Association between cardiorespiratory fitness and colorectal cancer in the UK Biobank
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Association between cardiorespiratory fitness and colorectal cancer in the UK Biobank Andrea Hillreiner1 · Sebastian E. Baumeister2,3 · Anja M. Sedlmeier1 · Jonas D. Finger4 · Hans J. Schlitt5 · Michael F. Leitzmann1 Received: 30 April 2019 / Accepted: 30 October 2019 © Springer Nature B.V. 2019
Abstract 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 P WC75%, the multivariableadjusted 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. Keywords Cardiorespiratory fitness · Colorectal cancer · Incidence · UK Biobank · Gender-specific
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10654-019-00575-6) contains supplementary material, which is available to authorized users. * Andrea Hillreiner [email protected] 1
Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz‑Josef‑Strauss‑Allee 11, 93053 Regensburg, Germany
2
Chair of Epidemiology, LMU München, UNIKA-T Augsburg, Neusässer Strasse 47, 86156 Augsburg, Germany
3
Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstrasse 1, 85764 Munich, Germany
4
Department of Epidemiology and Health Monitoring, Robert Koch Institute, General‑Pape Strasse 62‑66, 12101 Berlin, Germany
5
Department of Surgery, University Hospital Regensburg, Franz‑Josef‑Strauss‑Allee 11, 93053 Regensburg, Germany
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