International Journal of Epidemiology, Vol 28, 620-625, Copyright © 1999 by International Epidemiological Association
IM Lee, HD Sesso and RS Paffenbarger Jr
BACKGROUND: Physical activity has been proposed to decrease lung cancer
risk; however, few data are available. Further, no studies have examined
specific kinds and intensities of activities. METHODS: We conducted a
prospective cohort study among 13 905 male Harvard University alumni (mean
age, 58.3 years), free of cancer. Men reported their walking, stair
climbing and participation in sports or recreation on baseline
questionnaires in 1977, and the occurrence of lung cancer on follow-up
questionnaires in 1988 and 1993. Death certificates were obtained for
decedents through 1992 to determine lung cancers not previously reported.
RESULTS: During follow-up, 245 men developed lung cancer. Adjusting for
age, cigarette smoking, and body mass index, the relative risks of lung
cancer associated with <4200, 4200-8399, 8400-12 599 and > or =12 600
kJ/week of estimated energy expenditure at baseline were 1.00 (referent),
0.87 (95% CI: 0.64-1.18), 0.76 (95% CI: 0.52-1.11), and 0.61 (95% CI:
0.41-0.89), respectively; P trend = 0.0008. Similar trends were observed
among non-smokers or former smokers in 1977 (82.7% of men) as well as among
those who smoked >20 cigarettes a day in 1977 (8.0%), although the
findings in the latter group were not statistically significant, possibly
due to the small number. Walking, climbing stairs and participating in
activities of at least moderate intensity (> or =4.5 MET, or multiples
of resting metabolic rate) were each inversely associated with lung cancer
risk, independent of the other activity components. However, light
intensity activities (<4.5 MET) did not predict lung cancer risk.
CONCLUSIONS: These data indicate that physical activity may be associated
with lower risk of lung cancer among men. An energy expenditure of 12 600
kJ/week, achievable by perhaps 6-8 hours of at least moderate intensity
physical activity, may significantly lower risk. Further studies are
required to confirm these observations.
ARTICLES
Physical activity and risk of lung cancer
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
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