18 maart 2024: Bron: Department of Physical Activity and Health, Swedish School of Sport and Health Sciences GIH
Mannen met een gemeten cardiorespiratoire fitheid (CRF) en die hun CRF met meer dan 3% verhoogden door meer te sporten en te bewegen, hadden een significant lager risico op het ontstaan van prostaatkanker, zo bleek uit een groot Zweeds onderzoek.
De prospectieve analyse, gepubliceerd in het British Journal of Sports Medicine, uitgevoerd in een studiegroep van bijna 58.000 mensen, werd uitgevoerd door Kate A. Bolam, PhD, en collega's, een klinische inspanningsfysioloog aan de Zweedse School voor Sport en Gezondheidswetenschappen in Stockholm.
De gegevens waren afkomstig uit de cijfers van de Zweedse nationale gezondheidsprofieldatabase van 1982 tot 2019. De deelnemers voltooiden een beoordeling van het gezondheidsprofiel op het werk, inclusief ten minste twee geldige CRF-tests op een fietsergometer.
Tijdens een gemiddelde follow-up van 6,7 jaar werd bij 592 (1%) van de 57.652 mannen (gemiddelde leeftijd 41,3 jaar; standaarddeviatie 10,55) de diagnose prostaatkanker gesteld, en bij 46 (0,08%) was prostaatkanker de primaire oorzaak van de dood direct gerelateerd aan prostaatkanker.
Een toename van het absolute cardiorespiratoire fitheid (CRF) (als percentage van liters per minuut hartminuutvolume) ging gepaard met een verlaagd incidentierisico, met een risicoratio van 0,98 (95% BI, 0,96-0,99).
Door deelnemers te groeperen met verhoogde (+3%), stabiele (±3%) of verlaagde (-3%) cardiorespiratoire fitheid (CRF), ontdekten de onderzoekers dat een verhoogde fitheid geassocieerd was met een HR voor de incidentie van prostaatkanker van 0,65 (95% BI, 0,49- 0,86) versus verminderde conditie.
Gegroepeerd op baseline-CRF was de associatie tussen verandering in absolute CRF en de incidentie van prostaatkanker alleen significant voor deelnemers met een matige baseline-CRF. Bovendien waren veranderingen in zowel absolute als relatieve CRF niet geassocieerd met sterfte aan prostaatkanker.
"Het gebrek aan betekenis voor sterfte kan te wijten zijn aan de relatief weinige sterfgevallen als gevolg van prostaatkanker in de studiegroep, zei dr. Bolam. "Het kan zijn dat we niet in staat waren om iets met zulke lage aantallen te detecteren. En het is niet waarschijnlijk dat mannen zullen sterven aan prostaatkanker, maar waarschijnlijker aan meer voorkomende chronische ziekten, zoals hartziekten."
"De bevindingen suggereren wel dat artsen zouden kunnen werken aan het ondersteunen van patiënten om te begrijpen welke soorten activiteiten hun conditie kunnen verbeteren en hoe ze deze activiteiten op een plezierige manier in hun leven kunnen integreren, of op zijn minst patiënten kunnen doorverwijzen naar een bewegingsspecialist," aldus Dr. Bolam.
Het volledige studierapport is gratis in te zien of te downloaden. Hier het abstract van deze studie:
Abstract
Objectives To examine the associations between changes in cardiorespiratory fitness (CRF) in adulthood and prostate cancer incidence and mortality.
Methods In this prospective study, men who completed an occupational health profile assessment including at least two valid submaximal CRF tests, performed on a cycle ergometer, were included in the study. Data on prostate cancer incidence and mortality were derived from national registers. HRs and CIs were calculated using Cox proportional hazard regression with inverse probability treatment weights of time-varying covariates.
Results During a mean follow-up time of 6.7 years (SD 4.9), 592 (1%) of the 57 652 men were diagnosed with prostate cancer, and 46 (0.08%) died with prostate cancer as the primary cause of death. An increase in absolute CRF (as % of L/min) was associated with a reduced risk of prostate cancer incidence (HR 0.98, 95% CI 0.96 to 0.99) but not mortality, in the fully adjusted model. When participants were grouped as having increased (+3%), stable (±3%) or decreased (−3%) CRF, those with increased fitness also had a reduced risk of prostate cancer incidence compared with those with decreased fitness (HR 0.65, 95% CI 0.49 to 0.86), in the fully adjusted model.
Conclusion In this study of employed Swedish men, change in CRF was inversely associated with risk of prostate cancer incidence, but not mortality. Change in CRF appears to be important for reducing the risk of prostate cancer.
WHAT IS ALREADY KNOWN ON THIS TOPIC
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Cardiorespiratory fitness (CRF) is associated with the risk of being diagnosed with, or dying from, certain cancer types.
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The associations between CRF measured at one time point and risk of prostate cancer incidence are contradictory, which may be the result of the influence of higher prostate cancer screening rates in men with higher fitness.
WHAT THIS STUDY ADDS
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Our results suggest that increases in CRF are inversely associated with risk of prostate cancer incidence, but not mortality.
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The results highlight the importance of CRF for prostate cancer risk, which has been challenging to determine with single timepoint studies.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
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Improvements in CRF in adult men should be encouraged and may reduce the risk of prostate cancer.
Data availability statement
Data may be obtained from a third party and are not publicly available. The data underlying the findings in this study are currently not publicly available as the original ethical approval application and the informed consent form did not include such direct, free access to the data. Data are stored by and can be requested from the HPI Health Profile Institute at support@hpi.se.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Data availability statement
Data may be obtained from a third party and are not publicly available. The data underlying the findings in this study are currently not publicly available as the original ethical approval application and the informed consent form did not include such direct, free access to the data. Data are stored by and can be requested from the HPI Health Profile Institute at support@hpi.se.
Ethics statements
Patient consent for publication
Ethics approval
The study was approved by the Stockholm Ethics Review Board (Dnr 2015/1864-31/2, 2016/9-32 and 2019-05711), and adhered to the Declaration of Helsinki.
References
Supplementary materials
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Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
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KAB and EB-M are joint first authors.
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Twitter @katebolam
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Contributors All authors have contributed with the conception and design of the work. KAB and EB-M contributed equally to this paper and share joint first authorship. SP contributed to the acquisition of the data. EB-M contributed by conducting the analyses and he and KAB interpreted the data. KAB and EB-M drafted the work, while all authors have revised the work and contributed with intellectual content. EE-B and EB-M monitored adherence to the design and statistical analyses. All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses. All authors have approved the final version of the paper to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved. E-EB was responsible for the overall content of the paper as the guarantor.
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Funding This study was funded by the Swedish Cancer Society, ref. 21 1837 Pj.
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Competing interests None declared.
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Patient and public involvement We did not involve patients or the public in the design or while conducting our research. In addition to scientific journal articles, the results of the study will be disseminated to the public through online print media and with the cancer community through the Swedish Cancer Society.
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Provenance and peer review Not commissioned; externally peer reviewed.
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Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.
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