Ulf Hållmarker1, Stefan James2, Karl Michaëlsson3, Johan Ärnlöv4, Fredrik Sandin5, Lars Holmberg6. 1. Department of Medical Sciences Uppsala University, Uppsala, Sweden; Department of Internal Medicine, Mora Hospital, Mora, Sweden. Electronic address: ulf.hallmarker@ltdalarna.se. 2. Department of Medical Sciences Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala, Sweden. 3. Department of Surgical Sciences Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala, Sweden. 4. Department of Medical Sciences Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden. 5. Regional Cancer Center Uppsala-Örebro, Uppsala, Sweden. 6. Department of Surgical Sciences Uppsala University, Uppsala, Sweden; Regional Cancer Center Uppsala-Örebro, Uppsala, Sweden; King's College London, Faculty of Life Sciences & Medicine, London, UK.
Abstract
BACKGROUND: We studied the association between taking part in a long distance ski race and cancer incidence to address the hypothesis that a lifestyle involving a high degree of physical activity (PA) lowers cancer incidence with a pattern that is different by cancer site. METHODS: Cancer incidence was estimated in a large cohort of skiers (n=185,412) participating in the Vasaloppet long distance ski race in Sweden 1989-2010 and non-participants in the ski race, randomly selected from the Swedish general population (n=184,617). Data include race finishing times as a measurement of physical fitness. Hazard ratios (HRs) and net probability of cancer over twenty years of follow-up were estimated for all invasive cancer, and separately for prostate, breast, colo-rectal and lung cancer, and groups of cancers with presumed relation to lifestyle. FINDINGS: Participating in Vasaloppet was associated with a relative risk reduction for all invasive cancer of 6% (95% confidence interval 2-9%) and a relative risk reduction of 32% (95% confidence interval 28-37%) of cancer sites where there is epidemiological evidence that smoking, bodyweight, regular PA and consumption of fruit and vegetables are aetiological factors. For skin cancer the risk was increased, as for prostate cancer. Skiers with shorter finishing times had lower incidence of cancer. INTERPRETATION: This study indicates that it is unrealistic to reduce overall population cancer incidence drastically with life style. However, cancers that are epidemiologically associated with life style factors were significantly reduced by what presumably is a blend of non-smoking, normal body weight, sound dietary habits and PA. Our data thus provide additional support for present days' recommendations about life style prevention. Higher health awareness is associated with attendance to screening, which may explain our results for prostate cancer. FUNDING: University fund, independent funds from an insurance company and a private foundation.
BACKGROUND: We studied the association between taking part in a long distance ski race and cancer incidence to address the hypothesis that a lifestyle involving a high degree of physical activity (PA) lowers cancer incidence with a pattern that is different by cancer site. METHODS:Cancer incidence was estimated in a large cohort of skiers (n=185,412) participating in the Vasaloppet long distance ski race in Sweden 1989-2010 and non-participants in the ski race, randomly selected from the Swedish general population (n=184,617). Data include race finishing times as a measurement of physical fitness. Hazard ratios (HRs) and net probability of cancer over twenty years of follow-up were estimated for all invasive cancer, and separately for prostate, breast, colo-rectal and lung cancer, and groups of cancers with presumed relation to lifestyle. FINDINGS: Participating in Vasaloppet was associated with a relative risk reduction for all invasive cancer of 6% (95% confidence interval 2-9%) and a relative risk reduction of 32% (95% confidence interval 28-37%) of cancer sites where there is epidemiological evidence that smoking, bodyweight, regular PA and consumption of fruit and vegetables are aetiological factors. For skin cancer the risk was increased, as for prostate cancer. Skiers with shorter finishing times had lower incidence of cancer. INTERPRETATION: This study indicates that it is unrealistic to reduce overall population cancer incidence drastically with life style. However, cancers that are epidemiologically associated with life style factors were significantly reduced by what presumably is a blend of non-smoking, normal body weight, sound dietary habits and PA. Our data thus provide additional support for present days' recommendations about life style prevention. Higher health awareness is associated with attendance to screening, which may explain our results for prostate cancer. FUNDING: University fund, independent funds from an insurance company and a private foundation.
Authors: Matilda Ahl; Una Avdic; Maria Compagno Strandberg; Deepti Chugh; Emelie Andersson; Ulf Hållmarker; Stefan James; Tomas Deierborg; Christine T Ekdahl Journal: Sports Med Open Date: 2019-12-16
Authors: Jonatan Fernandez-Ruiz; Trinidad Montero-Vilchez; Agustin Buendia-Eisman; Salvador Arias-Santiago Journal: Int J Environ Res Public Health Date: 2022-08-17 Impact factor: 4.614