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Association between cardiorespiratory fitness and colorectal cancer in the UK Biobank

  • Andrea HillreinerEmail author
  • Sebastian E. Baumeister
  • Anja M. Sedlmeier
  • Jonas D. Finger
  • Hans J. Schlitt
  • Michael F. Leitzmann
CANCER

Abstract

Increased cardiorespiratory fitness is related to decreased risk of major chronic illnesses, including cardiovascular disease, type 2 diabetes, and cancer, but its association with colorectal cancer specifically has received very little attention. We examined the relation of cardiorespiratory fitness to colorectal cancer in 59,191 UK Biobank participants aged 39–70 years without prevalent cancer at baseline, followed from 2009 to 2014. Submaximal bicycle ergometry was conducted at study entry, and cardiorespiratory fitness was defined as physical work capacity at 75% of the maximum heart rate, standardised to body mass (PWC75%). Multivariable Cox proportional hazards regression was performed to obtain hazard ratios (HR) and corresponding 95% confidence intervals (CI). During a mean follow-up of 4.6 years, 232 participants developed colorectal cancer (151 colon cancers; 79 rectal cancers). When comparing the 75th to the 25th percentiles of PWC75%, the multivariable-adjusted HR of colorectal cancer was 0.78 (95% CI 0.62–0.97). That relation was largely driven by an inverse association with colon cancer (HR 0.74, 95% CI 0.56–0.97) and less so with rectal cancer (HR 0.88, 95% CI 0.62–1.26; p value for difference by colorectal cancer endpoint = 0.056). The inverse relation of cardiorespiratory fitness with colorectal cancer was more evident in men (HR 0.72, 95% CI 0.55–0.94) than women (HR 0.99, 95% CI 0.71–1.38), although the gender difference was not statistically significant (p value for interaction = 0.192). Increased cardiorespiratory fitness is associated with decreased risk of colorectal cancer. Potential heterogeneity by colorectal cancer anatomic subsite and gender requires further study.

Keywords

Cardiorespiratory fitness Colorectal cancer Incidence UK Biobank Gender-specific 

Abbreviations

BMI

Body mass index

bpm

Beats per minute

CI

Confidence interval

ECG

Electrocardiograph

HR

Hazard ratio

ICD

International classification of diseases

IPAQ

International Physical Activity Questionnaire

MET

Metabolic equivalent of task

MREC

North West Multi-centre Research Ethics Committee

NSAID

Nonsteroidal anti-inflammatory drug

PWC75%

Physical work capacity at 75% of the maximum heart rate standardised to body mass

Notes

Acknowledgement

This research has been conducted using the UK Biobank Resource under Application Number 24091. The authors thank all study participants and the study personnel.

Authors contribution

AH conducted the data preparation and analysis. AH drafted the manuscript with support from ML and SB. ML and SB conceived the original idea and supervised the project. All authors directly participated in interpretation of the results, provided critical comments to the manuscript and revised the text. All authors of this research paper have read and approved the final version submitted.

Funding

The UK Biobank was supported by the Wellcome Trust, Medical Research Council, Department of Health, Scottish government, and Northwest Regional Development Agency. It has also had funding from the Welsh Assembly government and British Heart Foundation. The research was designed, conducted, analysed, and interpreted by the authors entirely independently of the funding sources.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards and ethical approval was obtained from North West Multi-centre Research Ethics Committee (REC reference: 11/NW/03820).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10654_2019_575_MOESM1_ESM.docx (195 kb)
Supplementary material 1 (DOCX 196 kb)

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany
  2. 2.Chair of Epidemiology, LMU MünchenUNIKA-T AugsburgAugsburgGermany
  3. 3.Independent Research Group Clinical Epidemiology, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
  4. 4.Department of Epidemiology and Health MonitoringRobert Koch InstituteBerlinGermany
  5. 5.Department of SurgeryUniversity Hospital RegensburgRegensburgGermany

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