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The preventive role of cardiorespiratory fitness in current male smokers who meet the American Cancer Society criteria for lung cancer screening: a prospective pilot study

Cancer Causes & Control volume 31, pages 153–159 (2020)Cite this article

Abstract

Purpose

Survival benefits could be potentially improved by adding cardiorespiratory fitness (CRF) to lung cancer screening. The current pilot study aimed to assess the association between CRF and adverse outcomes in current male smokers who are meeting the American Cancer Society (ACS) criteria for lung cancer screening.

Methods

A total of 260 men with a baseline CRF assessment (treadmill exercise test) who are met the ACS lung cancer screening criteria (“current smokers aged 55–74 years with ≥ 30 pack/years smoking history”) were prospectively studied. Cox proportional hazard models were analyzed for all-cause and cancer mortality, total and lung cancer incidence.

Results

Mean age was 63.3 ± 5.4 years, smoking history 50.4 ± 26.7 pack/years, and CRF was 7.8 ± 3.2 metabolic equivalents (METs). During a mean of 10.2 ± 6.1 years follow-up, 80 participants developed any type of cancer, 19 were diagnosed with lung cancer and 66 died (cancer, n = 39, other causes, n = 27). In multivariable models, only CRF was associated with all-cause and cancer mortality. Each 1-MET higher CRF was associated with a 10% reduced risk for all-cause mortality [0.9, 95% CI (0.83 to 0.98), p = 0.017] and cancer mortality [0.9, 95% CI (0.8 to 0.99), p = 0.048]. CRF was not associated with total cancer incidence (p = 0.59) or lung cancer incidence (p = 0.96).

Conclusion

Higher CRF is independently associated with lower risk of all-cause and cancer mortality in current male smokers who meet the ACS criteria for lung cancer screening. Screening for CRF and achieving higher CRF levels could potentially reduce mortality and serve as complementary preventive strategy in heavy smokers.

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Acknowledgments

The authors thank to the medical students who assisted with the study.

Funding

No funding was received for this study.

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Affiliations

  1. Cardiology Division, Veterans Affairs Palo Alto Health Care System/Stanford University, Palo Alto, CA, USA

    Baruch Vainshelboim & Jonathan Myers

Authors
  1. Baruch Vainshelboim
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  2. Jonathan Myers
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Contributions

BV: study design and conception, statistical analysis, results interpretation, drafting, writing, and submitting the manuscript. JM: study design and conception, data collection, results interpretation, drafting the article, and revising it critically for important intellectual content.

Corresponding author

Correspondence to Baruch Vainshelboim.

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The authors declare that they have no competing interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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

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Vainshelboim, B., Myers, J. The preventive role of cardiorespiratory fitness in current male smokers who meet the American Cancer Society criteria for lung cancer screening: a prospective pilot study. Cancer Causes Control 31, 153–159 (2020). https://doi.org/10.1007/s10552-019-01262-3

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  • DOI: https://doi.org/10.1007/s10552-019-01262-3

Keywords

  • Exercise testing
  • Exercise capacity
  • Cancer incidence
  • Mortality
  • Survival