Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study

Sebastian E. Baumeister, Sabrina Schlesinger, Krasimira Aleksandrova, Carmen Jochem, Mazda Jenab, Marc J. Gunter, Kim Overvad, Anne Tjønneland, Marie Christine Boutron-Ruault, Franck Carbonnel, Agnès Fournier, Tilman Kühn, Rudolf Kaaks, Tobias Pischon, Heiner Boeing, Antonia Trichopoulou, Christina Bamia, Carlo La Vecchia, Giovanna Masala, Salvatore PanicoFrancesca Fasanelli, Rosario Tumino, Sara Grioni, Bas Bueno de Mesquita, Roel Vermeulen, Anne M. May, Kristin B. Borch, Sunday O. Oyeyemi, Eva Ardanaz, Miguel Rodríguez-Barranco, María Dolores Chirlaque López, Mireia Felez-Nobrega, Emily Sonestedt, Bodil Ohlsson, Oskar Hemmingsson, Mårten Werner, Aurora Perez-Cornago, Pietro Ferrari, Magdalena Stepien, Heinz Freisling, Konstantinos K. Tsilidis, Heather Ward, Elio Riboli, Elisabete Weiderpass, Michael F. Leitzmann

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (e.g. due to hepatitis virus infection). Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95% CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC. Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.

Original languageEnglish
Pages (from-to)885-892
Number of pages8
JournalJournal of Hepatology
Volume70
Issue number5
DOIs
Publication statusPublished - May 2019

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Cohort Studies
Bile Duct Neoplasms
Exercise
Hepatocellular Carcinoma
Neoplasms
Intrahepatic Bile Ducts
Extrahepatic Bile Ducts
Liver Neoplasms
Gallbladder Neoplasms
Hepatitis Viruses
Waist Circumference
Virus Diseases
Alcohol Drinking
Body Mass Index
Obesity
Smoking
Body Weight

Keywords

  • Hepatobiliary cancer
  • Hepatocellular carcinoma
  • Liver cancer
  • Physical activity

ASJC Scopus subject areas

  • Hepatology

Cite this

Baumeister, S. E., Schlesinger, S., Aleksandrova, K., Jochem, C., Jenab, M., Gunter, M. J., ... Leitzmann, M. F. (2019). Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study. Journal of Hepatology, 70(5), 885-892. https://doi.org/10.1016/j.jhep.2018.12.014

Association between physical activity and risk of hepatobiliary cancers : A multinational cohort study. / Baumeister, Sebastian E.; Schlesinger, Sabrina; Aleksandrova, Krasimira; Jochem, Carmen; Jenab, Mazda; Gunter, Marc J.; Overvad, Kim; Tjønneland, Anne; Boutron-Ruault, Marie Christine; Carbonnel, Franck; Fournier, Agnès; Kühn, Tilman; Kaaks, Rudolf; Pischon, Tobias; Boeing, Heiner; Trichopoulou, Antonia; Bamia, Christina; La Vecchia, Carlo; Masala, Giovanna; Panico, Salvatore; Fasanelli, Francesca; Tumino, Rosario; Grioni, Sara; Bueno de Mesquita, Bas; Vermeulen, Roel; May, Anne M.; Borch, Kristin B.; Oyeyemi, Sunday O.; Ardanaz, Eva; Rodríguez-Barranco, Miguel; Dolores Chirlaque López, María; Felez-Nobrega, Mireia; Sonestedt, Emily; Ohlsson, Bodil; Hemmingsson, Oskar; Werner, Mårten; Perez-Cornago, Aurora; Ferrari, Pietro; Stepien, Magdalena; Freisling, Heinz; Tsilidis, Konstantinos K.; Ward, Heather; Riboli, Elio; Weiderpass, Elisabete; Leitzmann, Michael F.

In: Journal of Hepatology, Vol. 70, No. 5, 05.2019, p. 885-892.

