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Physical activity, obesity, and bladder cancer incidence

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Abstract

Purpose

Cigarette smoking is an established risk factor for bladder cancer (BC), but evidence for physical inactivity and obesity is limited.

Methods

This analysis included 146,027 participants from the Cancer Prevention Study-II (CPS-II) Nutrition Cohort, a large prospective cohort of cancer incidence established in 1992. Multivariable-adjusted Cox proportional hazards models were used to examine associations between body mass index (BMI), moderate-to-vigorous intensity aerobic physical activity (MVPA), leisure-time spent sitting, and BC risk. Effect modification by stage, smoking status, and sex was examined.

Results

Only participants accumulating 15.0- < 30.0 MET-hrs/wk of MVPA had a lower risk of BC overall (RR 0.88, 95% CI 0.78, 0.99, compared to > 0–7.5 MET-hrs/wk) in the fully adjusted models. When stratifying on BC stage, MVPA (15- < 30 MET-hrs/wk vs. > 0- < 7.5 MET-hrs/wk, RR 0.83, 95% CI 0.70–0.99) and excess sitting time (≥ 6 h/day vs. 0- < 3 h/day RR 1.22, 95% CI 1.02, 1.47) were associated with risk of invasive BC only. There was no consistent evidence for effect modification by smoking status or sex.

Conclusion

This study supports that MVPA and sitting time may play a role in BC incidence, but associations likely differ by stage at diagnosis. While additional studies are needed to confirm associations by stage, this study adds to the evidence of the importance of being physically active for cancer prevention.

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Data availability

Data are available from the American Cancer Society by following the ACS Data Access Procedures (https://www.cancer.org/content/dam/cancer-org/research/epidemiology/cancer-prevention-study-data-access-policies.pdf) for researchers who meet the criteria for access to confidential data.

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Acknowledgements

The authors express sincere appreciation to all Cancer Prevention Study-II participants and to each member of the study and biospecimen management group. The authors would like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention's National Program of Cancer Registries and cancer registries supported by the National Cancer Institute's Surveillance Epidemiology and End Results Program. The views expressed here are those of the authors and do not necessarily represent the American Cancer Society or the American Cancer Society–Cancer Action Network.

Funding

The American Cancer Society funds the creation, maintenance, and updating of the Cancer Prevention Study-II cohort.

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Authors and Affiliations

  1. Department of Population Science, American Cancer Society, Kennesaw, GA, USA

    Sicha Chantaprasopsuk, Erika Rees-Punia & Alpa V. Patel

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  1. Sicha Chantaprasopsuk
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Contributions

All authors contributed to the study conceptualization and methodology. Material preparation, data collection, and other resources were provided by Alpa V. Patel. Data curation and formal data analysis was conducted by Sicha Chantaprasopsuk. The first draft of the manuscript was written by Sicha Chantaprasopsuk, and all authors commented on previous versions of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Sicha Chantaprasopsuk.

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Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Emory University (protocol #IRB00045780 last date of approval April 17, 2019).

Consent to participate

Informed consent to participate was implied by the return of a completed self-administered questionnaires in 1982 and 1992.

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Informed consent to publish was implied by the return of a completed self-administered questionnaires in 1982 and 1992.

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Chantaprasopsuk, S., Rees-Punia, E. & Patel, A.V. Physical activity, obesity, and bladder cancer incidence. Cancer Causes Control 34, 715–724 (2023). https://doi.org/10.1007/s10552-023-01711-0

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