ORCID Profile
0000-0002-4783-1966
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Alberta Health Services
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Publisher: Springer Science and Business Media LLC
Date: 15-09-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2012
Publisher: Springer International Publishing
Date: 2020
Publisher: BMJ
Date: 14-03-2022
Publisher: BMJ
Date: 19-10-2010
Abstract: To examine seasonal variations in self-reported physical activity among an urban population of Calgarian adults. Telephone surveys were conducted with two independent random cross-sectional s les of adults in summer and autumn 2007 (n=2199) and in winter and spring 2008 (n=2223). Participation and duration of walking for recreation (WR), walking for transportation (WT), moderate (MODPA) and vigorous physical activity (VIGPA) undertaken in a usual week were captured. Seasonal comparisons of participation related to these activities and sufficient MODPA (≥210 min/week) and VIGPA (≥90 min/week) physical activity were examined using logistic regression. Compared with winter, participation in WR was significantly (p<0.05) more likely in summer (OR 1.42), autumn (OR 1.35) and spring (OR 1.40), WT was more likely in autumn (OR 1.27), and MODPA was more likely in summer (OR 1.42). Achievement of sufficient MODPA was significantly more likely in summer (OR 1.80), autumn (OR 1.31) and spring (OR 1.24). Although there was no seasonal variation in sufficient VIGPA overall, variations in seasonal pattern among sub-populations were observed. Sex- and age-specific seasonal patterns in physical activity were also found. Measuring physical activity throughout the year, rather than at one time point, would more accurately monitor physical activity and assist in developing seasonally appropriate physical activity interventions. Moreover, in countries that experience extreme weather conditions, creating physical activity-friendly environments that help overcome these conditions might contribute to year-long physical activity participation.
Publisher: Springer Science and Business Media LLC
Date: 2008
Publisher: Springer Science and Business Media LLC
Date: 12-02-2007
DOI: 10.1007/S10552-006-0113-8
Abstract: To examine the association between anthropometry and endometrial cancer, particularly by menopausal status and exogenous hormone use subgroups. Among 223,008 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, there were 567 incident endometrial cancer cases during 6.4 years of follow-up. The analysis was performed with Cox proportional hazards modeling. Weight, body mass index (BMI), waist and hip circumferences and waist-hip ratio (WHR) were strongly associated with increased risk of endometrial cancer. The relative risk (RR) for obese (BMI 30- < 40 kg/m(2)) compared to normal weight (BMI or = 40) was 3.02, 95% CI = 1.66-5.52. The RR for women with a waist circumference of > or =88 cm vs. or =20 kg compared with stable weight (+/-3 kg) increased risk independent of body weight at age 20 (RR = 1.75, 95% CI = 1.11-2.77). These associations were generally stronger for postmenopausal than premenopausal women, and oral contraceptives never-users than ever-users, and much stronger among never-users of hormone replacement therapy compared to ever-users. Obesity, abdominal adiposity, and adult weight gain were strongly associated with endometrial cancer risk. These associations were particularly evident among never-users of hormone replacement therapy.
Publisher: American Association for Cancer Research (AACR)
Date: 2009
Publisher: Wiley
Date: 10-04-2007
DOI: 10.1002/IJC.22578
Abstract: We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition, to examine the associations between prediagnostic serum concentrations of C-peptide, insulin-like growth factor binding protein (IGFBP)-1 and IGFBP-2, and endometrial cancer risk. Among pre- and post-menopausal women, who were not currently using exogenous hormones, 286 women developed incident endometrial cancer during an average 5.1 years follow-up. Using risk set s ling, 555 matched control subjects were selected. In conditional logistic regression models adjusted for matching factors only, endometrial cancer risk increased with increasing serum levels of C-peptide (relative risks (RR) for the top vs. bottom quartile = 2.13 [95% confidence interval (CI) 1.33-3.41], p(trend) = 0.001, and decreasing serum levels of IGFBP-2 (RR for the top vs. bottom quartile = 0.56 [95% CI 0.35-0.90], p(trend) = 0.03, but was not significantly associated with IGFBP-1 levels (RR for the top vs. bottom quartile = 0.76 [95% CI 0.47-1.21], p(trend) = 0.25). In BMI-adjusted models, only the C-peptide association remained marginally statistically significant (RR for the top vs. bottom quartile = 1.56 [95% CI 0.94-2.57], p(trend) = 0.05 for C-peptide 0.84 [95% CI 0.50-1.40], p(trend) = 0.74 for IGFBP-2 and 1.08 [95% CI 0.65-1.78], p(trend) = 0.86 for IGFBP-1 levels). These associations were stronger among nonfasting women (< or =< or =6 hr since last meal 63% of subjects) but were not evident among fasting women, although the interactions were not statistically significant. The C-peptide-risk association was substantially attenuated after adjustment for free estradiol in postmenopausal women (RR for the top vs. bottom quartile = 1.28 [95% CI 0.67-2.45], p(trend) = 0.42. Our results provide modest support to the hypothesis that hyperinsulinaemia is a risk factor for endometrial cancer.
