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Association between change in cardiorespiratory fitness and prostate cancer incidence and mortality in 57 652 Swedish men
  1. Kate A Bolam1,
  2. Emil Bojsen-Møller1,
  3. Peter Wallin2,
  4. Sofia Paulsson2,
  5. Magnus Lindwall1,3,
  6. Helene Rundqvist4,
  7. Elin Ekblom-Bak1
  1. 1 Department of Physical Activity and Health, Swedish School of Sport and Health Sciences GIH, Stockholm, Sweden
  2. 2 Research Department, HPI Health Profile Institute, Stockholm, Sweden
  3. 3 Department of Psychology, University of Gothenburg, Goteborg, Sweden
  4. 4 Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Kate A Bolam, Department of Physical Activity and Health, Swedish School of Sport and Health Sciences GIH, Stockholm 114 33, Sweden; kate.bolam{at}gih.se

Abstract

Objectives To examine the associations between changes in cardiorespiratory fitness (CRF) in adulthood and prostate cancer incidence and mortality.

Methods In this prospective study, men who completed an occupational health profile assessment including at least two valid submaximal CRF tests, performed on a cycle ergometer, were included in the study. Data on prostate cancer incidence and mortality were derived from national registers. HRs and CIs were calculated using Cox proportional hazard regression with inverse probability treatment weights of time-varying covariates.

Results During a mean follow-up time of 6.7 years (SD 4.9), 592 (1%) of the 57 652 men were diagnosed with prostate cancer, and 46 (0.08%) died with prostate cancer as the primary cause of death. An increase in absolute CRF (as % of L/min) was associated with a reduced risk of prostate cancer incidence (HR 0.98, 95% CI 0.96 to 0.99) but not mortality, in the fully adjusted model. When participants were grouped as having increased (+3%), stable (±3%) or decreased (−3%) CRF, those with increased fitness also had a reduced risk of prostate cancer incidence compared with those with decreased fitness (HR 0.65, 95% CI 0.49 to 0.86), in the fully adjusted model.

Conclusion In this study of employed Swedish men, change in CRF was inversely associated with risk of prostate cancer incidence, but not mortality. Change in CRF appears to be important for reducing the risk of prostate cancer.

  • Physical fitness

Data availability statement

Data may be obtained from a third party and are not publicly available. The data underlying the findings in this study are currently not publicly available as the original ethical approval application and the informed consent form did not include such direct, free access to the data. Data are stored by and can be requested from the HPI Health Profile Institute at support@hpi.se.

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Data availability statement

Data may be obtained from a third party and are not publicly available. The data underlying the findings in this study are currently not publicly available as the original ethical approval application and the informed consent form did not include such direct, free access to the data. Data are stored by and can be requested from the HPI Health Profile Institute at support@hpi.se.

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Footnotes

  • KAB and EB-M are joint first authors.

  • Twitter @katebolam

  • Contributors All authors have contributed with the conception and design of the work. KAB and EB-M contributed equally to this paper and share joint first authorship. SP contributed to the acquisition of the data. EB-M contributed by conducting the analyses and he and KAB interpreted the data. KAB and EB-M drafted the work, while all authors have revised the work and contributed with intellectual content. EE-B and EB-M monitored adherence to the design and statistical analyses. All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses. All authors have approved the final version of the paper to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved. E-EB was responsible for the overall content of the paper as the guarantor.

  • Funding This study was funded by the Swedish Cancer Society, ref. 21 1837 Pj.

  • Competing interests None declared.

  • Patient and public involvement We did not involve patients or the public in the design or while conducting our research. In addition to scientific journal articles, the results of the study will be disseminated to the public through online print media and with the cancer community through the Swedish Cancer Society.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.