運動對癌症的預防與恢復效果

1. 運動對癌症的預防與恢復效果

2. Total PA and risk for colorectal cancer -cohort studies WCRF & AICR, 2007

3. Occupational PA and risk for colorectal cancer Colorectal cancer Rectal cancer WCRF & AICR, 2007

4. Recreational PA and risk for colorectal cancer WCRF & AICR, 2007

5. PA and proximal colon cancer Boyle et al, JNCI, 104: 1548-1561, 2012

6. PA and distal colon cancer Boyle et al, JNCI, 104: 1548-1561, 2012

7. PA and risk for colorectal cancerJapan Public Health Center prospective study (M) Lee et al, Cancer Causes Control, 18, 199-209, 2007

8. PA and risk for colorectal cancerJapan Public Health Center prospective study (F) Lee et al, Cancer Causes Control, 18, 199-209, 2007

9. Commuting PA and colon cancer, case-control study in Shanghi, male Hou et al, Am J Epidemiol 160: 860-867, 2004

10. Recreational PA and risk for postmenopausal breast cancer Cohort studies Case-control studies WCRF & AICR, 2007

11. Occupational and recreational PA and risk for endometrial cancer WCRF & AICR, 2007

12. PA and prostate cancer: total45997 men, 10-yr follow-up • ↓7% (95% CI: 1–12%) for every 30 min/d increment Orsini et al, Br J Cancer 101: 132-1938, 2009

13. PA and prostate cancer: advanced45997 men, 10-yr follow-up • ↓12% (95% CI: 2-20%) for every 30 min/d increment Orsini et al, Br J Cancer 101: 132-1938, 2009

14. PA and renal cancer riskcase-control studies Behrens & Leitzmann, BJC, 108: 798-811, 2013

15. PA and renal cancer riskcohort studies Behrens & Leitzmann, BJC, 108: 798-811, 2013

16. PA and risk for lung cancerHarvard Alumni Health Study, 13905 men, 1977-93 走路 爬樓梯 PA > 4.5 MET Lee et al, Int J Epidemiol 28: 620-625, 1999

17. PA in different life stages and stomach cancer: case-control study • Strenuous PA, 3+time/week vs <1 time/month • Mid-teens: OR=0.73 (0.54–0.99) • Early-30s: OR=0.63 (0.46–0.86) • Early-50s: OR=0.80 (0.56–1.15) • Average lifetime: OR=0.58 (0.41–0.83) • Moderate PA not significant Campbell & McTiernan, J Nutr 137: 161S-169S, 2007

18. World Cancer Research Fund/ American Institute for Cancer Research conclusions, 2007 • PA could reduce the risk for colorectal cancer • PA could reduce the risk for breast cancer in postmenopausal women • PA may reduce the risk for endometrial cancer • PA and risk for other sites require further investigation

19. Epidemiological evidence on PA and cancer prevention in Europe: Men • Convincing: colon cancer, RR=0.76 • 52 studies • Possibly: lung cancer, RR=0.70 • 9 studies • Possibly: prostate cancer, RR=0.80 • 27 studies Friedenreich et al Eur J Cancer, 46: 2593-2604, 2010

20. Epidemiological evidence on PA and cancer prevention in Europe: Women • Convincing: colon cancer, RR=0.75 • 62 studies • Probably: breast cancer, RR=0.70 • 9 studies • Probably: endometrial cancer, RR=0.70 • 18 studies • Possibly: ovarian cancer, RR=0.81 • 12 studies • Probably: lung cancer, RR=0.70 • 9 studies • 165,000-330,000 cases of the six major cancers could have been prevented in 2008 in Europe if sufficient PA Friedenreich et al Eur J Cancer, 46: 2593-2604, 2010

21. World Cancer Research Fund/ American Institute for Cancer Research recommendations • Be physically active as part of your everyday life • >60 min moderate or > 30 min vigorous PA per day • European Prospective Investigation into Nutrition and Cancer score • 0: < 15 min/d of cycling/sports • 0.5: 15-30 min/d of cycling/sports • 1: >30 min/d of cycling/sports, or 2 hr/wk vigorous PA • 378,384 participants in 9 European countries • HR for cancer mortality per 1-unit increase in Score • 0.93 (0.87-0.99) for men • 0.86 (0.81-0.92) for women Vergnaud et al, AJCN 97: 1107-1120, 2013

22. Physical Activity Guidelines for Americans • Aerobic exercise : 150 min/week moderate intensity, or 75 min/week vigorous intensity • Resistance exercise : moderate intensity at least 2 days/week for each major muscle group • Flexibility: Stretch major muscle groups and tendons on days other activities are performed • American College of Sports Medicine, Exercise Guidelines for Cancer Survivors modification: additional care/supervision for obese or post-surgery Wolin et al, J Support Oncol 10: 171-177, 2012

23. Potential mechanisms • PA reduces circulating estrogen and testosterone • by reducing body weight and/or body fat • PA improves insulin sensitivity/metabolic syndrome • Direct effect • Indirect effect, through reducing body weight and/or body fat • PA reduces DNA methylation

24. Association of BMI and PA with estrogen levels in post-menopausal women PA cut-off point 6.5 MET-hr/wk McTieman, 2006

25. Change in estradiol by change in body fat after 1-yr intervention Campbell, 2007

26. Change in testosterone by change in body fat after 1-yr intervention Campbell, 2007

27. Bed rest changes DNA methylation promoter of PPAR-g coactivator-1a in muscle □: before BR; gray: post BR; ■: retraining Alibegovic, 2010

28. 6-mo interval walking reduces methylation in ASC gene in elderly Nakajima, 2010

29. 6-mo interval walking reduces methylation in ASC gene in elderly Nakajima, 2010

30. PA and breast cancer survivor Ballard-Barbash et al, JNCI, 104: 815-840, 2012

31. PA and non-breast cancer survivor Ballard-Barbash et al, JNCI, 104: 815-840, 2012