Publisher: Springer Science and Business Media LLC
Date: 24-03-2013
DOI: 10.1007/S10552-013-0194-0
Abstract: Sedentary behavior may be a unique risk factor for some cancers, including breast cancer. The objective of this study was to determine the association between lifetime occupational sitting and likelihood of breast cancer. A case-control study of 2,452 women was conducted in Alberta, Canada, between 1995 and 1997. A comprehensive measure of lifetime physical activity assessed frequency and duration of sedentary jobs. Logistic regression estimated the odds of being diagnosed with breast cancer across quartiles of lifetime occupational sitting, by menopausal status and family history of breast cancer, and within body mass index categories and physical activity quartiles. There was no association between occupational sitting and breast cancer among pre-menopausal women and women with a family history of breast cancer. Unexpectedly, higher amounts of occupational sitting were associated with lower odds of breast cancer in post-menopausal women (top versus bottom categories of occupational sitting OR = 0.71, 95 % CI 0.52, 0.97), women without a family history of breast cancer (OR = 0.77, 95 % CI 0.60, 1.00), and women in the third highest quartile of total lifetime physical activity (OR = 0.57, 95 % CI 0.33, 0.97). Occupational sitting levels were lower than would be expected in a contemporary study. Exposures may have been insufficient to make a determinable contribution to breast cancer risk.
Publisher: MDPI AG
Date: 11-06-2018
Publisher: Wiley
Date: 18-07-2012
DOI: 10.1002/PON.2010
Abstract: Supervised exercise is beneficial for lymphoma patients, but it needs to be maintained to optimize long-term benefits. Here, we report the predictors of follow-up exercise behavior 6 months after a randomized controlled trial in lymphoma patients. Lymphoma patients were randomly assigned to 12 weeks of supervised aerobic exercise (n = 60) or usual care (n = 62). At baseline and post-intervention, data were collected on demographic, medical, health-related fitness, quality of life, and motivational variables. At 6-month follow-up, participants were mailed a questionnaire that assessed exercise behavior and were categorized as meeting or not meeting public health exercise guidelines. At 6-month follow-up, 110 participants (90.2%) responded, of which 61 (55.5%) were meeting public health exercise guidelines. In univariate analyses, 16 variables predicted 6-month follow-up exercise behavior. In a stepwise regression analysis, five variables entered the model and explained 38% (p < 0.001) of the variance including the following: accepting a post-intervention exercise prescription (β = 0.33 p < 0.001), achieving a higher peak power output at post-intervention (β = 0.28 p = 0.001), experiencing a larger positive change in perceived behavioral control (β = 0.18 p = 0.028), having Hodgkin lymphoma (β = 0.19 p = 0.025), and having a stronger post-intervention intention (β = 0.18 p = 0.034). Exercise behavior in lymphoma patients 6 months after a randomized trial was predicted by a wide range of demographic, medical, health-related fitness, quality of life, and motivational variables. These findings may help facilitate the uptake of self-directed exercise after short-term supervised exercise in lymphoma patients.
Publisher: Wiley
Date: 17-11-2020
DOI: 10.1002/IJC.33360
Abstract: A full‐term pregnancy is associated with reduced endometrial cancer risk however, whether the effect of additional pregnancies is independent of age at last pregnancy is unknown. The associations between other pregnancy‐related factors and endometrial cancer risk are less clear. We pooled in idual participant data from 11 cohort and 19 case‐control studies participating in the Epidemiology of Endometrial Cancer Consortium (E2C2) including 16 986 women with endometrial cancer and 39 538 control women. We used one‐ and two‐stage meta‐analytic approaches to estimate pooled odds ratios (ORs) for the association between exposures and endometrial cancer risk. Ever having a full‐term pregnancy was associated with a 41% reduction in risk of endometrial cancer compared to never having a full‐term pregnancy (OR = 0.59, 95% confidence interval [CI] 0.56‐0.63). The risk reduction appeared the greatest for the first full‐term pregnancy (OR = 0.78, 95% CI 0.72‐0.84), with a further ~15% reduction per pregnancy up to eight pregnancies (OR = 0.20, 95% CI 0.14‐0.28) that was independent of age at last full‐term pregnancy. Incomplete pregnancy was also associated with decreased endometrial cancer risk (7%‐9% reduction per pregnancy). Twin births appeared to have the same effect as singleton pregnancies. Our pooled analysis shows that, while the magnitude of the risk reduction is greater for a full‐term pregnancy than an incomplete pregnancy, each additional pregnancy is associated with further reduction in endometrial cancer risk, independent of age at last full‐term pregnancy. These results suggest that the very high progesterone level in the last trimester of pregnancy is not the sole explanation for the protective effect of pregnancy.
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.CCT.2017.10.015
Abstract: Physical activity is positively associated with survival and quality of life among breast cancer survivors. Despite these benefits, the majority of breast cancer survivors are insufficiently active. The potential health benefits of reducing sedentary behaviour (sitting time) in this population have not been extensively investigated. The ACTIVATE Trial will evaluate the efficacy of an intervention that combines wearable technology (the Garmin Vivofit2®) with traditional behavioural change approaches to increase physical activity and reduce sedentary behaviour performed by breast cancer survivors. This randomised controlled trial includes inactive, postmenopausal women diagnosed with stage I-III breast cancer who have completed their primary treatment. Participants are randomly assigned to the primary intervention group (Garmin Vivofit2® behavioural feedback and goal setting session and, five telephone-delivered health coaching sessions) or to the wait-list control group. The primary intervention is delivered over a 12-week period. The second 12-week period comprises a maintenance phase for the primary intervention group, and an abridged intervention (Garmin Vivofit2® only) for the wait-list control group. Moderate- to vigorous-intensity physical activity (MVPA) and sedentary behaviour are assessed by accelerometry at baseline (T1), end of intervention (T2), and end of maintenance phase (T3). The ACTIVATE Trial is one of the first studies to incorporate wearable technology into an intervention for cancer survivors. If the use of wearable technology (in combination with behaviour change strategies, or alone) proves efficacious, it may become an inexpensive and sustainable addition to the health promotion strategies available to health care providers in the cancer survivorship context. ACTRN12616000175471.
