Physical activity and cancer prevention: Etiologic evidence and biological mechanisms
Physical activity and cancer prevention: Etiologic evidence and biological mechanisms
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DOI：
10.1093/jn/132.11.3456s
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发表时间：
2002-11-01
影响因子：
4.2
通讯作者：
Orenstein, MR
中科院分区：
文献类型：
--
作者：
Friedenreich, CM;Orenstein, MR
越来越多的科学证据表明，体育活动是一级预防癌症的一种手段。在一些特定的癌症部位进行了近170项关于体育活动和癌症风险的观察性流行病学研究。增加体力活动降低风险的证据被归类为乳腺癌和结肠癌的可信证据，前列腺癌的可能证据，肺癌和子宫内膜癌的可能证据，其他部位的癌症的证据不足。尽管对体育活动和癌症进行了大量的研究，但由于对体育活动的评估不完整，缺乏对影响改变和混淆的充分检查，大多数研究都受到了阻碍。体育活动与癌症之间存在一些似是而非的生物学机制，包括内源性性激素和代谢激素水平以及生长因子的变化，肥胖和中枢性肥胖的减少以及免疫功能的可能变化。体重控制可能起着特别重要的作用，因为超重与癌症风险增加之间的联系已经在几个部位得到证实，而中枢性肥胖尤其与促进易致癌的代谢状况有关。根据现有证据，一些公共卫生组织发布了预防癌症的体育活动指南，一般建议每周至少进行30分钟的中等至高强度体育活动，每次活动大于或等于5天。虽然大多数研究都集中在体育活动在预防癌症方面的功效，但越来越多的证据表明，运动也会影响癌症经历的其他方面，包括癌症检测、应对、康复和诊断后的生存。
Scientific evidence is accumulating on physical activity as a means for the primary prevention of cancer. Nearly 170 observational epidemiologic studies of physical activity and cancer risk at a number of specific cancer sites have been conducted. The evidence for decreased risk with increased physical activity is classified as convincing for breast and colon cancers, probable for prostate cancer, possible for lung and endometrial cancers and insufficient for cancers at all other sites. Despite the large number of studies conducted on physical activity and cancer, most have been hampered by incomplete assessment of physical activity and a lack of full examination of effect modification and confounding. Several plausible hypothesized biological mechanisms exist for the association between physical activity and cancer, including changes in endogenous sexual and metabolic hormone levels and growth factors, decreased obesity and central adiposity and possibly changes in immune function. Weight control may play a particularly important role because links between excess weight and increased cancer risk have been established for several sites, and central adiposity has been particularly implicated in promoting metabolic conditions amenable to carcinogenesis. Based on existing evidence, some public health organizations have issued physical activity guidelines for cancer prevention, generally recommending at least 30 min of moderate-to-vigorous intensity physical activity on greater than or equal to5 d/wk. Although most research has focused on the efficacy of physical activity in cancer prevention, evidence is increasing that exercise also influences other aspects of the cancer experience, including cancer detection, coping, rehabilitation and survival after diagnosis.