根据流行病学研究结果,体力活动与乳腺癌和结直肠癌风险减少存在相关性。不过,该相关性属于因果关系还是混杂关系尚不明确。
2020年1月31日,英国《自然》旗下《自然通讯》发表世界卫生组织下属国际癌症研究中心等学术机构的研究报告,通过孟德尔随机化抽样,探讨了体力活动与乳腺癌和结直肠癌风险的相关性。
该研究利用英国生物样本库和全基因组关联研究联盟的基因汇总数据,进行两个独立样本孟德尔随机分析。
结果发现,体力活动平均加速度每增加一个标准差:
乳腺癌风险低49%(比值比:0.51,95%置信区间:0.27~0.98,P=0.04)
雌激素受体阳性乳腺癌风险低54%(比值比:0.45,95%置信区间:0.20~1.01,P=0.054)
雌激素受体阴性乳腺癌风险相似(比值比:0.95,95%置信区间:0.44~2.04,P=0.89)
结直肠癌风险低34%(比值比:0.66,95%置信区间:0.48~0.90,P=0.01)
结肠癌风险低36%(比值比:0.64,95%置信区间:0.44~0.94,P=0.02)
直肠癌风险相似(比值比:0.7,95%置信区间:0.43~1.14,P=0.15)
因此,该研究结果表明,体力活动水平较高与乳腺癌和结直肠癌风险较低之间存在因果关系。根据这些数据,促进体力活动可能是初步预防这些癌症的有效策略。
Nat Commun. 2020 Jan 31;11(1):597.
Physical activity and risks of breast and colorectal cancer: a Mendelian randomisation analysis.
Papadimitriou N, Dimou N, Tsilidis KK, Banbury B, Martin RM, Lewis SJ, Kazmi N, Robinson TM, Albanes D, Aleksandrova K, Berndt SI, Timothy Bishop D, Brenner H, Buchanan DD, Bueno-de-Mesquita B, Campbell PT, Castellví-Bel S, Chan AT, Chang-Claude J, Ellingjord-Dale M, Figueiredo JC, Gallinger SJ, Giles GG, Giovannucci E, Gruber SB, Gsur A, Hampe J, Hampel H, Harlid S, Harrison TA, Hoffmeister M, Hopper JL, Hsu L, María Huerta J, Huyghe JR, Jenkins MA, Keku TO, Kühn T, La Vecchia C, Le Marchand L, Li CI, Li L, Lindblom A, Lindor NM, Lynch B, Markowitz SD, Masala G, May AM, Milne R, Monninkhof E, Moreno L, Moreno V, Newcomb PA, Offit K, Perduca V, Pharoah PDP, Platz EA, Potter JD, Rennert G, Riboli E, Sánchez MJ, Schmit SL, Schoen RE, Severi G, Sieri S, Slattery ML, Song M, Tangen CM, Thibodeau SN, Travis RC, Trichopoulou A, Ulrich CM, van Duijnhoven FJB, Van Guelpen B, Vodicka P, White E, Wolk A, Woods MO, Wu AH, Peters U, Gunter MJ, Murphy N.
International Agency for Research on Cancer, Lyon, France; University of Ioannina School of Medicine, Ioannina, Greece; Imperial College London, London, UK; Fred Hutchinson Cancer Research Center, Seattle, WA, USA; University of Bristol, Bristol, UK; National Cancer Institute, National Institutes of Health, Bethesda, MA, USA; German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; University of Leeds, Leeds, UK; German Cancer Research Center, Heidelberg, Germany; German Cancer Research Center, National Center for Tumor Diseases, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany; The University of Melbourne, Melbourne, VIC, Australia; The University of Melbourne, Parkville, VIC, Australia; The Royal Melbourne Hospital, Parkville, VIC, Australia; National Institute for Public Health and the Environment, Bilthoven, Netherlands; University Medical Centre, Utrecht, Netherlands; Imperial College London, London, UK; University of Malaya, Kuala Lumpur, Malaysia; American Cancer Society, Atlanta, GA, USA; University of Barcelona, Barcelona, Spain; Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; University Medical Centre Hamburg-Eppendorf, University Cancer Centre Hamburg (UCCH), Hamburg, Germany; Cedars-Sinai Medical Center, Los Angeles, CA, USA; University of Southern California, Los Angeles, CA, USA; Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada; Cancer Council Victoria, Melbourne, VIC, Australia; Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Medical University Vienna, Vienna, Austria; Technische Universitat Dresden (TU Dresden), Dresden, Germany; The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA; Umea University, Umea, Sweden; Seoul National University, Seoul, South Korea; University of Washington, Seattle, WA, USA; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; University of North Carolina, Chapel Hill, NC, USA; Hellenic Health Foundation, Athens, Greece; Università degli Studi di Milano, Milano, Italy; University of Hawaii Cancer Center, Honolulu, HI, USA; University of Virginia, Charlottesville, VA, USA; Karolinska University Hospital, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden; Mayo Clinic, Scottsdale, AZ, USA; Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Case Western Reserve University, and University Hospitals of Cleveland, Cleveland, OH, USA; Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy; Utrecht University, Utrecht, Netherlands; Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA; Univ. Paris-Sud, Fac. de médecine - UVSQ I, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France; Université Paris Descartes, Paris, France; University of Cambridge, Cambridge, UK; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Lady Davis Carmel Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel; Clalit National Cancer Control Center, Haifa, Israel; University of Granada, Granada, Spain; H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA; University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; University of Utah, Salt Lake City, UT, USA; Mayo Clinic, Rochester, MN, USA; University of Oxford, Oxford, UK; Wageningen University and Research, Wageningen, Netherlands; Czech Academy of Sciences, Prague, Czech Republic; Charles University, Pilsen, Czech Republic; Charles University, Prague, Czech Republic; Memorial University of Newfoundland, St. John's, Canada.
Physical activity has been associated with lower risks of breast and colorectal cancer in epidemiological studies; however, it is unknown if these associations are causal or confounded. In two-sample Mendelian randomisation analyses, using summary genetic data from the UK Biobank and GWA consortia, we found that a one standard deviation increment in average acceleration was associated with lower risks of breast cancer (odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.27 to 0.98, P-value=0.04) and colorectal cancer (OR: 0.66, 95% CI: 0.48 to 0.90, P-value=0.01). We found similar magnitude inverse associations for estrogen positive (ER+ve) breast cancer and for colon cancer. Our results support a potentially causal relationship between higher physical activity levels and lower risks of breast cancer and colorectal cancer. Based on these data, the promotion of physical activity is probably an effective strategy in the primary prevention of these commonly diagnosed cancers.
PMID: 32001714
DOI: 10.1038/s41467-020-14389-8
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