Publisher: Wiley
Date: 07-08-2020
DOI: 10.1002/IJC.33206
Publisher: Human Kinetics
Date: 09-2013
Abstract: The built and social environments may contribute to physical activity motivations and behavior. We examined the extent to which the Theory of Planned Behavior (TPB) mediated the association between neighborhood walkability and walking. Two random cross-sectional s les (n = 4422 adults) completed telephone interviews capturing walking-related TPB variables (perceived behavioral control (PBC), attitudes, subjective norm, intention). Of those, 2006 completed a self-administered questionnaire capturing walkability, social support (friends, family, dog ownership), and neighborhood-based transportation (NTW) and recreational walking (NRW). The likelihood of undertaking 1) any vs. none and 2) sufficient vs. insufficient levels (≥150 vs. minutes/week) of NTW and NWR, in relation to walkability, social support, and TPB was estimated. Any and sufficient NTW were associated with access to services, connectivity, residential density, not owning a dog (any NTW only), and friend and family support. Any and sufficient NRW were associated with neighborhood aesthetics (any NRW only), dog ownership, and friend and family support. PBC partially mediated the association between access to services and NTW (any and sufficient), while experiential attitudes partially mediated the association between neighborhood aesthetics and any NRW. Interventions that increase positive perceptions of the built environment may motivate adults to undertake more walking.
Publisher: American Association for Cancer Research (AACR)
Date: 2021
DOI: 10.1158/1055-9965.EPI-20-0739
Abstract: Accumulating evidence suggests a relationship between endometrial cancer and ovarian cancer. Independent genome-wide association studies (GWAS) for endometrial cancer and ovarian cancer have identified 16 and 27 risk regions, respectively, four of which overlap between the two cancers. We aimed to identify joint endometrial and ovarian cancer risk loci by performing a meta-analysis of GWAS summary statistics from these two cancers. Using LDScore regression, we explored the genetic correlation between endometrial cancer and ovarian cancer. To identify loci associated with the risk of both cancers, we implemented a pipeline of statistical genetic analyses (i.e., inverse-variance meta-analysis, colocalization, and M-values) and performed analyses stratified by subtype. Candidate target genes were then prioritized using functional genomic data. Genetic correlation analysis revealed significant genetic correlation between the two cancers (rG = 0.43, P = 2.66 × 10−5). We found seven loci associated with risk for both cancers (PBonferroni & 2.4 × 10−9). In addition, four novel subgenome-wide regions at 7p22.2, 7q22.1, 9p12, and 11q13.3 were identified (P & 5 × 10−7). Promoter-associated HiChIP chromatin loops from immortalized endometrium and ovarian cell lines and expression quantitative trait loci data highlighted candidate target genes for further investigation. Using cross-cancer GWAS meta-analysis, we have identified several joint endometrial and ovarian cancer risk loci and candidate target genes for future functional analysis. Our research highlights the shared genetic relationship between endometrial cancer and ovarian cancer. Further studies in larger s le sets are required to confirm our findings.
Publisher: Oxford University Press (OUP)
Date: 19-06-2010
DOI: 10.1007/S12160-010-9205-5
Abstract: Exercise improves health in lymphoma patients but the determinants of adherence in this population are unknown. The purpose of this study is to examine predictors of exercise adherence in lymphoma patients. In a randomized trial, 60 lymphoma patients were assigned to the exercise group and asked to attend three supervised exercise sessions per week for 12 weeks. Baseline data were collected on demographic, medical, fitness, psychosocial, and motivational variables. Adherence was assessed by objective attendance. Adherence was 77.8% and was significantly predicted by age (beta = 0.29 p = 0.016) and past exercise (beta = 0.27 p = 0.024) and borderline significantly predicted by previous treatments (beta = 0.22 p = 0.053), body mass index (beta = -0.21 p = 0.076), and smoking (beta = -0.19 p = 0.092). Poorer exercise adherence was experienced by lymphoma patients under age 40, insufficiently active at baseline, previously treated with radiation therapy, overweight or obese, and smokers. Findings may facilitate the development of targeted interventions to improve exercise adherence in this understudied patient population.
Publisher: Universidad de Alicante Servicio de Publicaciones
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 13-06-2014
Publisher: Health Promotion and Chronic Disease Prevention Branch (HPCDP) Public Health Agency of Canada
Date: 2019
Abstract: vidence to date suggests that the built environment has the potential to facilitate and even discourage physical activity. A limitation of previous reviews is that they have typically not been country-specific. We conducted a systematized literature review of quantitative studies that estimated associations between the built environment—which were objectively measured—and walking among Canadian adults. ive scientific databases were searched for peer-reviewed studies published in all years up to December 31, 2016, that estimated the association between the built environment (i.e. objectively measured using audits and Geographic Information Systems [GIS]) and physical activity among a s le of Canadian adults. The database searches, title and abstract screen, full-text review and data extraction were undertaken by two reviewers. f 4140 articles identified, 25 met the inclusion criteria. Most studies included data from a single Canadian province. All but two studies were cross-sectional. Most studies captured self-reported walking for transportation and walking for any purpose. Overall walkability and land use were consistently associated with walking for transportation, while proximity to destinations was associated with walking for any purpose. ur review findings suggest that the built environment is potentially important for supporting adult walking. Overall walkability, land use and proximity to destinations appear to be important given their association with transportation walking and walking for any purpose.
