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Prospective study of physical activity and risk of primary adenocarcinomas of the oesophagus and stomach in the EPIC (European Prospective Investigation into Cancer and nutrition) cohort

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Abstract

Objective

To analyse the association between types of physical activity (occupational, recreational and household, vigorous and overall) and risk of primary oesophageal (OAC) or gastric adenocarcinoma (GAC).

Methods

From nine European countries, 420,449 participants were recruited between 1991 and 2000 and followed-up for a mean of 8.8 years to register incident GAC and OAC. Information on physical activity (PA), diet, lifestyle and health-related variables was obtained at baseline. Helicobacter pylori infection status was considered in a subset of 1,211 participants. Analyses were repeated by tumour site (cardia/non-cardia) and histological type (intestinal/diffuse).

Results

During the follow-up, 410 GAC and 80 OAC occurred. A lower risk of overall and non-cardia GAC was found for increasing levels of a PA index which combined occupational PA with weekly time spent in sports and cycling. The hazard ratio (HR) of GAC was 0.69, 95% CI: 0.50–0.94, for the comparison between active and inactive participants according to the PA index (HR = 0.44, 95% CI:0.26–0.74, for non-cardia GAC). No effect was found for cardia tumours or histological subtypes of GAC. PA of any kind was not associated with OAC.

Conclusions

Overall and distal (non-cardia) gastric tumours were inversely associated with time spent on cycling and sports and a total PA index. No association was found for any type of PA and risk of cardia cancers of the stomach.

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Acknowledgments

We would like to thank all EPIC participants for their collaboration.

Financial support

European Commission FP5 project (QLG1-CT-2001-01049). The EPIC study was funded by “Europe Against Cancer” Programme of the European Commission (SANCO); Ligue contre le Cancer (France); Société 3 M (France); Mutuelle Générale de l’Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; ISCIII of the Spanish Ministry of Health (RETICC RD06/0020); the participating regional governments and institutions of Spain; Cancer Research UK; Medical Research Council, UK; Greek Ministry of Health; Stavros Niarchos Foundation; Hellenic Health Foundation; Italian Association for Research on Cancer (AIRC); Dutch Ministry of Public Health, Welfare and Sports; Dutch Ministry of Health; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Norwegian Cancer Society. Some authors are partners of ECNIS, a network of excellence of the EC (6FP contract 513943).

Author information

Authors and Affiliations

  1. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    José María Huerta, Carmen Navarro, María-Dolores Chirlaque, María-José Tormo, Eva Ardanaz, Larraitz Arriola & Esther Molina-Montes

  2. Epidemiology Department, Regional Council of Health and Consumer Affairs, Murcia, Spain

    José María Huerta, Carmen Navarro, María-Dolores Chirlaque & María-José Tormo

  3. Unit of Environmental Epidemiology, German Cancer Research Center, Heidelberg, Germany

    Karen Steindorf

  4. Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona (ICO-IDIBELL), Spain

    Genevieve Buckland, Antonio Agudo & Carlos A. González

  5. Institute of Molecular Pathology and Immunology of the University of Porto and Medical Faculty, Porto, Portugal

    Fátima Carneiro

  6. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    Nina Føns Johnsen & Anne Tjønneland

  7. Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    Kim Overvad & Jakob Stegger

  8. Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    Kim Overvad

  9. INSERM (ERI20) & Paris XI University, Institut Gustave-Roussy, Villejuif, France

    Marie-Christine Boutron-Ruault, Françoise Clavel-Chapelon & Sophie Morois

  10. German Institute of Human Nutrition, Potsdam-Rehbücke, Germany

    Heiner Boeing & Matthäus Vigl

  11. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany

    Rudolf Kaaks & Sabine Rohrmann

  12. Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece

    Pagona Lagiou & Antonia Trichopoulou

  13. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Dimitrios Trichopoulos

  14. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece

    Dimitrios Trichopoulos

  15. Hellenic Health Foundation, Athens, Greece

    Antonia Trichopoulou

  16. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    H. Bas Bueno-de-Mesquita

  17. Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

    H. Bas Bueno-de-Mesquita

  18. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    Evelyn M. Monninkhof, Mattijs E. Numans & Petra H. Peeters

  19. Department of Epidemiology and Public Health, Imperial College, London, UK

    Petra H. Peeters, Paolo Vineis, Teresa Norat, Dora Romaguera & Elio Riboli

  20. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy

    Amalia Mattiello

  21. Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy

    Valeria Pala

  22. Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Florence, Italy

    Domenico Palli

  23. Cancer Registry and Histopathology Unit, Civile M.P.Arezzo Hospital, Ragusa, Italy

    Rosario Tumino

  24. ISI Foundation, Torino, Italy

    Paolo Vineis

  25. Public Health Institute of Navarra, Pamplona, Spain

    Eva Ardanaz

  26. Public Health Department of Gipuzkoa, Basque Government, San Sebastian, Spain

    Larraitz Arriola

  27. Andalusian School of Public Health, Granada, Spain

    Esther Molina-Montes

  28. Public Health Directorate, Asturias, Spain

    Laudina Rodríguez

  29. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Björn Lindkvist

  30. Department of Surgery, Malmö University Hospital, Malmö, Sweden

    Jonas Manjer

  31. Department of Medical Biosciences, University of Umeä, Umeä, Sweden

    Roger Stenling

  32. Institute of Community Medicine, University of Tromsø, Tromsø, Norway

    Eiliv Lund

  33. Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    Francesca L. Crowe & Timothy J. Key

  34. Department of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK

    Kay-Tee Khaw

  35. MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK

    Nicholas J. Wareham

  36. Lifestyle, Environment and Cancer Group, International Agency for Research on Cancer (IARC), Lyon, France

    Mazda Jenab

  37. Servicio de Epidemiología, Consejería Sanidad y Consumo, Ronda de Levante, 11, 30008, Murcia, Spain

    José María Huerta

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  1. José María Huerta
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  2. Carmen Navarro
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  3. María-Dolores Chirlaque
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  15. Heiner Boeing
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  39. Eiliv Lund
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  40. Francesca L. Crowe
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  41. Timothy J. Key
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  42. Kay-Tee Khaw
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  43. Nicholas J. Wareham
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  44. Mazda Jenab
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  45. Teresa Norat
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  47. Elio Riboli
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  48. Carlos A. González
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Corresponding author

Correspondence to José María Huerta.

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Appendix

Appendix

See Table 6.

Table 6 Classification of physical activity based on occupational activity and practice of sports and cycling (Cambridge Physical Activity Index, CPAI)
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Huerta, J.M., Navarro, C., Chirlaque, MD. et al. Prospective study of physical activity and risk of primary adenocarcinomas of the oesophagus and stomach in the EPIC (European Prospective Investigation into Cancer and nutrition) cohort. Cancer Causes Control 21, 657–669 (2010). https://doi.org/10.1007/s10552-009-9493-x

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