Increased cardiorespiratory fitness is related to decreased risk of major chronic illnesses, including cardiovascular disease, type 2 diabetes, and cancer, but its association with colorectal cancer specifically has received very little attention. We examined the relation of cardiorespiratory fitness to colorectal cancer in 59,191 UK Biobank participants aged 39-70 years without prevalent cancer at baseline, followed from 2009 to 2014. Submaximal bicycle ergometry was conducted at study entry, and cardiorespiratory fitness was defined as physical work capacity at 75% of the maximum heart rate, standardised to body mass (PWC75%). Multivariable Cox proportional hazards regression was performed to obtain hazard ratios (HR) and corresponding 95% confidence intervals (CI). During a mean follow-up of 4.6 years, 232 participants developed colorectal cancer (151 colon cancers; 79 rectal cancers). When comparing the 75th to the 25th percentiles of PWC75%, the multivariable-adjusted HR of colorectal cancer was 0.78 (95% CI 0.62-0.97). That relation was largely driven by an inverse association with colon cancer (HR 0.74, 95% CI 0.56-0.97) and less so with rectal cancer (HR 0.88, 95% CI 0.62-1.26; p value for difference by colorectal cancer endpoint = 0.056). The inverse relation of cardiorespiratory fitness with colorectal cancer was more evident in men (HR 0.72, 95% CI 0.55-0.94) than women (HR 0.99, 95% CI 0.71-1.38), although the gender difference was not statistically significant (p value for interaction = 0.192). Increased cardiorespiratory fitness is associated with decreased risk of colorectal cancer. Potential heterogeneity by colorectal cancer anatomic subsite and gender requires further study.

译文

心肺功能的增强与主要慢性疾病 (包括心血管疾病,2型糖尿病和癌症) 的风险降低有关,但其与结直肠癌的相关性却很少受到关注。我们在59,191名年龄39-70岁的英国生物库参与者中,在基线时没有流行癌症,随后2009年2014年检查了心肺适应性与结直肠癌的关系。在研究开始时进行次最大自行车测功,并将心肺适应性定义为最大心率75% 时的体力劳动能力,并标准化为体重 (PWC75 %)。进行多变量Cox比例风险回归以获得风险比 (HR) 和相应的95% 置信区间 (CI)。在平均4.6年的随访中,232名参与者发展为结直肠癌 (151例结肠癌; 79例直肠癌)。当比较PWC75% 的第75至第25百分位数时,结直肠癌的多变量调整HR为0.78 (95% CI 0.62-0.97)。这种关系主要由与结肠癌的反向关联 (HR 0.74,95% CI 0.56-0.97) 驱动,而与直肠癌的反向关联较少 (HR 0.88,95% CI 0.62-1.26; 结直肠癌终点差异的p值   =   0.056)。男性 (HR 0.72,95% CI 0.55-0.94) 与女性 (HR 0.99,95% CI 0.71-1.38) 的心肺适性与结直肠癌的反比关系更为明显,但性别差异无统计学意义 (交互作用p值   =   0.192)。心肺适应性增强与结直肠癌风险降低相关。大肠癌解剖亚位点和性别的潜在异质性需要进一步研究。

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