Publisher: American Association for Cancer Research (AACR)
Date: 31-05-2016
DOI: 10.1158/1055-9965.EPI-15-1267
Abstract: Background: There is strong interest in testing lifestyle interventions to improve cancer outcomes however, the optimal methods for achieving behavior change in large-scale pragmatic trials are unknown. Here, we report the 1-year feasibility results for exercise behavior change in the Canadian Cancer Trials Group CO.21 (CHALLENGE) Trial. Methods: Between 2009 and 2014, 273 high-risk stage II and III colon cancer survivors from 42 centers in Canada and Australia were randomized to a structured exercise program (SEP n = 136) or health education materials (HEM n = 137). The primary feasibility outcome in a prespecified interim analysis was a difference between randomized groups of ≥5 metabolic equivalent task (MET)-hours/week in self-reported recreational physical activity (PA) after at least 250 participants reached the 1-year follow-up. Secondary outcomes included health-related fitness. Results: The SEP group reported an increase in recreational PA of 15.6 MET-hours/week compared with 5.1 MET-hours/week in the HEM group [mean difference = +10.5 95% confidence interval (CI) = +3.1–+17.9 P = 0.002]. The SEP group also improved relative to the HEM group in predicted VO2max (P = 0.068), 6-minute walk (P & 0.001), 30-second chair stand (P & 0.001), 8-foot up-and-go (P = 0.004), and sit-and-reach (P = 0.08). Conclusions: The behavior change intervention in the CHALLENGE Trial produced a substantial increase in self-reported recreational PA that met the feasibility criterion for trial continuation, resulted in objective fitness improvements, and is consistent with the amount of PA associated with improved colon cancer outcomes in observational studies. Impact: The CHALLENGE Trial is poised to determine the causal effects of PA on colon cancer outcomes. Cancer Epidemiol Biomarkers Prev 25(6) 969–77. ©2016 AACR.
Publisher: Wiley
Date: 26-09-2006
DOI: 10.1002/IJC.22125
Abstract: Research conducted predominantly in male populations on physical activity and lung cancer has yielded inconsistent results. We examined this relationship among 416,277 men and women from the European Prospective Investigation into Cancer and Nutrition (EPIC). Detailed information on recent recreational, household and occupational physical activity, smoking habits and diet was assessed at baseline between 1992 and 2000. Relative risks (RR) were estimated using Cox regression. During 6.3 years of follow-up we identified 607 men and 476 women with incident lung cancer. We did not observe an inverse association between recent occupational, recreational or household physical activity and lung cancer risk in either males or females. However, we found some reduction in lung cancer risk associated with sports in males (adjusted RR = 0.71 95% confidence interval 0.50-0.98 highest tertile vs. inactive group), cycling (RR = 0.73 0.54-0.99) in females and non-occupational vigorous physical activity. For occupational physical activity, lung cancer risk was increased for unemployed men (adjusted RR = 1.57 1.20-2.05) and men with standing occupations (RR = 1.35 1.02-1.79) compared with sitting professions. There was no evidence of heterogeneity of physical activity associations across countries, or across any of the considered cofactors. For some histologic subtypes suggestive sex-specific reductions, limited by subgroup sizes, were observed, especially with vigorous physical activity. In total, our study shows no consistent protective associations of physical activity with lung cancer risk. It can be assumed that the elevated risks found for occupational physical activity are not produced mechanistically by physical activity itself but rather reflect exposure to occupation-related lung cancer risk factors.
Publisher: American Association for Cancer Research (AACR)
Date: 03-2018
DOI: 10.1158/1055-9965.EPI-17-0509
Abstract: Very large international and ethnic differences in cancer rates exist, are minimally explained by genetic factors, and show the huge potential for cancer prevention. A substantial portion of the differences in cancer rates can be explained by modifiable factors, and many important relationships have been documented between diet, physical activity, and obesity, and incidence of important cancers. Other related factors, such as the microbiome and the metabolome, are emerging as important intermediary components in cancer prevention. It is possible with the incorporation of newer technologies and studies including long follow-up and evaluation of effects across the life cycle, additional convincing results will be produced. However, several challenges exist for cancer researchers for ex le, measurement of diet and physical activity, and lack of standardization of s les for microbiome collection, and validation of metabolomic studies. The United States National Cancer Institute convened the Research Strategies for Nutritional and Physical Activity Epidemiology and Cancer Prevention Workshop on June 28–29, 2016, in Rockville, Maryland, during which the experts addressed the state of the science and areas of emphasis. This current paper reflects the state of the science and priorities for future research. Cancer Epidemiol Biomarkers Prev 27(3) 233–44. ©2017 AACR.
