Physical Activity, Sedentary Behavior, and Cancer Incidence in Women

摘要 在美国，2016年估计将有60万人死于癌症，170万新病例 癌症将被诊断出来。考虑到寿命，几乎40%的女性和男性将被诊断为 癌症在他们一生中的某个时候。了解导致这一大型公众 健康负担至关重要。观察性研究一致表明，自我报告的 身体活动和多种癌症的风险增加，特别是乳腺癌。不过有 关于减少所需体力活动的数量、强度、持续时间和类型的证据不足 癌症风险，尤其是老年女性。久坐行为可能提供更可行的干预目标， 尤其是对老年人来说。然而，人们对久坐行为和癌症风险的了解更少。到目前为止， 没有前瞻性研究检查了加速度计衍生的身体活动和久坐行为的风险 偶然的癌症结果。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。在本申请中，我们建议组装 加速度计评估的身体活动和久坐行为与癌症事件和死亡 两项妇女队列研究：妇女健康研究（WHS）和妇女健康倡议（WHI） Study.我们将应用复杂的，但直接解释，方法来确定哪些身体活动， 久坐行为特征对降低超过22，000名女性的癌症风险最为重要 活到101岁。对于两个队列，以类似的方式收集一周的加速度数据 在2011-2014年期间。计划到2020年对两个队列的裁定癌症结局进行随访， 可能超越。我们提出三个目标。目标1将应用新型和平移的加速度测量方法- 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3的原始加速度测量数据的学习算法。我们会调查 加速度计评估的身体活动（目标2）和久坐行为（目标3），以整体和特定地点 (e.g.,乳腺癌、子宫癌、卵巢癌）偶发性和致命性癌症。这项成本效益研究将详细调查 是否以及如何模式的频率，持续时间，强度，发作，和类型的身体活动和久坐 行为预测癌症结果。确定新的癌症保护模式的体力活动和 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，可用于干预措施，以减少风险，并可能彻底改变 监测人体对体力活动和久坐行为干预的反应。

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.