A prospective study of physical activity and incident and fatal prostate cancer
A prospective study of physical activity and incident and fatal prostate cancer
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DOI：
10.1001/archinte.165.9.1005
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发表时间：
2005-05-09
影响因子：
--
通讯作者：
Willett, WC
中科院分区：
文献类型：
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作者：
Giovannucci, EL;Liu, Y;Willett, WC
背景：体力活动是否有助于预防前列腺癌的发生或进展尚不清楚。因此，我们评估了体力活动与前列腺癌发病率、死亡率和Gleason组织学分级的关系。方法：我们使用前瞻性队列研究Health Offessionals后续研究的数据，确定了从1986年2月1日到2000年1月31日期间，47620名美国男性卫生专业人员中发生、晚期(精囊侵袭、转移或死亡)、死亡和高级别前列腺癌的病例数量。结果：在14年的随访中，我们记录了2892例新的前列腺癌病例，其中482例晚期病例(其中280例死亡)。对于总的前列腺癌，没有观察到总的、剧烈的和非剧烈的体力活动之间的联系。在65岁或65岁以上的男性中，我们观察到晚期(多变量相对风险0.33；95%可信区间0.17-0.62，超过29个代谢当量小时)和致命性前列腺癌(相对风险0.26；95%可信区间0.110.66)剧烈活动最高类别的风险较低。在年轻男性中没有观察到这种联系。通过前列腺特异性抗原的差别筛查或因未诊断的前列腺癌而导致的体力活动减少似乎不能解释这一结果。在病例中，高水平体力活动的男性被诊断为低分化癌症的可能性较小(Gleason 7级)。结论：尽管机制尚不清楚，但这些发现表明，定期剧烈运动可以减缓前列腺癌的进展，并可能被推荐用于降低前列腺癌的死亡率，特别是考虑到运动还有许多其他有据可查的好处。
Background: Whether physical activity has benefits against prostate cancer incidence or progression is unclear. Therefore, we assessed physical activity in relation to prostate cancer incidence, mortality, and Gleason histologic grade.Methods: We used data from the Health Professionals Follow-up Study, a prospective cohort study, to determine the number of cases of incident, advanced (seminal vesicle invasion, metastasis, or fatal), fatal, and high-grade prostate cancer in a cohort of 47 620 US male health professionals, followed up from February 1, 1986, to January 31, 2000.Results: During 14 years of follow-up, we documented 2892 new cases of prostate cancer, including 482 advanced cases (280 of which were fatal). For total prostate cancer, no association was observed for total, vigorous, and nonvigorous physical activity. In men 65 years or older, we observed a lower risk in the highest category of vigorous activity for advanced (multivariable relativ risk, 0.33; 95% confidence interval, 0.17-0.62, for more than 29 vs 0 metabolic equivalent hours) and for fatal (relative risk, 0.26; 95% confidence interval, 0.110.66) prostate cancer. No associations were observed in younger men. Differential screening by prostate-specific antigen or a reduction in physical activity due to undiagnosed prostate cancer did not appear to account for the results. Among cases, men with high levels of physical activity were less likely to be diagnosed with poorly differentiated cancers (Gleason grade 7).Conclusion: Although the mechanisms are not yet understood, these findings suggest that regular vigorous activity could slow the progression of prostate cancer and might be recommended to reduce mortality from prostate cancer, particularly given the many other documented benefits of exercise.