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: Elsevier BV
Date: 11-2012
Publisher: Springer Science and Business Media LLC
Date: 08-05-2011
DOI: 10.1007/S10549-011-1559-2
Abstract: Physical activity reduces the risk of postmenopausal breast cancer through multiple inter-related biologic mechanisms sedentary time may contribute additionally to this risk. We examined cross-sectional associations of objectively assessed physical activity and sedentary time with established biomarkers of breast cancer risk in a population-based s le of postmenopausal women. Accelerometer, anthropometric and laboratory data were available for 1,024 (n = 443 fasting) postmenopausal women in the U.S. National Health and Nutrition Examination Survey 2003-2006. Associations of quartiles of the accelerometer variables (moderate- to vigorous-intensity activity, light-intensity activity and sedentary time per day average length of active and sedentary bouts) with the continuous biomarkers were assessed using linear regression models. Following adjustment for potential confounders, including sedentary time, moderate- to vigorous-intensity activity had significant (P < 0.05), inverse associations with all biomarker outcomes (body mass index, waist circumference, C-reactive protein, fasting plasma glucose, fasting insulin and homeostasis model assessment of insulin resistance). Light-intensity activity and sedentary time were significantly associated in fully adjusted models with all biomarkers except fasting glucose. Active bout length was associated with a smaller waist circumference and lower C-reactive protein levels, while sedentary bout length was associated with a higher BMI. The associations of objectively assessed moderate- to vigorous-intensity activity with breast cancer biomarkers are consistent with the established beneficial effects of self-reported exercise on breast cancer risk. Our findings further suggest that light-intensity activity may have a protective effect, and that sedentary time may independently contribute to breast cancer risk.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: American Physiological Society
Date: 08-2011
Publisher: American Association for Cancer Research (AACR)
Date: 10-2009
DOI: 10.1158/1055-9965.EPI-09-0504
Abstract: Background: The Healthy Exercise for Lymphoma Patients trial showed that aerobic exercise training improved important health outcomes in lymphoma patients. Here, we examine potential moderators of the exercise training response. Methods: Lymphoma patients were stratified by major disease type and current treatment status and randomly assigned to usual care (n = 62) or aerobic exercise training (n = 60) for 12 weeks. Endpoints were quality of life, cardiovascular fitness, and body composition. Moderators were patient preference for group assignment, age, sex, marital status, disease stage, body mass index, and general health. Results: Patient preference did not statistically moderate the effects of exercise training on quality of life (P for interaction = 0.36), but the interaction effect of 7.8 points favoring patients with no preference was clinically meaningful. Marital status (P for interaction = 0.083), general health (P for interaction = 0.012), and body mass index (P for interaction = 0.010) moderated the effects of aerobic exercise training on quality of life with better outcomes for unmarried versus married patients, patients in poor/fair health versus good-to-excellent health, and normal weight/obese versus overweight patients. Disease stage (P for interaction = 0.056) and general health (P for interaction = 0.012) moderated the effects of aerobic exercise training on body composition with better outcomes for patients with advanced disease versus early disease/no disease and patients in good health versus very good-to-excellent health. No variables moderated intervention effects on cardiovascular fitness. Findings were not explained by differences in adherence. Conclusions: Clinically available variables predicted quality of life and body composition responses to aerobic exercise training in lymphoma patients. If replicated, these results may inform future randomized trials and clinical practice. (Cancer Epidemiol Biomarkers Prev 2009 (10):2600–7)
Publisher: Springer Science and Business Media LLC
Date: 08-01-2007
DOI: 10.1007/S10552-006-0094-7
Abstract: To (1) determine the nature of the association between physical activity and endometrial cancer risk (2) assess the contribution of variation in the quality of physical activity measurement to inconsistencies in study results and (3) review the biologic mechanisms that might mediate possible effects of physical activity on risk. We reviewed and summarized all published epidemiologic studies examining physical activity and endometrial cancer risk, and evidence relating to possible biologic mechanisms. We assigned each study a quality score for physical activity measurement. Fourteen of the 18 studies showed a convincing or possible protective effect of physical activity on endometrial cancer risk, with an average relative risk reduction of around 30%. A dose-response relation was observed in 7 of 13 studies. The quality score was not related to the observed strength of association or the presence of a dose-response relation. There was epidemiologic and biologic evidence that vigorous activity, as well as light and moderate intensity activities, such as housework, gardening or walking for transportation, may reduce risk. Physical activity probably has a protective role in endometrial cancer development. More epidemiologic and biologic evidence is needed to make conclusive recommendations on optimal types, characteristics or time periods of physical activity.
Publisher: Springer Science and Business Media LLC
Date: 09-2014
Publisher: Human Kinetics
Date: 05-2009
DOI: 10.1123/JPAH.6.3.367
Abstract: Capturing neighborhood-specific physical activity is necessary to advance understanding of the relations between neighborhood walkability and physical activity. This study examined the test–retest reliability of previously developed items (from the Neighborhood Physical Activity Questionnaire) for capturing setting-specific physical activity among Canadian adults. Randomly s led adults (N = 117) participated in 2 telephone interviews 2 to 5 days apart. Respondents were asked a series of items capturing frequency and duration of transportation-related walking, recreational walking, and moderate- and vigorous-intensity physical activity undertaken inside and outside the neighborhood in a usual week. The test–test reliability of reported physical activity levels were then examined using intraclass and Spearman’s rank correlations, kappa coefficients, and overall agreement. Participation, frequency, and the duration of transportation-related and recreational walking and vigorous-intensity physical activity inside and outside the neighborhood showed moderate to excellent test–retest reliability. Moderate reliability was found for moderate-intensity physical activity undertaken inside ( k = .48 ICC frequency = .38 ICC duration = .39) and outside ( k = .51 ICC frequency = .79 ICC duration = .31) the neighborhood. Neighborhood-specific physical activity items administered by telephone interview are reliable and are therefore appropriate for use in future studies examining neighborhood walk-ability and physical activity.
Publisher: Springer Berlin Heidelberg
Date: 2011
DOI: 10.1007/978-3-642-04231-7_2
Abstract: Breast cancer is the most commonly diagnosed invasive malignancy and the second leading cause of cancer death in women. This chapter considers epidemiologic evidence regarding the association between physical activity and breast cancer risk from 73 studies conducted around the world. Across these studies there was a 25% average risk reduction amongst physically active women as compared to the least active women. The associations were strongest for recreational activity, for activity sustained over the lifetime or done after menopause, and for activity that is of moderate to vigorous intensity and performed regularly. There is also some evidence for a stronger effect of physical activity amongst postmenopausal women, women who are normal weight, have no family history of breast cancer, and are parous. It is likely that physical activity is associated with decreased breast cancer risk via multiple interrelated biologic pathways that may involve adiposity, sex hormones, insulin resistance, adipokines, and chronic inflammation. Future research should include prospective observational epidemiologic studies relating proposed biomarkers to breast cancer risk and also randomized controlled trials to examine how physical activity influences the proposed biomarkers. Exercise trials will provide more clarity regarding the appropriate type, dose, and timing of activity that relate to breast cancer risk reduction.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2018
DOI: 10.1038/S41467-018-05427-7
Abstract: Endometrial cancer is the most commonly diagnosed cancer of the female reproductive tract in developed countries. Through genome-wide association studies (GWAS), we have previously identified eight risk loci for endometrial cancer. Here, we present an expanded meta-analysis of 12,906 endometrial cancer cases and 108,979 controls (including new genotype data for 5624 cases) and identify nine novel genome-wide significant loci, including a locus on 12q24.12 previously identified by meta-GWAS of endometrial and colorectal cancer. At five loci, expression quantitative trait locus (eQTL) analyses identify candidate causal genes risk alleles at two of these loci associate with decreased expression of genes, which encode negative regulators of oncogenic signal transduction proteins ( SH2B3 (12q24.12) and NF1 (17q11.2)). In summary, this study has doubled the number of known endometrial cancer risk loci and revealed candidate causal genes for future study.
