Early-Life Cardiorespiratory Fitness and Long-Term Risk of Prostate Cancer
Mené en Suède à partir de données portant sur 699 125 participants sur la période 1972-1985, cette étude de cohorte analyse l’association entre la santé cardiorespiratoire mesurée à la fin de l’adolescence et le risque de cancer de la prostate (période de suivi : 38, 8 millions personnes-années ; 10 782 cas de cancer de la prostate)
Résumé en anglais
Background: Adolescence is a period of rapid prostatic growth, yet is understudied for susceptibility for future risk of prostate cancer (PC). We examined cardiorespiratory fitness (CRF) in late adolescence in relation to long-term PC risk. Methods: A population-based cohort study was conducted of all 699,125 Swedish military conscripts during 1972-1985 (97-98% of 18-year-old men) in relation to risk of PC overall, aggressive PC, and PC mortality during 1998-2017 (ages 50-65 years). CRF was measured by maximal aerobic workload, and PC was ascertained using the National Prostate Cancer Register. Muscle strength was examined as a secondary predictor. Results: In 38.8 million person-years of follow-up, 10,782 (1.5%) men were diagnosed with PC. Adjusting for sociodemographic factors, height, weight, and family history of PC, high CRF was associated with a slightly increased risk of any PC (highest vs. lowest quintile: incidence rate ratio [IRR], 1.10; 95% CI, 1.03-1.19; P=0.008), but was not significantly associated with aggressive PC (1.01; 0.85-1.21; P=0.90) nor PC mortality (1.24; 0.73-2.13; P=0.42). High muscle strength also was associated with a modestly increased risk of any PC (highest vs. lowest quintile: IRR, 1.14; 95% CI, 1.07-1.23; P<0.001), but not aggressive PC (0.88; 0.74-1.04; P=0.14) nor PC mortality (0.81; 0.48-1.37; P=0.43). Conclusions: High CRF or muscle strength in late adolescence was associated with slightly increased future risk of PC, possibly related to increased screening, but not risk of aggressive PC nor PC mortality. Impact: These findings illustrate the importance of distinguishing aggressive from indolent PC and assessing for potential detection bias.
