TY - JOUR
T1 - Association between physical activity and risk of hepatobiliary cancers
T2 - A multinational cohort study
AU - Baumeister, Sebastian E
AU - Schlesinger, Sabrina
AU - Aleksandrova, Krasimira
AU - Jochem, Carmen
AU - Jenab, Mazda
AU - Gunter, Marc J
AU - Overvad, Kim
AU - Tjønneland, Anne
AU - Boutron-Ruault, Marie-Christine
AU - Carbonnel, Franck
AU - Fournier, Agnès
AU - Kühn, Tilman
AU - Kaaks, Rudolf
AU - Pischon, Tobias
AU - Boeing, Heiner
AU - Trichopoulou, Antonia
AU - Bamia, Christina
AU - La Vecchia, Carlo
AU - Masala, Giovanna
AU - Panico, Salvatore
AU - Fasanelli, Francesca
AU - Tumino, Rosario
AU - Grioni, Sara
AU - Bueno de Mesquita, Bas
AU - Vermeulen, Roel
AU - May, Anne M
AU - Borch, Kristin B
AU - Oyeyemi, Sunday O
AU - Ardanaz, Eva
AU - Rodríguez-Barranco, Miguel
AU - Dolores Chirlaque López, María
AU - Felez-Nobrega, Mireia
AU - Sonestedt, Emily
AU - Ohlsson, Bodil
AU - Hemmingsson, Oskar
AU - Werner, Mårten
AU - Perez-Cornago, Aurora
AU - Ferrari, Pietro
AU - Stepien, Magdalena
AU - Freisling, Heinz
AU - Tsilidis, Konstantinos K
AU - Ward, Heather
AU - Riboli, Elio
AU - Weiderpass, Elisabete
AU - Leitzmann, Michael F
N1 - Funding Information:
This work was in part supported by the French National Cancer Institute (L’Institut National du Cancer; INCA – grant number 2009-139; principal investigator: MJ). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by the Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS) PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford); Medical Research Council (1000143 to EPIC-Norfolk and MR/M012190/1 to EPIC-Oxford; United Kingdom); Medical Research Council (1000143 to EPIC-Norfolk; United Kingdom).
Publisher Copyright:
© 2019 European Association for the Study of the Liver
PY - 2019/5
Y1 - 2019/5
N2 - Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (e.g. due to hepatitis virus infection). Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95% CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC. Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.
AB - Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (e.g. due to hepatitis virus infection). Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95% CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC. Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.
KW - Hepatobiliary cancer
KW - Hepatocellular carcinoma
KW - Liver cancer
KW - Physical activity
UR - http://www.scopus.com/inward/record.url?scp=85060909545&partnerID=8YFLogxK
U2 - 10.1016/j.jhep.2018.12.014
DO - 10.1016/j.jhep.2018.12.014
M3 - Article
C2 - 30582978
SN - 0168-8278
VL - 70
SP - 885
EP - 892
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 5
ER -