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

Sebastian E Baumeister; Sabrina Schlesinger; Krasimira Aleksandrova; Carmen Jochem; Mazda Jenab; Marc J Gunter; Kim Overvad; Anne Tjønneland; Marie-Christine Boutron-Ruault; Franck Carbonnel; Agnès Fournier; Tilman Kühn; Rudolf Kaaks; Tobias Pischon; Heiner Boeing; Antonia Trichopoulou; Christina Bamia; Carlo La Vecchia; Giovanna Masala; Salvatore Panico; Francesca Fasanelli; Rosario Tumino; Sara Grioni; Bas Bueno de Mesquita; Roel Vermeulen; Anne M May; Kristin B Borch; Sunday O Oyeyemi; Eva Ardanaz; Miguel Rodríguez-Barranco; María Dolores Chirlaque López; Mireia Felez-Nobrega; Emily Sonestedt; Bodil Ohlsson; Oskar Hemmingsson; Mårten Werner; Aurora Perez-Cornago; Pietro Ferrari; Magdalena Stepien; Heinz Freisling; Konstantinos K Tsilidis; Heather Ward; Elio Riboli; Elisabete Weiderpass; Michael F Leitzmann

doi:10.1016/j.jhep.2018.12.014

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

Sebastian E Baumeister, Sabrina Schlesinger, Krasimira Aleksandrova, Carmen Jochem, Mazda Jenab, Marc J Gunter, Kim Overvad, Anne Tjønneland, Marie-Christine Boutron-Ruault, Franck Carbonnel, Agnès Fournier, Tilman Kühn, Rudolf Kaaks, Tobias Pischon, Heiner Boeing, Antonia Trichopoulou, Christina Bamia, Carlo La Vecchia, Giovanna Masala, Salvatore PanicoFrancesca Fasanelli, Rosario Tumino, Sara Grioni, Bas Bueno de Mesquita, Roel Vermeulen, Anne M May, Kristin B Borch, Sunday O Oyeyemi, Eva Ardanaz, Miguel Rodríguez-Barranco, María Dolores Chirlaque López, Mireia Felez-Nobrega, Emily Sonestedt, Bodil Ohlsson, Oskar Hemmingsson, Mårten Werner, Aurora Perez-Cornago, Pietro Ferrari, Magdalena Stepien, Heinz Freisling, Konstantinos K Tsilidis, Heather Ward, Elio Riboli, Elisabete Weiderpass, Michael F Leitzmann

Forskningsoutput: Tidskriftsbidrag › Artikel › Peer review

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BACKGROUND & AIMS: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been 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 (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) 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 and 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% 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 (95% CI 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: These 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.

Originalspråk	Engelska
Sidor (från-till)	885-892
Antal sidor	8
Tidskrift	Journal of Hepatology
Volym	70
Nummer	5
DOI	https://doi.org/10.1016/j.jhep.2018.12.014
Status	Publicerad - 2019-maj
Externt publicerad	Ja

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Baumeister, S. E., Schlesinger, S., Aleksandrova, K., Jochem, C., Jenab, M., Gunter, M. J., 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., ... Leitzmann, M. F. (2019). Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study. Journal of Hepatology, 70(5), 885-892. https://doi.org/10.1016/j.jhep.2018.12.014

@article{edefebacdd6746838ac585a745309eb1,

title = "Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study",

abstract = "BACKGROUND & AIMS: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been 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 (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) 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 and 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% 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 (95% CI 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: These 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.",

keywords = "Adult, Aged, Bile Duct Neoplasms/prevention & control, Carcinoma, Hepatocellular/prevention & control, Exercise, Female, Humans, Liver Neoplasms/prevention & control, Male, Middle Aged, Obesity/complications, Prospective Studies, Risk",

