Effect of physical activity and body size on survival after diagnosis with colorectal cancer
Effect of physical activity and body size on survival after diagnosis with colorectal cancer
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DOI：
10.1136/gut.2005.068189
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发表时间：
2006-01-01
期刊：
影响因子：
24.5
通讯作者：
Giles, GG
中科院分区：
文献类型：
--
作者：
Haydon, AMM;MacInnis, RJ;Giles, GG
背景：缺乏体力活动和肥胖会增加患结直肠癌的风险，但对它们是否会影响确诊后的预后知之甚少。方法：在墨尔本协作队列研究的参与者中确定了结直肠癌的发病病例，这是一项前瞻性队列研究，从1990年到1994年招募了41528名澳大利亚人。在招募至2002年8月1日期间被诊断为首次结直肠癌的参与者符合条件。在研究进入时，测量了身体尺寸，并采访了参与者的体力活动。通过系统回顾病历，获得肿瘤的部位和分期、给予的治疗、复发和死亡的信息。结果：共发现526例结直肠癌患者。幸存者的中位随访期为5.5年，有208人死亡，其中181人死于结直肠癌。在调整了年龄、性别和肿瘤分期后，运动者的疾病特异性存活率有所提高(风险比0.73(95%可信区间0.54-1.00))。锻炼的益处主要限于II-III期肿瘤(风险比0.49(95%可信区间0.30-0.79))。增加体脂百分比导致特定疾病死亡的增加(危险比为每10公斤1.33(95%可信区间1.04-1.71))。同样，增加腰围会降低特定疾病的存活率(风险比为1.20/10厘米(95%可信区间为1.05-1.37))。结论：在诊断为结直肠癌之前，中心性肥胖增加和缺乏规律的体力活动与较差的总体和疾病特定存活率相关。
Background: Physical inactivity and obesity increase the risk of colorectal cancer but little is known about whether they influence prognosis after diagnosis.Methods: Incident cases of colorectal cancer were identified among participants of the Melbourne Collaborative Cohort Study, a prospective cohort study of 41 528 Australians recruited from 1990 to 1994. Participants diagnosed with their first colorectal cancer between recruitment and 1 August 2002 were eligible. At the time of study entry, body measurements were taken and participants were interviewed about their physical activity. Information on tumour site and stage, treatments given, recurrences, and deaths were obtained from systematic review of the medical records.Results: A total of 526 cases of colorectal cancer were identified. Median follow up among survivors was 5.5 years, and 208 deaths had occurred, including 181 from colorectal cancer. After adjusting for age, sex, and tumour stage, exercisers had an improved disease specific survival ( hazard ratio 0.73 ( 95% confidence interval (CI) 0.54 - 1.00)). The benefit of exercise was largely confined to stage II - III tumours ( hazard ratio 0.49 ( 95% CI 0.30 - 0.79)). Increasing per cent body fat resulted in an increase in disease specific deaths ( hazard ratio 1.33 per 10 kg ( 95% CI 1.04 - 1.71)). Similarly, increasing waist circumference reduced disease specific survival ( hazard ratio 1.20 per 10 cm ( 95% CI 1.05 - 1.37)).Conclusions: Increased central adiposity and a lack of regular physical activity prior to the diagnosis of colorectal cancer is associated with poorer overall and disease specific survival.