Physical Activity Domains And Risk Of Gastric Adenocarcinoma In The MCC-Spain Study
José HUERTA, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Spain
NAVARRO C. 1,2,18
, CHIRLAQUE M. 1,2,18
, MOLINA A. 3,18
, AMIANO P. 4,18
, FERNÁNDEZ-TARDÓN G. 5,18
, DIERSSEN-SOTOS T. 6,7,18
, OLMEDO-REQUENA R. 8,18
, CAPELO-ÁLVAREZ R. 9,18
, GUEVARA M. 10,18
, PEIRÓ R. 11,18
, KOGEVINAS M. 12,13,14,15,18
, POLLÁN M. 16,17,18
, CASTAÑO-VINYALS G. 12,13,14,18
, ARAGONÉS N. 16,17,18
1 Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
2 Department of Health and Social Sciences, Universidad de Murcia, Spain
3 Universidad de León, León, Spain
4 Subdirección de Salud Pública de Gipuzkoa, Donostia, Spain
5 Universidad de Oviedo, Oviedo, Asturias, Spain
6 University of Cantabria, Santander, Spain
7 Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV), Santander, Spain
8 Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
9 Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain
10 Instituto de Salud Pública de Navarra, Pamplona, Navarra
11 Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO–Salud Pública, Valencia, Spain
12 Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
13 IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
14 Universitat Pompeu Fabra (UPF), Barcelona, Spain
15 National School of Public Health, Athens, Greece
16 Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
17 Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro, Madrid, Spain
18 CIBER Epidemiología y Salud Pública (CIBERESP), Spain
Purpose: Evidence for a protective role of physical activity against development of stomach cancer is yet inconclusive. We studied the association of domain-specific physical activity and the risk of gastric adenocarcinoma (GAC), by site and histological type, in the MCC-Spain case-control study.
Methods: 428 histologically confirmed GAC cases including gastro-esophageal region (67% men) and 3225 controls were included. Cases were recruited in hospitals from 9 different Spanish regions, and age- and sex-matched population controls were randomly selected within the respective hospitals' catchment areas. A physical activity questionnaire was used to gather information on the type, frequency and duration of household and recreational activities, allowing estimation of physical activity volume (in MET-h/week). Participants also self-reported the intensity of working physical activity (from sedentary to very active) and their daily sitting time. Questionnaire data on diet, lifestyle and clinical factors (including Helicobacter pylori serology) were available. Adjusted odds ratios (OR) of GAC were estimated for domains of physical activity, stratifying by sex, site (cardia vs. non-cardia), and Lauren classification (intestinal vs. diffuse).
Results: Recreational physical activity was associated with lower overall GAC risk (OR=0.65, 95% CI: 0.50, 0.85 –highest recreational activity vs. none), particularly at moderate levels of intensity such as walking (OR=0.60, 95% CI: 0.45, 0.78). Household physical activity showed the strongest association among men (OR=0.41, 95% CI: 0.29, 0.60 –highest vs. none). Associations were stronger for non-cardia tumours, whereas no significant results were found in women. Sedentary time was not related to GAC risk (p-trend=0.438), but the potential protective effects of recreational physical activity were restricted to non-sedentary participants.
Conclusions: Both recreational and household physical activity were independently related to lower GAC risk. Gastric cancer prevention strategies should concomitantly promote adherence to recommended physical activity levels and avoidance of sedentary behaviours.
Funding source: Institute of Health Carlos III (PI11/01403).