Physical Activity, Sedentary Behavior, and Cancer Incidence in Women

摘要 2016年，美国估计将有60万人死于癌症，新增170万例癌症病例。 癌症就会被诊断出来。考虑到寿命，近40%的女性和男性将被诊断为 在他们一生中的某个时候患上癌症。了解导致这种大规模公众的可服从的风险因素 健康负担至关重要。观察性研究一致地表明，自我报告的 体力活动会增加患多种癌症的风险，尤其是乳腺癌。然而，还有 关于需要减少的体力活动的数量、强度、持续时间和类型的证据不足 癌症风险，特别是对老年女性。久坐行为可以提供更可行的干预目标， 尤其是对老年人来说。然而，关于久坐行为和癌症风险的了解就更少了。到目前为止， 没有前瞻性研究检验加速度计衍生的体力活动和久坐行为对风险的影响 意外癌症结果。我们的团队在新的测量方法方面取得了进展，但 没有应用于健康结果来评估其价值。在本应用程序中，我们建议将 加速计量学-评估体力活动和久坐行为以及癌症事件和死亡 两项妇女队列研究：妇女健康研究(WHS)和妇女健康倡议(WHI) 学习。我们将应用复杂但直接可解释的方法来确定哪些体力活动和 在超过22,000名女性中，久坐行为特征对于降低癌症风险是最重要的63 到101岁。对于这两个队列，以类似的方式收集了一周的加速度计数据 2011-2014年间。对已判定的癌症结果的两个队列的随访计划持续到2020年和 很可能会更远。我们提出了三个目标。目标1将应用新的和平移的加速度计措施- 使用潜在类别分析、活动指数和机器评估身体活动和久坐行为 用于目标2和目标3的原始加速度计数据的学习算法。然后我们将调查这种关联 从加速度计评估的体力活动(目标2)和久坐行为(目标3)到整体和特定地点 (例如，乳腺癌、子宫癌、卵巢癌)和致命性癌症。这项具有成本效益的研究将详细调查 是否以及如何表现出频率、持续时间、强度、活动次数以及体力活动和久坐的类型 行为可以预测癌症的结果。确定新的防癌模式的体力活动和 久坐行为将为身体活动和久坐行为提供急需的证据 疾病预防指南，可用于降低风险的干预措施，并可能使 监测人体在体力活动和久坐行为干预中的反应。

Abstract In the United States in 2016, an estimated 600,000 people will die from cancer and 1.7 million new cases of cancer will be diagnosed. Considering the life span, almost 40% of women and men will be diagnosed with cancer at some point in their lifetime. Understanding amenable risk factors that contribute to this large public health burden is essential. Observational studies consistently indicate associations between self-reported physical activity and increased risk of many types of cancer, especially breast cancer. However, there is insufficient evidence regarding the amount, intensity, duration, and types of physical activity required to reduce cancer risk, especially for older women. Sedentary behavior may provide a more feasible intervention target, especially for older adults. However, even less is known about sedentary behavior and cancer risk. To date, no prospective studies have examined accelerometry-derived physical activity and sedentary behavior to risk of incident cancer outcomes. Advances have been made in new measurement methods by our team, but have not been applied to health outcomes to assess their value. In this application, we propose to assemble accelerometry-assessed physical activity and sedentary behavior and cancer incident events and deaths from two cohort studies of women: the Women's Health Study (WHS) and the Women's Health Initiative (WHI) Study. We will apply sophisticated, yet directly interpretable, methods to determine which physical activity and sedentary behavior features are most important for reducing cancer risk among more than 22,000 women 63 to 101 years of age. For both cohorts, one-week of accelerometry data were collected in a similar manner during 2011-2014. Follow-up of both cohorts for adjudicated cancer outcomes is planned through 2020 and likely beyond. We propose three aims. Aim 1 will apply novel and translational measures of accelerometry- assessed physical activity and sedentary behavior using latent class analysis, an activity index, and machine learning algorithms of raw accelerometry data for use in Aims 2 and 3. We will then investigate the association of accelerometry-assessed physical activity (Aim 2) and sedentary behavior (Aim 3) to overall and site-specific (e.g., breast, uterine, ovarian) incident and fatal cancer. This cost-efficient study will investigate in detail whether and how patterns of frequency, duration, intensity, bouts, and type of physical activity and sedentary behavior predict cancer outcomes. Identification of new cancer-protective patterns of physical activity and sedentary behavior will provide much-needed evidence to inform physical activity and sedentary behavior guidelines for disease prevention, can be used in interventions to reduce risk, and could revolutionize the monitoring of human responses in physical activity and sedentary behavior interventions.