Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women: The Women's Health Initiative

Ange Wang, Fei Fei Qin, Haley Hedlin, Manisha Desai, Rowan Chlebowski, Scarlett Gomez, Charles B. Eaton, Karen Johnson, Lihong Qi, Jean Wactawski-Wende, Catherine Womack, Heather A. Wakelee, Marcia L. Stefanick

Research output: Contribution to journalArticle

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Abstract

Physical activity has been associated with lower lung cancer incidence and mortality in several populations. We investigated these relationships in the Women's Health Initiative Observational Study (WHI-OS) and Clinical Trial (WHI-CT) prospective cohort of postmenopausal women. The WHI study enrolled 161,808 women aged 50–79 years between 1993 and 1998 at 40 U.S. clinical centers; 129,401 were eligible for these analyses. Cox proportional hazards models were used to assess the association of baseline physical activity levels [metabolic equivalent (MET)-min/week: none <100 (reference), low 100 to <500, medium 500 to <1,200, high 1,200+] and sedentary behavior with total lung cancer incidence and mortality. Over 11.8 mean follow-up years, 2,148 incident lung cancer cases and 1,365 lung cancer deaths were identified. Compared with no activity, higher physical activity levels at study entry were associated with lower lung cancer incidence [p = 0.009; hazard ratios (95% confidence intervals) for each physical activity category: low, HR: 0.86 (0.76–0.96); medium, HR: 0.82 (0.73–0.93); and high, HR: 0.90 (0.79–1.03)], and mortality [p < 0.0001; low, HR: 0.80 (0.69–0.92); medium, HR: 0.68 (0.59–0.80); and high, HR: 0.78 (0.66–0.93)]. Body mass index (BMI) modified the association with lung cancer incidence (p = 0.01), with a stronger association in women with BMI < 30 kg/m2. Significant associations with sedentary behavior were not observed. In analyses by lung cancer subtype, higher total physical activity levels were associated with lower lung cancer mortality for both overall NSCLC and adenocarcinoma. In conclusion, physical activity may be protective for lung cancer incidence and mortality in postmenopausal women, particularly in non-obese women.

Original languageEnglish (US)
Pages (from-to)2178-2192
Number of pages15
JournalInternational Journal of Cancer
Volume139
Issue number10
DOIs
StatePublished - Nov 15 2016

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Women's Health
Lung Neoplasms
Exercise
Mortality
Incidence
Body Mass Index
Metabolic Equivalent
Proportional Hazards Models
Observational Studies
Adenocarcinoma
Clinical Trials
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women : The Women's Health Initiative. / Wang, Ange; Qin, Fei Fei; Hedlin, Haley; Desai, Manisha; Chlebowski, Rowan; Gomez, Scarlett; Eaton, Charles B.; Johnson, Karen; Qi, Lihong; Wactawski-Wende, Jean; Womack, Catherine; Wakelee, Heather A.; Stefanick, Marcia L.

In: International Journal of Cancer, Vol. 139, No. 10, 15.11.2016, p. 2178-2192.

Research output: Contribution to journalArticle

Wang, A, Qin, FF, Hedlin, H, Desai, M, Chlebowski, R, Gomez, S, Eaton, CB, Johnson, K, Qi, L, Wactawski-Wende, J, Womack, C, Wakelee, HA & Stefanick, ML 2016, 'Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women: The Women's Health Initiative', International Journal of Cancer, vol. 139, no. 10, pp. 2178-2192. https://doi.org/10.1002/ijc.30281
Wang, Ange ; Qin, Fei Fei ; Hedlin, Haley ; Desai, Manisha ; Chlebowski, Rowan ; Gomez, Scarlett ; Eaton, Charles B. ; Johnson, Karen ; Qi, Lihong ; Wactawski-Wende, Jean ; Womack, Catherine ; Wakelee, Heather A. ; Stefanick, Marcia L. / Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women : The Women's Health Initiative. In: International Journal of Cancer. 2016 ; Vol. 139, No. 10. pp. 2178-2192.
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abstract = "Physical activity has been associated with lower lung cancer incidence and mortality in several populations. We investigated these relationships in the Women's Health Initiative Observational Study (WHI-OS) and Clinical Trial (WHI-CT) prospective cohort of postmenopausal women. The WHI study enrolled 161,808 women aged 50–79 years between 1993 and 1998 at 40 U.S. clinical centers; 129,401 were eligible for these analyses. Cox proportional hazards models were used to assess the association of baseline physical activity levels [metabolic equivalent (MET)-min/week: none <100 (reference), low 100 to <500, medium 500 to <1,200, high 1,200+] and sedentary behavior with total lung cancer incidence and mortality. Over 11.8 mean follow-up years, 2,148 incident lung cancer cases and 1,365 lung cancer deaths were identified. Compared with no activity, higher physical activity levels at study entry were associated with lower lung cancer incidence [p = 0.009; hazard ratios (95{\%} confidence intervals) for each physical activity category: low, HR: 0.86 (0.76–0.96); medium, HR: 0.82 (0.73–0.93); and high, HR: 0.90 (0.79–1.03)], and mortality [p < 0.0001; low, HR: 0.80 (0.69–0.92); medium, HR: 0.68 (0.59–0.80); and high, HR: 0.78 (0.66–0.93)]. Body mass index (BMI) modified the association with lung cancer incidence (p = 0.01), with a stronger association in women with BMI < 30 kg/m2. Significant associations with sedentary behavior were not observed. In analyses by lung cancer subtype, higher total physical activity levels were associated with lower lung cancer mortality for both overall NSCLC and adenocarcinoma. In conclusion, physical activity may be protective for lung cancer incidence and mortality in postmenopausal women, particularly in non-obese women.",
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