDEMIOLOGY AND CLINICAL MEDICINE 

The Journal of Sports Medicine and Physical Fitness 2019 August;59(8):1405-12

DOI: 10.23736/S0022-4707.18.08989-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Precancer diagnosis cardiorespiratory fitness, physical activity and cancer mortality in men

Baruch VAINSHELBOIM 1, 2 , Ricardo M. LIMA 2, 3, Kerem SHUVAL 4, Kelley PETTEE GABRIEL 5, 6, Jonathan MYERS 2

1 School of Health Sciences, Saint Francis University, Loretto, PA, USA; 2 Division of Cardiology, Veterans Affairs Palo Alto Health Care System/Stanford University, Palo Alto, CA, USA; 3 Faculty of Physical Education, University of Brasilia, Brasilia, Brazil; 4 Department of Intramural Research, American Cancer Society, Atlanta, GA, USA; 5 Department of Epidemiology, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, TX, USA; 6 Department of Women’s Health, The University of Texas at Austin, Dell Medical School, Austin, TX, USA



BACKGROUND: The preventive role of precancer diagnosis cardiorespiratory fitness (CRF) and physical activity (PA) in cancer mortality is poorly characterized. The aim of this study was to assess the association between CRF, PA at precancer-diagnosis and cancer mortality in men who diagnosed with cancer later in life.
METHODS: A total of 699 men (63±10 years) who were diagnosed with cancer during 7.5±4.9 years from a baseline treadmill exercise test and reported PA were analyzed. Multivariate Cox models for CRF and univariate model for PA were conducted. Population Attributable Risks (PARs%) and exposure impact number (EIN) of low CRF (<5 METs) and inactivity were determined.
RESULTS: During 6.5±5.2 years from cancer diagnosis, 56% died from cancer. CRF was inversely, graded and independently associated with cancer death. A 1-MET increase and categories of moderate and high CRF were associated with 7%, 28% and 51% reductions in risk of cancer death, respectively. Active compared to inactive individuals had a 23% reduced risk of cancer mortality (HR=0.77, 95% CI [0.63-0.94], P=0.01). PARs% of low CRF and inactivity were 4.8% and 9.4%, respectively, while the respective EIN were 3 and 9.
CONCLUSIONS: Higher CRF and being active at precancer-diagnosis were associated with lower cancer mortality and longer survival time in men who developed cancer later in life. Screening and intervening for low CRF and inactivity as risk factors during middle-age and maintaining at least moderate CRF and activity levels may be effective strategies for prevention of cancer mortality.


KEY WORDS: Exercise Test; Exercise tolerance; Physical fitness

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