Association of physical activity and risk of hepatobiliary cancers: a multinational cohort study

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Title: Association of physical activity and risk of hepatobiliary cancers: a multinational cohort study
Authors: Baumeister, SE
Schlesinger, S
Aleksandrova, K
Jochem, C
Jenab, M
Gunter, MJ
Overvad, K
Tjønneland, A
Boutron-Ruault, M-C
Carbonnel, F
Fournier, A
Kühn, T
Kaaks, R
Pischon, T
Boeing, H
Trichopoulou, A
Bamia, C
La Vecchia, C
Masala, G
Panico, S
Fasanelli, F
Tumino, R
Grioni, S
De Mesquita, BB
Vermeulen, R
May, AM
Borch, KB
Oyeyemi, SO
Ardanaz, E
Rodríguez-Barranco, M
López, MDC
Felez-Nobrega, M
Sonestedt, E
Ohlsson, B
Hemmingsson, O
Werner, M
Perez-Cornago, A
Ferrari, P
Stepien, M
Freisling, H
Tsilidis, KK
Ward, H
Riboli, E
Weiderpass, E
Leitzmann, MF
Item 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.
Issue Date: 1-May-2019
Date of Acceptance: 6-Dec-2018
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
Sponsor/Funder: Imperial College Trust
Funder's Grant Number: P47328
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Hepatobiliary cancer
Hepatocellular carcinoma
Liver cancer
Physical activity
Hepatobiliary cancer
Hepatocellular carcinoma
Liver cancer
Physical activity
Hepatobiliary cancer
Hepatocellular carcinoma
Liver cancer
Physical activity
Gastroenterology & Hepatology
1103 Clinical Sciences
Publication Status: Published
Conference Place: Netherlands
Embargo Date: 2019-12-22
Online Publication Date: 2018-12-22
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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