3% Increase in Cardiorespiratory Health Linked to 35% Lower Prostate Cancer Risk

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3% Increase in Cardiorespiratory Health Linked to 35% Lower Prostate Cancer Risk

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3% Increase in Cardiorespiratory Health Linked to 35% Lower Prostate Cancer Risk

Unlike other common cancers such as breast, colon, and lung cancer, there are relatively few identified preventable factors that can decrease the risk of prostate cancer. Apart from developmental factors, being diagnosed as overweight or obese is a major risk factor for advanced prostate cancer, although there isn’t enough evidence to extend this conclusion to non-advanced prostate cancer. While there’s a clear relationship between levels of physical activity and the incidence and mortality rates of many cancer types, the research findings regarding prostate cancer are not consistent. Some studies report a decrease in prostate cancer incidence among populations with higher levels of physical activity, while others report an increase.

To date, there has been limited research on the relationship between cardiorespiratory fitness (CRF) and the incidence and mortality risk of prostate cancer. Previous studies have found an association between local and systemic inflammation and an increased risk of prostate cancer, and because there is a strong correlation between CRF and systemic inflammation, the role of CRF in cancer risk is gaining attention. However, only four small-scale studies have explored the relationship between changes in CRF or physical activity and cancer incidence or mortality, and none of these studies have statistically analyzed the incidence or mortality rates of specific cancer types.

On January 30, 2024, a research team from the Swedish School of Sport and Health Sciences published a paper titled “Association between change in cardiorespiratory fitness and prostate cancer incidence and mortality in 57,652 Swedish men” in the British Journal of Sports Medicine.

This study, based on a large-scale population, focused on investigating whether there is an association between changes in CRF and the incidence and mortality rates of prostate cancer.

The study findings indicate that changes in CRF are negatively associated with the incidence of prostate cancer but not with mortality. Therefore, changes in CRF seem to be important in reducing the risk of prostate cancer.

Key Research Findings:

Among the 181,673 men included in this study, 58,971 met the criteria for at least two examinations with an interval of at least 11 months. Additionally, 1,319 individuals were excluded due to annual CRF changes exceeding 20%, resulting in a sample of 57,652 men for analysis, with an average age of 41.4 years.

Among these 57,652 men, 592 (1%) were diagnosed with prostate cancer, and 46 (0.08%) died from prostate cancer. At baseline, the average relative CRF and absolute CRF of the sample were 37.4 mL/kg/min and 3.12 L/min, respectively. Between the first and second health assessments, the average relative CRF decreased by 0.27 mL/kg/min, and the average absolute CRF decreased by 0.01 L/min. The average time between the two tests was 4.9 years, and the average follow-up time for incidence analysis was 6.7 years.

When adjusting for relevant covariates, there was no association between baseline CRF or CRF at the last test and the incidence of prostate cancer. Only in the unadjusted model was there a negative association between CRF at baseline and at the last test and the incidence of prostate cancer.

Further analysis revealed that the percentage change in absolute CRF was negatively associated with the risk of being diagnosed with prostate cancer, and this association remained significant after adjusting for all covariates (baseline CRF, age, education level, test year, BMI, smoking) and physical activity. In contrast, the percentage change in relative CRF was only associated with the incidence of prostate cancer in models adjusted for baseline CRF.

When participants were grouped according to changes in CRF absolute values (+3%, stable (±3%), or decrease (−3%)), those with an increase in CRF absolute values had a significantly lower cancer incidence compared to those with stable CRF values, even after adjusting for all covariates. In sensitivity analysis, patients diagnosed with prostate cancer within 2 years after the last health assessment were excluded, and the subsequent analysis still showed a significant correlation between absolute CRF and the risk of prostate cancer.

Additionally, there was a positive correlation between changes in absolute CRF and self-reported changes in physical activity. However, in this study, only 46 cases of prostate cancer death were observed, and changes in CRF were not associated with prostate cancer mortality.

Conclusion:

In summary, this is the largest study to date examining the relationship between changes in CRF and the incidence and mortality rates of cancer, and the first specifically focused on the relationship between the incidence and mortality rates of prostate cancer and changes in CRF.

The results of this study, involving over 57,000 men, suggest a negative association between changes in CRF and the risk of prostate cancer incidence, which remains significant after adjusting for relevant covariates.

Furthermore, individuals with an annual increase in CRF absolute values of 3% have a significantly reduced risk of being diagnosed with cancer compared to those with stable CRF values. However, changes in absolute and relative CRF were not associated with prostate cancer mortality.

Therefore, the findings of this study make an important contribution to understanding the relationship between CRF and prostate cancer.

The strengths of this study lie primarily in its large sample size and focus on a specific type of cancer, ensuring specific conclusions about prostate cancer.

Additionally, a novelty of this study is the use of standardized methods to objectively measure CRF at two time points.

Although current research findings on the correlation between physical activity and cancer are inconsistent, studies aiming to understand the underlying mechanisms behind the beneficial effects of physical activity on cancer prevention will provide more targeted prevention recommendations.

In conclusion, the results of this study emphasize the importance of promoting increased CRF or engaging in moderate physical activity for public health support.

3% Increase in Cardiorespiratory Health Linked to 35% Lower Prostate Cancer Risk

References:

1. Bolam KA, et al. Association between change in cardiorespiratory fitness and prostate cancer incidence and mortality in 57 652 Swedish men. Br J Sports Med (2024).
2. Kunutsor SK, Voutilainen A, Laukkanen JA. Cardiorespiratory fitness is not associated with reduced risk of prostate cancer: a cohort study and review of the literature. Eur J Clin Invest 2021;51:e13545.
3. Ahmadi MN, et al. Changes in physical activity and adiposity with all-­cause, cardiovascular disease, and cancer mortality. Int J Obes 2022;46:1849–58.

(source:internet, reference only)

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