Association of Physical Activity and Risk of Hepatobiliary Cancers: A Multinational Cohort Study
Abstract
1 Background & Aims: Evidence on the association between physical activity and risk of 2 hepatobiliary cancers is inconclusive. We examined this association in the European Prospective 3 Investigation into Cancer and Nutrition cohort (EPIC). 4 Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct 5 cancers (IHBC), and 164 non-gallbladder extrahepatic bile duct cancers (NGBC) among 467,336 6 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios 7 (HRs) for total physical activity and vigorous physical activity, performed mediation analysis, and 8 secondary analyses to assess robustness to confounding (e.g., due to hepatitis virus infection). 9 Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% confidence 10 intervals (CI) 0.38-0.80) comparing active and inactive individuals. Regarding vigorous physical 11 activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR 12 for HCC was 0.50 (0.33-0.76). Estimates were similar in sensitivity analyses for confounding. 13 Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, 14 waist circumference explained about 40% and body mass index 30% of the overall association 15 of total physical activity and HCC. 16 Conclusions: Findings suggest an inverse association between physical activity and risk of 17 HCC, which is potentially mediated by obesity. 18 Lay…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 467,336 participants or records.
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