Elsevier

Annals of Oncology

Volume 26, Issue 2, February 2015, Pages 272-278
Annals of Oncology

reviews
Cardiorespiratory fitness as predictor of cancer mortality: a systematic review and meta-analysis

https://doi.org/10.1093/annonc/mdu250Get rights and content
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ABSTRACT

The present meta-analysis revealed that a high level of cardiorespiratory fitness represents a strong predictor of decreased cancer mortality. Results were virtually unchanged after adjustment for adiposity. These findings suggest that cardiorespiratory fitness plays a potentially important role in protecting against cancer mortality even within the context of weight management programs.

Background

Epidemiologic studies have reported that cardiorespiratory fitness is inversely associated with mortality from cancer. However, the evidence relating cardiorespiratory fitness to cancer mortality has not yet been quantitatively summarized.

Methods

Following the preferred reporting items for sytematic reviews and meta-analyses (PRISMA) checklist, we conducted a systematic review and meta-analysis of the association between cardiorespiratory fitness and total cancer mortality. Relevant studies were identified through a literature search in PubMed up to August 2013 and by screening reference lists of qualifying articles. Data extraction was carried out independently by both authors and summary risk estimates were obtained using random-effects models.

Results

Six prospective studies with an overall number of 71 654 individuals and 2002 cases of total cancer mortality were included. The median follow-up time in the studies was 16.4 years. Cardiorespiratory fitness showed a strong, graded, inverse association with total cancer mortality. Using low cardiorespiratory fitness as the reference group, intermediate and high levels of cardiorespiratory fitness were related to statistically significant decreased summary relative risks (RRs) of total cancer mortality of 0.80 [95% confidence interval (CI) 0.67–0.97] and 0.55 (95% CI 0.47–0.65), respectively. Studies that adjusted for adiposity yielded similar results to those that did not adjust for adiposity.

Conclusion

Increased cardiorespiratory fitness represents a strong predictor of decreased total cancer mortality risk, independent of adiposity.

Key words

cardiorespiratory fitness
cancer mortality
meta-analysis

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