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Cardiorespiratory fitness levels predict risk for cancer diagnosis, mortality
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Middle-aged men with a high cardiorespiratory fitness level displayed decreased risks for lung and colon cancers, as well as a decreased risk for cancer-related death if diagnosed later in life, according to results of a prospective, observational analysis.
However, high fitness levels were not associated with a decreased risk for prostate cancer, the study researchers also found.
The link between cardiorespiratory fitness and cardiovascular disease is well established, according to study background. However, cardiorespiratory fitness as a predictor for primary cancer diagnosis and mortality has not been adequately evaluated, the researchers wrote.
Susan G. Lakoski
Susan G. Lakoski, MD, MS, of the department of internal medicine at the Vermont Cancer Center, and colleagues evaluated data from 13,949 men (mean age, 49 years) who completed a medical examination, cardiovascular risk factor assessment and incremental treadmill test to evaluate their cardiorespiratory fitness between 1971 and 2009. Researchers used these data to define the men as having low (n = 2,603), moderate (n = 5,843) or high mid-life cardiorespiratory fitness (n = 5,503).
The researchers then tracked cancer incidence and mortality in the men for an average of 6.5 years using Medicare Parts A and B claims data from 1999 to 2009.
Overall, 1,310 of the men were diagnosed with prostate cancer, 200 were diagnosed with lung cancer and 181 were diagnosed with colorectal cancer.
The risk for lung cancer was significantly lower in men with moderate (HR = 0.57; 95% CI, 0.41-0.81) and high cardiorespiratory fitness (HR = 0.45; 95% CI, 0.29-0.68) compared with men with low cardiorespiratory fitness. The risk for colorectal cancer also was lower for men with moderate (HR = 0.67; 95% CI, 0.46-0.98) and high cardiorespiratory fitness (HR = 0.56; 95% CI, 0.36-0.87).
However, high cardiorespiratory fitness was a risk factor for prostate cancer even after adjusting for confounding variables. Compared with men with low cardiorespiratory fitness, adjusted HRs for prostate cancer were 1.04 (95% CI, 0.88-1.23) for men with moderate cardiorespiratory fitness and 1.22 (95% CI, 1.02-1.46) for men with high cardiorespiratory fitness. The researchers noted this association may be related to the health behaviors of men with high or moderate cardiorespiratory fitness, who may be screened for disease more frequently than those with low cardiorespiratory fitness.
High mid-life cardiorespiratory fitness also was associated with a significantly decreased risk for cancer mortality (HR = 0.68; 95% CI, 0.47-0.98) and cardiovascular disease mortality (HR = 0.32; 95% CI, 0.16-0.64) among men who were diagnosed with cancer at Medicare age.
Because cardiorespiratory fitness was determined years before the onset of lung, colon or prostate cancers, the researchers noted they could not determine whether changes in fitness routines had an effect on disease incidence or long-term mortality.
“To our knowledge, this is the first study to demonstrate that cardiorespiratory fitness is predictive of site-specific cancer incidence, as well as the risk of death from cancer following a diagnosis,” Lakoski and colleagues concluded. “These findings provide further support for the effectiveness of cardiorespiratory fitness assessment in preventive health care settings. Future studies are required to determine the absolute level of cardiorespiratory fitness necessary to prevent site-specific cancer as well as evaluating the long-term effect of cancer diagnosis and mortality in women.” – by Cameron Kelsall
Disclosure: Lakoski reports no relevant financial disclosures. One researcher is the co-founder of Exercise by Science Inc.
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