Benny Rana1,2, Liang Hu1,3, Andrew Harper1, Chao Cao4, Cheryl Peters1,5, Darren Brenner1,5, Lin Yang6,7. 1. Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210-2 St. SW, Calgary, AB, T2S 3C3, Canada. 2. School of Public Health, University of Saskatchewan, Saskatoon, Canada. 3. Department of Sport and Exercise Science, Zhejiang University, Hangzhou, China. 4. Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA. 5. Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada. 6. Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210-2 St. SW, Calgary, AB, T2S 3C3, Canada. lin.yang@ahs.ca. 7. Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada. lin.yang@ahs.ca.
Abstract
OBJECTIVE: To deliver a systematic review of the literature synthesizing data on the association of occupational physical activity with lung cancer risk in observational studies. DESIGN: Systematic review with meta-analysis. DATA SOURCE: A literature search was performed in the electronic databases of PubMed/Medline and Embase. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We screened peer-reviewed articles from prospective cohort and case-control studies assessing the association of occupational physical activity with lung cancer risk. A sex-specific meta-analysis assessed the association of high (compared to low/sedentary) level occupational physical activity with lung cancer risk, estimating the relative risk (RR) and odds ratio (OR) with a 95% confidence interval (CI). RESULTS: The systematic search identified 2065 articles, among which, eight journal articles met the inclusion criteria. The meta-analysis adjusted for age, smoking status and/or intensity, with a pooled sample size of 532,282 participants (men: 219,410; women: 312,872). A random-effect model of four prospective and four case-control studies indicated that men who engage in high-level occupational physical activity had a 15% higher risk (OR 1.15, 95% CI 1.04-1.28) of lung cancer than those engaging in low/sedentary-level occupational physical activity. There was no association observed among women (OR = 1.01, 95% CI 0.77-1.34) based on three available studies (prospective cohort: n = 2; case-control: n = 1). CONCLUSIONS: Findings from the review suggest a higher risk of lung cancer among men reporting high-level occupational physical activity. Further prospective studies incorporating rigorous measures of domain-specific physical activity, detailed smoking status and intensity, and other occupational exposures are needed to elucidate this association. PROSPERO REGISTRATION ID: CRD42019137911.
OBJECTIVE: To deliver a systematic review of the literature synthesizing data on the association of occupational physical activity with lung cancer risk in observational studies. DESIGN: Systematic review with meta-analysis. DATA SOURCE: A literature search was performed in the electronic databases of PubMed/Medline and Embase. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We screened peer-reviewed articles from prospective cohort and case-control studies assessing the association of occupational physical activity with lung cancer risk. A sex-specific meta-analysis assessed the association of high (compared to low/sedentary) level occupational physical activity with lung cancer risk, estimating the relative risk (RR) and odds ratio (OR) with a 95% confidence interval (CI). RESULTS: The systematic search identified 2065 articles, among which, eight journal articles met the inclusion criteria. The meta-analysis adjusted for age, smoking status and/or intensity, with a pooled sample size of 532,282 participants (men: 219,410; women: 312,872). A random-effect model of four prospective and four case-control studies indicated that men who engage in high-level occupational physical activity had a 15% higher risk (OR 1.15, 95% CI 1.04-1.28) of lung cancer than those engaging in low/sedentary-level occupational physical activity. There was no association observed among women (OR = 1.01, 95% CI 0.77-1.34) based on three available studies (prospective cohort: n = 2; case-control: n = 1). CONCLUSIONS: Findings from the review suggest a higher risk of lung cancer among men reporting high-level occupational physical activity. Further prospective studies incorporating rigorous measures of domain-specific physical activity, detailed smoking status and intensity, and other occupational exposures are needed to elucidate this association. PROSPERO REGISTRATION ID: CRD42019137911.
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