Int J Sports Med 2000; 21(3): 216-220
DOI: 10.1055/s-2000-8878
Orthopedics and Clinical Science
Georg Thieme Verlag Stuttgart ·New York

Cancer Incidence Among Finnish World Class Male Athletes

E. Pukkala1 , J. Kaprio2 , M. Koskenvuo3 , U. Kujala4 , S. Sarna5
  • 1 Finnish Cancer Registry, Helsinki, Finland
  • 2 National Public Health Institute, Helsinki, Finland
  • 3 Department of Public Health, University of Turku, Turku, Finland
  • 4 Unit of Sports and Exercise Medicine, Institute of Biomedicine, University of Helsinki, Helsinki, Finland
  • 5 Department of Public Health, University of Helsinki, Helsinki, Finland
Further Information

Publication History

Publication Date:
31 December 2000 (online)

A cohort of 2269 male world class athletes from the years 1920 - 65 was followed up through the Finnish Cancer Registry for cancer incidence during 1967 - 95. There were 331 cases of cancer while the expected number based on the national cancer incidence rates was 404; the standardized incidence ratio (SIR) was 0.82 and its 95 % confidence interval (CI) 0.73 - 0.91. There was a decreased risk of cancers of the lung (SIR 0.35, 95 % CI 0.25 - 0.48), especially among endurance athletes (0.12, 0.01 - 0.41). This fits well with the low prevalence of smoking among the athletes. The SIR for kidney cancer was also significantly low (0.43, 0.16 - 0.93), possibly partly due to the better diet (more vegetables, less fat). Incidence of cancers not related to smoking was not reduced. None of the cancer sites showed a significant excess in the whole cohort but hurdlers had a significantly high relative risk of sarcomas of the bone and soft tissue which according to suggested causal mechanisms might be related e.g. to injuries during their active sport period. This as well as other observations without sound a priori hypotheses needs to be confirmed in more detailed analyses and in other data sets before final conclusions.