Publisher: Elsevier BV
Date: 09-2010
DOI: 10.1016/J.EJCA.2010.07.028
Abstract: Physical activity is a modifiable lifestyle risk factor that has the potential to reduce the risk of most major cancer sites. We examined the strength, consistency, dose-response and biological plausibility of an association between physical activity and risk of colon, breast, endometrium, lung, prostate, ovarian, gastric, rectal, pancreatic, bladder, testicular, kidney and haematological cancers. We also estimated the population-attributable risk (PAR) for physical inactivity and cancer in 15 European countries. There is convincing or probable evidence for a beneficial effect of physical activity on the risk of colon, breast and endometrial cancers. The evidence is weaker for ovarian, lung and prostate cancers and generally either null or insufficient for all remaining cancers. Several hypothesised biological mechanisms include a likely effect of physical activity on insulin resistance, body composition, sex steroid hormones and a possible effect on vitamin D, adipokines, inflammation and immune function. Somewhere between 165,000 and 330,000 cases of the six major cancers (breast, colon, lung, prostate, endometrium and ovarian) could have been prevented in 2008 in Europe alone if the population had maintained sufficient levels of physical activity. There is strong and consistent evidence that physical activity reduces the risk of several of the major cancer sites, and that between 9% and 19% of cancer cases could be attributed to lack of sufficient physical activity in Europe. Public health recommendations for physical activity and cancer prevention generally suggest 30-60 min of moderate or vigorous-intensity activity done at least 5d per week.
Publisher: American Association for Cancer Research (AACR)
Date: 19-07-2018
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.HEALTHPLACE.2012.04.014
Abstract: We investigated the association between objectively-assessed neighborhood walkability and local walking among adults. Two independent random cross-sectional s les of Calgary (Canada) residents were recruited. Neighborhood-based walking, attitude towards walking, neighborhood self-selection, and socio-demographic characteristics were captured. Built environmental attributes underwent a two-staged cluster analysis which identified three neighborhood types (HW: high walkable MW: medium walkable LW: low walkable). Adjusting for all other characteristics, MW (OR 1.40, p < 0.05) and HW (OR 1.34, approached p < 0.05) neighborhood residents were more likely than LW neighborhood residents to participate in neighborhood-based transportation walking. HW neighborhood residents spent 30-min/wk more on neighborhood-based transportation walking than both LW and MW neighborhood residents. MW neighborhood residents spent 14-min/wk more on neighborhood-based recreational walking than LW neighborhood residents. Neighborhoods with a highly connected pedestrian network, large mix of businesses, high population density, high access to sidewalks and pathways, and many bus stops support local walking.
Publisher: Springer Science and Business Media LLC
Date: 21-03-2018
Publisher: Wiley
Date: 18-05-2007
DOI: 10.1002/IJC.22676
Abstract: The etiologic role of physical activity in endometrial cancer risk remains unclear given the few epidemiologic studies that have been conducted. To investigate this relation more fully, an analysis was undertaken in the European prospective investigation into cancer and nutrition (EPIC). During an average 6.6 years of follow-up, 689 incident endometrial cancer cases were identified from an analytic cohort within EPIC of 253,023 women. Cox proportional hazards models were used to estimate the associations between type of activity (total, occupational, household, recreational) and endometrial cancer risk. For total activity, women in the highest compared with the lowest quartile of activity had a risk of 0.88 (95% confidence interval (95% CI=0.61-1.27). No clear associations between each type of activity and endometrial cancer risk were found for the total study population combined. Associations were more evident in the stratified results, with premenopausal women who were active versus inactive experiencing a risk of 0.66 (95% CI=0.38-1.14) overall. Among premenopausal women, for household and recreational activities the risk estimates in the highest as compared with the lowest quartiles were, respectively, 0.48 (95% CI=0.23-0.99) and 0.78 (95% CI=0.44-1.39). No effect modification by body mass index, hormone replacement therapy, oral contraceptive use or energy intake was found. This study provides no evidence of a protective effect of increased physical activity in endometrial cancer risk in all women but some support for a benefit among premenopausal women. The relative risk reductions are most apparent for household activities.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-09-2009
Abstract: Lymphoma patients commonly experience declines in physical functioning and quality of life (QoL) that may be reversed with exercise training. We conducted a randomized controlled trial in Edmonton, Alberta, Canada, between 2005 and 2008 that stratified 122 lymphoma patients by major disease type and current treatment status and randomly assigned them to usual care (UC n = 62) or 12 weeks of supervised aerobic exercise training (AET n = 60). Our primary end point was patient-rated physical functioning assessed by the Trial Outcome Index-Anemia. Secondary end points were overall QoL, psychosocial functioning, cardiovascular fitness, and body composition. Follow-up assessment for our primary end point was 96% (117 of 122) at postintervention and 90% (110 of 122) at 6-month follow-up. Median adherence to the supervised exercise program was 92%. At postintervention, AET was superior to UC for patient-rated physical functioning (mean group difference, +9.0 95% CI, 2.0 to 16.0 P = .012), overall QoL (P = .021), fatigue (P = .013), happiness (P = .004), depression (P = .005), general health (P .001), cardiovascular fitness (P .001), and lean body mass (P = .008). Change in peak cardiovascular fitness mediated the change in patient-rated physical functioning. AET did not interfere with chemotherapy completion rate or treatment response. At 6-month follow-up, AET was still borderline or significantly superior to UC for overall QoL (P = .054), happiness (P = .034), and depression (P = .009) without an increased risk of disease recurrence rogression. AET significantly improved important patient-rated outcomes and objective physical functioning in lymphoma patients without interfering with medical treatments or response. Exercise training to improve cardiovascular fitness should be considered in the management of lymphoma patients.
