Physical activity domains and risk of gastric adenocarcinoma in the MCC-Spain study José M. Huerta1,18, Carmen Navarro1,2,18, María Dolores Chirlaque1,2,18, Antonio J. Molina3,18, Pilar Amiano4,18, Guillermo Fernández-Tardón5,18, Trinidad Dierssen-Sotos6,7,18, Rocío Olmedo Requena8,18, Rocío Capelo-Álvarez9,18, Marcela Guevara10,18, Rosana Peiró11,18, Manolis Kogevinas12,13,14,15,18, Marina Pollán16,17,18, Gemma Castaño-Vinyals12,13,14,18, Nuria Aragonés16,17,18 1Department of Epidemiology, Murcia Regional Health Council, IMIBArrixaca, Murcia, Spain. 2Department of Health and Social Sciences, Universidad de Murcia, Spain. 3Universidad de León, León, Spain 4Subdirección de Salud Pública de Gipuzkoa, Donostia, Spain. 5Universidad de Oviedo, Oviedo, Asturias, Spain. 6University of Cantabria, Santander, Spain. 7Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV), Santander, Spain. 8Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. 9Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain. 10Instituto de Salud Pública de Navarra, Pamplona, Navarra. 11Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO–Salud Pública, Valencia, Spain. 12Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. 13IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 14Universitat Pompeu Fabra (UPF), Barcelona, Spain. 15National School of Public Health, Athens, Greece. 16Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain. 17Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta deHierro, Madrid, Spain. 18CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
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Evidence for a protective role of physical activity against development of stomach cancer is yet inconclusive. We studied the association of domain-specific physical activity and the risk of gastric adenocarcinoma (GAC), by site and histological type, in the MCC-Spain case-control study.
Results Recreational physical activity was associated with lower overall GAC risk (OR=0.65, 95% CI: 0.50, 0.85 –highest recreational activity vs. none), particularly at moderate levels of intensity such as walking (OR=0.60, 95% CI: 0.45, 0.78). Household physical activity showed the strongest association among men (OR=0.41, 95% CI: 0.29, 0.60 –highest vs. none). Associations were stronger for non-cardia tumours. No significant results were found in women. Sedentary time was not related to GAC risk (ptrend=0.438), but the potential protective effects of recreational physical activity were restricted to non-sedentary participants.
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Methods •
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428 histologically confirmed GAC cases, including gastroesophageal region (67% men), and 3225 controls were included. Cases were recruited in hospitals from 9 different Spanish regions, and age- and sex-matched population controls were randomly selected within the respective hospitals' catchment areas. A physical activity questionnaire was used to gather information on the type, frequency and duration of household and recreational activities, allowing estimation of physical activity volume (in METh/week). Participants also self-reported the intensity of working physical activity (from sedentary to very active) and their daily sitting time. Questionnaire data on diet, lifestyle and clinical factors (including Helicobacter pylori serology) were available. Adjusted odds ratios (OR) of GAC were estimated for domains of physical activity, stratifying by sex, site (cardia vs. Non-cardia), and Lauren classification (intestinal vs. diffuse).
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Funding: Institute of Health Carlos III (PI11/010403), Spain
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Both recreational and household physical activity were independently related to lower GAC risk. Gastric cancer prevention strategies should concomitantly promote adherence to recommended physical activity levels and avoidance of sedentary behaviours.