References

  • 1 Albanes D, Blair A, Taylor P R. Physical activity and risk of cancer in the NHANES 1 population.  Am J Public Health. 1989;  79 744-750
  • 2 Blair S N, Kohl H W, Gordon N F, Paffenberger Jr R S. How much physical activity is good for health.  Ann Rev Public Health. 1992;  13 99-126
  • 3 Dreyer L, Winther J F, Pukkala E, Andersen A. Tobacco smoking. In: Olsen JH, Andersen A, Dreyer L, Pukkala E, Tryggvadottir L, Gerhardsson de Verdier M, Winther JF (eds) Avoidable cancers in the Nordic countries.  APMIS 1997 105: 9-47
  • 4 Fogelholm M, Kaprio J, Sarna S. Healthy lifestyles of former Finnish world class athletes.  Med Sci Sports Exerc. 1994;  26 224-229
  • 5 Garabrant D H, Peter J M, Mack T M, Bernstein L. Job activity and colon cancer risk.  Am J Epidemiol. 1984;  119 1005-1014
  • 6 Gerhardsson M, Norell S E, Kiviranta H, Pedersen N L, Ahlbom A. Sedentary jobs and colon cancer.  Am J Epidemiol. 1986;  123 775-780
  • 7 Hakulinen T, Pukkala E, Puska P, Tuomilehto J, Vartiainen E. Various measures of smoking as predictors of cancer of different types in two Finnish cohorts. In: Colditz GA (ed) Proceedings of the Consensus Conference on Smoking and Prostate Cancer. Brisbane February 12 - 14, 1996. Brisbane; Repatriation Medical Authority 1997: 57-70
  • 8 Hartman T J, Albanes D, Rautalahti M, Tangrea J A, Virtamo J, Stolzenberg R, Taylor P R. Physical activity and prostate cancer in the Alpha-Tocopherol, Beta-Carotene (ATBC) Cancer Prevention Study (Finland).  CCC. 1998;  9 11-18
  • 9 Kohl H, LaPorte R E, Blair S N. Physical activity and cancer: an epidemiological perspective.  Sports Med. 1988;  6 222-237
  • 10 Kujala U M, Alen M, Huhtaniemi I T. Gonadotropin-releasing hormone and chorionic gonadotropin tests reveal that both hypothalamic and testicular endocrine functions are suppressed during acute prolonged physical exercise.  Clin Endocrinol. 1990;  33 219-225
  • 11 Lee I-M, Paffenberger Jr R S, Hsieh C-C. Physical activity and risk of colorectal cancer among college alumni.  J Natl Cancer Inst. 1991;  83 1324-1329
  • 12 Lee I-M, Paffenberger Jr R S, Hsieh C-C. Physical activity and risk of prostatic cancer among college alumni.  Am J Epidemiol. 1992;  135 169-179
  • 13 Miller R W, Boice Jr J D, Curtis R E. Bone cancer. In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and prevention. New York; Oxford University Press 1996: 971-983
  • 14 Paffenberger R S, Hyde R T, Wing A L. Physical activity and incidence of cancer in diverse populations: a preliminary report.  Am Clin Nutr. 1987;  45 312-317
  • 15 Peters R K, Garabrandt D H, Yu M C, Mack T M. A case-control study of occupational and dietary factors in colorectal cancer in young men by subsite.  Cancer Res. 1989;  49 5459-5468
  • 16 Pukkala E. Cancer risk by social class and occupation. A survey of 109,000 cancer cases among Finns of working age. Contributions to Epidemiology and Biostatistics, Vol. 7. Basel; Karger 1995
  • 17 Pukkala E. Use of record linkage in small-area studies. In: Elliot P, Guzick J, English D, Stern R (eds) Geographical and Environmental Epidemiology. Oxford; Oxford University Press 1992: 125-131
  • 18 Sarna S, Kaprio J, Kujala U M. Health status of former elite athletes - the Finnish experience. Aging: clinical and experimental research.  Clin Exp Res. 1997;  9 35-41
  • 19 Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes.  Med Sci Sports Exerc. 1993;  25 237-244
  • 20 Severson R K, Nomura A MY, Grove J S, Stemmerman G N. A prospective analysis of physical activity and cancer.  Am J Epidemiol. 1989;  130 522-529
  • 21 Shephard R J. Exercise, coronary heart disease, and risk factors.  Sports Med. 1984;  1 341-349
  • 22 Slattery M L, Schumacher M C, Smith K R, West D W, Abd-Elghany N. Physical activity, diet and risk of colon cancer in Utah.  Am J Epidemiol. 1988;  128 989-999
  • 23 Teppo L, Pukkala E, Lehtonen M. Data quality and quality control of a population-based cancer registry. Experience in Finland.  Acta Oncol. 1995;  33 365-369
  • 24 Vena J E, Graham S, Zielesny M, Swanson M K, Barnes R E, Nolan J. Lifetime occupational exercise and colon cancer.  Am J Epidemiol. 1985;  122 357-365
  • 25 Whittemore A S, Wu-Williams A H, Lee M, Zheng S, Gallagher R P. Diet, physical activity, and colorectal cancer among Chinese in North America and China.  J Natl Cancer Inst. 1990;  82 915-926
  • 26 Wilson J D. Androgen abuse by athletes.  Endocrine Rev. 1988;  9 181-197
  • 27 Wolk A, Lindblad P, Adami H-O. Nutrition and renal cell cancer.  CCC. 1996;  7 5-18
  • 28 Wu A H, Paganini-Hill A, Ross R K, Henderson B E. Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study.  Br J Cancer. 1987;  55 687-694
  • 29 Zahm H S, Tucker M A, Fraumeni Jr J F. Soft tissue sarcomas. In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer Epidemiology and prevention. New York; Oxford University Press 1996: 984-999

Ph.D. Eero Pukkala

Finnish Cancer Registry

Liisankatu 21 B

FIN-00170 Helsinki

Finland

Phone: + 358 (9) 135331

Fax: + 358 (9) 1355378

Email: eero.pukkala@cancer.fi

    >