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Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study

Baumeister, Sebastian E.; Sonestedt, Emily LU ; Ohlsson, Bodil LU ; Leitzmann, Michael F. and , (2018) In Journal of Hepatology
Abstract
Background & Aims: Evidence on the association between physical activity and risk of hepatobiliary cancers is 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... (More)
Background & Aims: Evidence on the association between physical activity and risk of hepatobiliary cancers is 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. © 2019 European Association for the Study of the Liver (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Hepatobiliary cancer, Hepatocellular carcinoma, Liver cancer, Physical activity
in
Journal of Hepatology
publisher
Elsevier
external identifiers
  • scopus:85060909545
ISSN
0168-8278
DOI
10.1016/j.jhep.2018.12.014
language
English
LU publication?
yes
id
3cdc1f4c-aa54-4b58-8652-d5a9ddc5132b
date added to LUP
2019-02-13 11:57:05
date last changed
2019-03-05 04:32:47
@article{3cdc1f4c-aa54-4b58-8652-d5a9ddc5132b,
  abstract     = {Background & Aims: Evidence on the association between physical activity and risk of hepatobiliary cancers is 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. © 2019 European Association for the Study of the Liver},
  author       = {Baumeister, Sebastian E. and Sonestedt, Emily and Ohlsson, Bodil and Leitzmann, Michael F. and , },
  issn         = {0168-8278},
  keyword      = {Hepatobiliary cancer,Hepatocellular carcinoma,Liver cancer,Physical activity},
  language     = {eng},
  month        = {12},
  publisher    = {Elsevier},
  series       = {Journal of Hepatology},
  title        = {Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study},
  url          = {http://dx.doi.org/10.1016/j.jhep.2018.12.014},
  year         = {2018},
}