title: Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women: The Women's Health Initiative.
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/m(2) . 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.
authors.affiliation: Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Ange
authors.initials: A
authors.lastname: Wang
authors.affiliation: Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA.
authors.forename: FeiFei
authors.initials: F
authors.lastname: Qin
authors.affiliation: Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Haley
authors.initials: H
authors.lastname: Hedlin
authors.affiliation: Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Manisha
authors.initials: M
authors.lastname: Desai
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA.
authors.forename: Rowan
authors.initials: R
authors.lastname: Chlebowski
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA.
authors.forename: Scarlett
authors.initials: S
authors.lastname: Gomez
authors.affiliation: Department of Family Medicine, Memorial Hospital of Rhode Island, and Department of Epidemiology, School of Public Health at Brown University, Providence, RI.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.affiliation: Department of Public Health Sciences, University of California Davis, Davis, CA.
authors.forename: Lihong
authors.initials: L
authors.lastname: Qi
authors.affiliation: Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY.
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
authors.affiliation: Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Catherine
authors.initials: C
authors.lastname: Womack
authors.affiliation: Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Wakelee
authors.affiliation: Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA. stefanick@stanford.edu.
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D057185:Sedentary Behavior; D016387:Women's Health
keywords: Women's Health Initiative; exercise; incidence; lung cancer; mortality; physical activity; sedentary behavior