Association of physical activity and risk of hepatobiliary cancers: a multinational cohort study
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
BACKGROUND & AIMS: Evidence on the association between physical activity and risk of hepatobiliary cancers is inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). METHODS: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBC), and 164 non-gallbladder extrahepatic bile duct cancers (NGBC) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity, performed mediation analysis, and secondary analyses to assess robustness to confounding (e.g., due to hepatitis virus infection). RESULTS: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% confidence intervals (CI) 0.38-0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (0.33-0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC. CONCLUSIONS: Findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. LAY SUMMARY: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.
Date Issued
2019-05-01
Date Acceptance
2018-12-06
Citation
Journal of Hepatology, 2019, 70 (5), pp.885-892
ISSN
0168-8278
Publisher
Elsevier
Start Page
885
End Page
892
Journal / Book Title
Journal of Hepatology
Volume
70
Issue
5
Copyright Statement
© 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.
Sponsor
Imperial College Trust
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30582978
PII: S0168-8278(18)32633-3
Grant Number
P47328
Subjects
Hepatobiliary cancer
Hepatocellular carcinoma
Liver cancer
Physical activity
Publication Status
Published
Coverage Spatial
Netherlands
Date Publish Online
2018-12-22