Research output: Contribution to journalArticle

Baumeister, SE, Schlesinger, S, Aleksandrova, K, Jochem, C, Jenab, M, Gunter, MJ, Overvad, K, Tjønneland, A, Boutron-Ruault, MC, Carbonnel, F, Fournier, A, Kühn, T, Kaaks, R, Pischon, T, Boeing, H, Trichopoulou, A, Bamia, C, La Vecchia, C, Masala, G, Panico, S, Fasanelli, F, Tumino, R, Grioni, S, Bueno de Mesquita, B, Vermeulen, R, May, AM, Borch, KB, Oyeyemi, SO, Ardanaz, E, Rodríguez-Barranco, M, Dolores Chirlaque López, M, Felez-Nobrega, M, Sonestedt, E, Ohlsson, B, Hemmingsson, O, Werner, M, Perez-Cornago, A, Ferrari, P, Stepien, M, Freisling, H, Tsilidis, KK, Ward, H, Riboli, E, Weiderpass, E & Leitzmann, MF 2019, 'Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study', Journal of Hepatology, vol. 70, no. 5, pp. 885-892. https://doi.org/10.1016/j.jhep.2018.12.014
Baumeister SE, Schlesinger S, Aleksandrova K, Jochem C, Jenab M, Gunter MJ et al. Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study. Journal of Hepatology. 2019 May;70(5):885-892. https://doi.org/10.1016/j.jhep.2018.12.014
Baumeister, Sebastian E. ; Schlesinger, Sabrina ; Aleksandrova, Krasimira ; Jochem, Carmen ; Jenab, Mazda ; Gunter, Marc J. ; Overvad, Kim ; Tjønneland, Anne ; Boutron-Ruault, Marie Christine ; Carbonnel, Franck ; Fournier, Agnès ; Kühn, Tilman ; Kaaks, Rudolf ; Pischon, Tobias ; Boeing, Heiner ; Trichopoulou, Antonia ; Bamia, Christina ; La Vecchia, Carlo ; Masala, Giovanna ; Panico, Salvatore ; Fasanelli, Francesca ; Tumino, Rosario ; Grioni, Sara ; Bueno de Mesquita, Bas ; Vermeulen, Roel ; May, Anne M. ; Borch, Kristin B. ; Oyeyemi, Sunday O. ; Ardanaz, Eva ; Rodríguez-Barranco, Miguel ; Dolores Chirlaque López, María ; Felez-Nobrega, Mireia ; Sonestedt, Emily ; Ohlsson, Bodil ; Hemmingsson, Oskar ; Werner, Mårten ; Perez-Cornago, Aurora ; Ferrari, Pietro ; Stepien, Magdalena ; Freisling, Heinz ; Tsilidis, Konstantinos K. ; Ward, Heather ; Riboli, Elio ; Weiderpass, Elisabete ; Leitzmann, Michael F. / Association between physical activity and risk of hepatobiliary cancers : A multinational cohort study. In: Journal of Hepatology. 2019 ; Vol. 70, No. 5. pp. 885-892.
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abstract = "Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (e.g. due to hepatitis virus infection). Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95{\%} CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95{\%} CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40{\%} and body mass index 30{\%} of the overall association of total physical activity and HCC. Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.",
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T1 - Association between physical activity and risk of hepatobiliary cancers

T2 - A multinational cohort study

AU - Baumeister, Sebastian E.

AU - Schlesinger, Sabrina

AU - Aleksandrova, Krasimira

AU - Jochem, Carmen

AU - Jenab, Mazda

AU - Gunter, Marc J.

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Boutron-Ruault, Marie Christine

AU - Carbonnel, Franck

AU - Fournier, Agnès

AU - Kühn, Tilman

AU - Kaaks, Rudolf

AU - Pischon, Tobias

AU - Boeing, Heiner

AU - Trichopoulou, Antonia

AU - Bamia, Christina

AU - La Vecchia, Carlo

AU - Masala, Giovanna

AU - Panico, Salvatore

AU - Fasanelli, Francesca

AU - Tumino, Rosario

AU - Grioni, Sara

AU - Bueno de Mesquita, Bas

AU - Vermeulen, Roel

AU - May, Anne M.

AU - Borch, Kristin B.

AU - Oyeyemi, Sunday O.

AU - Ardanaz, Eva

AU - Rodríguez-Barranco, Miguel

AU - Dolores Chirlaque López, María

AU - Felez-Nobrega, Mireia

AU - Sonestedt, Emily

AU - Ohlsson, Bodil

AU - Hemmingsson, Oskar

AU - Werner, Mårten

AU - Perez-Cornago, Aurora

AU - Ferrari, Pietro

AU - Stepien, Magdalena

AU - Freisling, Heinz

AU - Tsilidis, Konstantinos K.

AU - Ward, Heather

AU - Riboli, Elio

AU - Weiderpass, Elisabete

AU - Leitzmann, Michael F.

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N2 - Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (e.g. due to hepatitis virus infection). Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95% CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC. Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.

AB - Background & Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (e.g. due to hepatitis virus infection). Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting >2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95% CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC. Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity. Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.

KW - Hepatobiliary cancer

KW - Hepatocellular carcinoma

KW - Liver cancer

KW - Physical activity

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