Publisher: BMJ
Date: 03-06-2008
Abstract: To review (1) the epidemiological literature on physical activity and the risk of breast cancer, examining the effect of the different parameters of activity and effect modification within different population subgroups and (2) the biological mechanisms whereby physical activity may influence the risk of breast cancer. A review of all published literature to September 2007 was conducted using online databases 34 case-control and 28 cohort studies were included. The impact of the different parameters of physical activity on the association between activity and the risk of breast cancer was examined by considering the type of activity performed, the timing of activity over the life course and the intensity of activity. Effect modification of this association by menopausal status, body mass index (BMI), racial group, family history of breast cancer, hormone receptor status, energy intake and parity were also considered. Evidence for a risk reduction associated with increased physical activity was found in 47 (76%) of 62 studies included in this review with an average risk decrease of 25-30%. A dose-response effect existed in 28 of 33 studies. Stronger decreases in risk were observed for recreational activity, lifetime or later life activity, vigorous activity, among postmenopausal women, women with normal BMI, non-white racial groups, those with hormone receptor negative tumours, women without a family history of breast cancer and parous women. The effect of physical activity on the risk of breast cancer is stronger in specific population subgroups and for certain parameters of activity that need to be further explored in future intervention trials.
Publisher: MDPI AG
Date: 26-04-2021
Abstract: Endometrial cancer (EC) is the leading female reproductive tract malignancy in developed countries. Currently, genome-wide association studies (GWAS) have identified 17 risk loci for EC. To identify novel EC-associated proteins, we used previously reported protein quantitative trait loci for 1434 plasma proteins as instruments to evaluate associations between genetically predicted circulating protein concentrations and EC risk. We studied 12,906 cases and 108,979 controls of European descent included in the Endometrial Cancer Association Consortium, the Epidemiology of Endometrial Cancer Consortium, and the UK Biobank. We observed associations between genetically predicted concentrations of nine proteins and EC risk at a false discovery rate of .05 (p-values range from 1.14 × 10−10 to 3.04 × 10−4). Except for vascular cell adhesion protein 1, all other identified proteins were independent from known EC risk variants identified in EC GWAS. The respective odds ratios (95% confidence intervals) per one standard deviation increase in genetically predicted circulating protein concentrations were 1.21 (1.13, 1.30) for DNA repair protein RAD51 homolog 4, 1.27 (1.14, 1.42) for desmoglein-2, 1.14 (1.07, 1.22) for MHC class I polypeptide-related sequence B, 1.05 (1.02, 1.08) for histo-blood group ABO system transferase, 0.77 (0.68, 0.89) for intestinal-type alkaline phosphatase, 0.82 (0.74, 0.91) for carbohydrate sulfotransferase 15, 1.07 (1.03, 1.11) for D-glucuronyl C5-epimerase, and 1.07 (1.03, 1.10) for CD209 antigen. In conclusion, we identified nine potential EC-associated proteins. If validated by additional studies, our findings may contribute to understanding the pathogenesis of endometrial tumor development and identifying women at high risk of EC along with other EC risk factors and biomarkers.
Publisher: SAGE Publications
Date: 2012
DOI: 10.2217/WHE.11.75
Publisher: Bioscientifica
Date: 09-2007
DOI: 10.1677/ERC-07-0132
Abstract: To clarify the role of metabolic factors in endometrial carcinogenesis, we conducted a case–control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), and examined the relation between prediagnostic plasma lipids, lipoproteins, and glucose, the metabolic syndrome (MetS a cluster of metabolic factors) and endometrial cancer risk. Among pre- and postmenopausal women, 284 women developed endometrial cancer during follow-up. Using risk set s ling, 546 matched control subjects were selected. From conditional logistic regression models, high-density lipoprotein cholesterol (HDL-C) levels were inversely associated with risk body mass index (BMI)-adjusted relative risk (RR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38–0.97), P trend = 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% CI 0.99–2.90), P trend = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% CI 1.46–4.66), P trend = 0.0006, P heterogeneity = 0.13) and never-users of exogenous hormones ( P heterogeneity = 0.005 for oral contraceptive (OC) use and 0.05 for hormone replacement therapy-use). The associations of HDL-C and glucose with risk were no longer statistically significant after further adjustment for obesity-related hormones. Plasma total cholesterol, Low-density lipoprotein cholesterol (LDL-C), and triglycerides were not significantly related to overall risk. The presence of MetS was associated with risk (RR 2.12 (95% CI 1.51–2.97)), which increased with the number of MetS factors ( P trend = 0.02). An increasing number of MetS factors other than waist circumference, however, was marginally significantly associated with risk only in women with waist circumference above the median ( P interaction = 0.01). None of the associations differed significantly by fasting status. These findings suggest that metabolic abnormalities and obesity may act synergistically to increase endometrial cancer risk.