author = "Baumeister, {Sebastian E} and Sabrina Schlesinger and Krasimira Aleksandrova and Carmen Jochem and Mazda Jenab and Gunter, {Marc J} and Kim Overvad and Anne Tj{\o}nneland and Marie-Christine Boutron-Ruault and Franck Carbonnel and Agn{\`e}s Fournier and Tilman K{\"u}hn and Rudolf Kaaks and Tobias Pischon and Heiner Boeing and Antonia Trichopoulou and Christina Bamia and {La Vecchia}, Carlo and Giovanna Masala and Salvatore Panico and Francesca Fasanelli and Rosario Tumino and Sara Grioni and {Bueno de Mesquita}, Bas and Roel Vermeulen and May, {Anne M} and Borch, {Kristin B} and Oyeyemi, {Sunday O} and Eva Ardanaz and Miguel Rodr{\'i}guez-Barranco and {Dolores Chirlaque L{\'o}pez}, Mar{\'i}a and Mireia Felez-Nobrega and Emily Sonestedt and Bodil Ohlsson and Oskar Hemmingsson and M{\aa}rten Werner and Aurora Perez-Cornago and Pietro Ferrari and Magdalena Stepien and Heinz Freisling and Tsilidis, {Konstantinos K} and Heather Ward and Elio Riboli and Elisabete Weiderpass and Leitzmann, {Michael F}",

year = "2019",

month = may,

doi = "10.1016/j.jhep.2018.12.014",

language = "English",

volume = "70",

pages = "885--892",

journal = "Journal of Hepatology",

issn = "0168-8278",

publisher = "Elsevier",

number = "5",

}

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, Bueno de Mesquita, B, Vermeulen, R, May, AM, Borch, KB, Oyeyemi, SO, Ardanaz, E, Rodríguez-Barranco, M, Dolores Chirlaque López, M, 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 2019, 'Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study', Journal of Hepatology, vol. 70, nr. 5, s. 885-892. https://doi.org/10.1016/j.jhep.2018.12.014

TY - JOUR

T1 - Association between physical activity and risk of hepatobiliary cancers

T2 - A multinational cohort study

AU - Baumeister, Sebastian E

AU - Schlesinger, Sabrina

AU - Aleksandrova, Krasimira

AU - Jochem, Carmen

AU - Jenab, Mazda

AU - Gunter, Marc J

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Boutron-Ruault, Marie-Christine

AU - Carbonnel, Franck

AU - Fournier, Agnès

AU - Kühn, Tilman

AU - Kaaks, Rudolf

AU - Pischon, Tobias

AU - Boeing, Heiner

AU - Trichopoulou, Antonia

AU - Bamia, Christina

AU - La Vecchia, Carlo

AU - Masala, Giovanna

AU - Panico, Salvatore

AU - Fasanelli, Francesca

AU - Tumino, Rosario

AU - Grioni, Sara

AU - Bueno de Mesquita, Bas

AU - Vermeulen, Roel

AU - May, Anne M

AU - Borch, Kristin B

AU - Oyeyemi, Sunday O

AU - Ardanaz, Eva

AU - Rodríguez-Barranco, Miguel

AU - Dolores Chirlaque López, María

AU - Felez-Nobrega, Mireia

AU - Sonestedt, Emily

AU - Ohlsson, Bodil

AU - Hemmingsson, Oskar

AU - Werner, Mårten

AU - Perez-Cornago, Aurora

AU - Ferrari, Pietro

AU - Stepien, Magdalena

AU - Freisling, Heinz

AU - Tsilidis, Konstantinos K

AU - Ward, Heather

AU - Riboli, Elio

AU - Weiderpass, Elisabete

AU - Leitzmann, Michael F

PY - 2019/5

Y1 - 2019/5

N2 - BACKGROUND & AIMS: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been 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 (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) 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 and 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% 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 (95% CI 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: These 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.

AB - BACKGROUND & AIMS: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been 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 (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) 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 and 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% 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 (95% CI 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: These 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.

KW - Adult

KW - Aged

KW - Bile Duct Neoplasms/prevention & control

KW - Carcinoma, Hepatocellular/prevention & control

KW - Exercise

KW - Female

KW - Humans

KW - Liver Neoplasms/prevention & control

KW - Male

KW - Middle Aged

KW - Obesity/complications

KW - Prospective Studies

KW - Risk

U2 - 10.1016/j.jhep.2018.12.014

DO - 10.1016/j.jhep.2018.12.014

M3 - Article

C2 - 30582978

SN - 0168-8278

VL - 70

SP - 885

EP - 892

JO - Journal of Hepatology

JF - Journal of Hepatology

IS - 5

ER -

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

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