Publisher: Human Kinetics
Date: 12-2015
Abstract: Sedentary behavior has been proposed as a risk factor for obesity that is distinct from physical inactivity. This study aimed to examine the association between occupational sedentary behavior and obesity, and to determine if this association is independent of leisure-time physical activity (LTPA). Fully employed participants enrolled between 2001 and 2008 to Alberta’s Tomorrow Project, a prospective cohort study in Alberta, Canada, were studied (n = 12,409). Associations between occupational sedentary behavior and waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI) were examined using multiple binary and multinomial logistic regressions. In men, a positive association was observed between daily occupational sedentary hours and WC, WHR, BMI, and with high risk profiles that incorporated both BMI and WC ( P .01). Controlling for vigorous-intensity LTPA in all models strengthened associations between sedentary behavior and measures of obesity. In contrast, inverse associations were observed for occupational sedentary hours and WHR for women ( P .05). In fully employed men, occupational sedentary behavior was positively associated with obesity risk that was not attenuated by physical activity. In women, an increase in obesity risk was not observed with sedentary behavior. Gender differences in the health effects of sedentary behavior require further study.
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.HEALTHPLACE.2014.04.001
Abstract: This study investigated whether associations between the neighborhood built environment and neighborhood-based physical activity (PA) varied by sociodemographic and health-related characteristics. A random s le of adults (n=2006) completed telephone- and self-administered questionnaires. Questionnaires captured PA, sociodemographic, and health-related characteristics. Neighborhood-based PA (MET-minutes/week) was compared across low, medium, and high walkable neighborhoods for each sociodemographic (sex, age, dependents, education, income, motor vehicle access, and dog ownership) and health-status (general health and weight status) subpopulation. With few exceptions, subpopulations residing in high walkable neighborhoods undertook more (p<0.05) neighborhood-based PA than their counterparts in less walkable neighborhoods. Improving neighborhood walkability is a potentially effective population health intervention for increasing neighborhood-based PA.
Publisher: American Association for Cancer Research (AACR)
Date: 05-2014
DOI: 10.1158/1055-9965.EPI-13-0808
Abstract: Sedentary behavior (sitting time) has been proposed as an independent risk factor for some cancers however, its role in the development of prostate cancer has not been determined. We examined the prospective associations of self-reported daily sitting time and daily television/video viewing time with the risk of developing or dying from prostate cancer among 170,481 men in the NIH–AARP Diet and Health Study. We estimated HRs and 95% confidence intervals (CI) using Cox proportional hazards regression. Between 1996 and 2006, there were 13,751 incident (including 1,365 advanced) prostate cancer cases identified prostate cancer mortality (through 2008) was 669. No strong or significant association with prostate cancer risk was seen in fully adjusted models for either daily sitting or television/video time. There were some suggestions of effect modification by body mass index (BMI interaction for television/video time and BMI, P = 0.02). For total prostate cancer risk, television/video time was associated with a slightly elevated, but nonsignificant, increase amongst obese men (HR = 1.28 95% CI, 0.98–1.69) a null association was observed amongst overweight men (HR = 1.04 0.89–1.22) and, for men with a normal BMI, television/video time was associated with a nonsignificant risk decrease (HR = 0.82 95% CI, 0.66–1.01). Similar patterns were observed for total daily sitting and television/video time in advanced prostate cancer and prostate cancer mortality. Sedentary behavior seems to play a limited role in the development of prostate cancer however, we cannot rule out potential effect modification by BMI or the impact of measurement error on results. Cancer Epidemiol Biomarkers Prev 23(5) 882–9. ©2014 AACR.
Publisher: American Association for Cancer Research (AACR)
Date: 06-2012
DOI: 10.1158/1055-9965.EPI-12-0075
Abstract: Background: Patients with lymphoma experience sleep problems that may be managed with aerobic exercise but no previous study has examined this issue. Methods: We randomized 122 patients with lymphoma to usual care (n = 62) or 12 weeks of supervised aerobic exercise training (AET n = 60). Our primary sleep endpoint was global sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI). Secondary endpoints were the PSQI component scores. Planned subgroup analyses were also conducted. Results: Intention-to-treat analyses indicated that AET resulted in a nonsignificant (P = 0.16) improvement in global sleep quality compared with usual care [mean group difference = −0.64 95% confidence interval (CI), −1.56 to +0.27]. In planned subgroup analyses, statistically significant or borderline significant interactions were identified for type of lymphoma (Pinteraction = 0.006), current treatment status (Pinteraction = 0.036), time since diagnosis (Pinteraction = 0.010), body mass index (Pinteraction = 0.075), and baseline sleep quality (Pinteraction = 0.041). Specifically, AET improved global sleep quality in patients with lymphoma who had indolent non–Hodgkin lymphoma (P = 0.001), were receiving chemotherapy (P = 0.013), were & years post-diagnosis (P = 0.005), were obese (P = 0.025), and were poor sleepers at baseline (P = 0.007). Conclusions: AET did not significantly improve sleep quality in this heterogeneous s le of patients with lymphoma however, clinically identifiable subgroups appeared to benefit. Future exercise trials targeting these responsive subgroups are needed to confirm these findings. Impact: If replicated in larger and more focused trials, aerobic exercise may be an attractive option to manage sleep dysfunction in patients with cancer because of its favorable safety profile and other documented health benefits. Cancer Epidemiol Biomarkers Prev 21(6) 887–94. ©2012 AACR.
No related grants have been discovered for Christine Friedenreich.