Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study

Baumeister, Sebastian E.; Schlesinger, Sabrina; Aleksandrova, Krasimira; Jochem, Carmen; Jenab, Mazda; Gunter, Marc J.; Overvad, Kim; Tjønneland, Anne; Boutron-Ruault, Marie Christine; Carbonnel, Franck; Fournier, Agnès; Kühn, Tilman; Kaaks, Rudolf; Pischon, Tobias; Boeing, Heiner; Trichopoulou, Antonia; Bamia, Christina; Vecchia, Carlo La; Masala, Giovanna; Panico, Salvatore; Fasanelli, Francesca; Tumino, Rosario; Grioni, Sara; Mesquita, Bas Bueno de; Vermeulen, Roel; May, Anne M.; Borch, Kristin Benjaminsen; Oyeyemi, Sunday Oluwafemi; Ardanaz, Eva; Rodríguez‐Barranco, Miguel; López, María Dolores Chirlaque; Félez-Nóbrega, Mireia; Sonestedt, Emily; Ohlsson, Bodil; Hemmingsson, Oskar; Werner, Mårten; Pérez-Cornago, Aurora; Ferrari, Pietro; Stępień, Magdalena; Freisling, Heinz; Tsilidis, Konstantinos K.; Ward, Heather; Riboli, Elio; Weiderpass, Elisabete; Leitzmann, Michael F.

doi:10.1016/j.jhep.2018.12.014

Cited by 63 publications

(61 citation statements)

References 37 publications

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“…Population expansion, aging, and increasing prevalence of obesity and diabetes might partly explain the marked increase, especially the dramatic increase in the number of cases, among older people. [25][26][27] Additionally, the "lag effect" of the large HBV infection reservoir in several countries might also contribute the increase of PLC in this population. Namely, a considerable proportion of people infected with HBV in their early life progressed to liver cancer as they aged.…”

Section: Discussionmentioning

confidence: 99%

Global incidence trends in primary liver cancer by age at diagnosis, sex, region, and etiology, 1990‐2017

Liu

Suo

Mao

et al. 2020

Cancer

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BACKGROUND: The incidence of primary liver cancer (PLC) continues to increase worldwide. The incidence trends and patterns of PLC associated with different age at diagnosis remain unknown. METHODS: We collected detailed information on PLC between 1990 and 2017 from Global Burden of Disease Study 2017. Estimated annual percentage changes in the PLC age-standardized incidence rate (ASR) diagnosed by age, sex, region, and etiology were calculated to quantify the temporal trends in PLC ASR. RESULTS: Globally, the number of PLC cases for which the age at diagnosis was <30 years decreased from 17,381 in 1990 to 14,661 in 2017, whereas the number of PLC cases diagnosed at age 30 to 59 and ≥60 years old increased from 216,561 and 241,189 in 1990 to 359,770 and 578,344 in 2017, respectively. The ASR of PLC cases with age at diagnosis <30 years and between 30 and 59 years decreased in both sexes, whereas the ASR of PLC with age at diagnosis ≥60 years increased in males and remained stable in females at the global level. Males had a more dramatic increase in PLC diagnosed at age ≥60 years but a milder decrease in PLC diagnosed between 30 and 59 years of age. This decrease was attributed largely to the reduction in PLC caused by hepatitis B and hepatitis C and was consistent in most regions except for developed countries, in which the ASR of PLC increased irrespective of sex and age. The ASR of PLC due to nonalcoholic steatohepatitis (NASH) increased by the greatest magnitude in most regions. CONCLUSION: PLC in highly endemic regions has been partly alleviated due to the potent control of hepatitis, especially among young and middle-aged people. However, an unfavorable trend was observed in most developed countries and in elderly populations. As such, PLC prevention schedules should give more attention to NASH and elderly patients. Cancer 2020;126:2267-2278.

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Section: Discussionmentioning

confidence: 99%

Global incidence trends in primary liver cancer by age at diagnosis, sex, region, and etiology, 1990‐2017

Liu

Suo

Mao

et al. 2020

Cancer

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“…19 Published epidemiological evidence regarding physical activity and long-term hepatic events derive from just 3 prior studies, that linked higher physical activity levels to reduced incidence of hepatobiliary cancer. [9][10][11] However, those prior studies did not assess liver-related mortality, nor did they include prospectively updated exposures, or account for key clinical and lifestyle factors, including underlying cirrhosis, alcohol use, diet and smoking, which are essential to accurately estimate the long-term effects of physical activity and adiposity on hepatic outcomes. Specifically, failing to address underlying cirrhosis can lead to reverse causation, because cirrhosis contributes to weight loss and to increased mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 80% of Americans with NAFLD are overweight, 3 and most do not engage in physical activity, 4 even when their liver disease is mild. 5,6 Obesity is a risk factor for cirrhosis, 7,8 HCC [9][10][11][12] and liverrelated death. 7,13 Furthermore, physical activity is inversely associated with HCC incidence, 9 and in short-term clinical studies, physical activity interventions improve liver fat, inflammation and fibrosis, even in the absence of weight loss.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Obesity is a risk factor for cirrhosis, 7,8 HCC [9][10][11][12] and liverrelated death. 7,13 Furthermore, physical activity is inversely associated with HCC incidence, 9 and in short-term clinical studies, physical activity interventions improve liver fat, inflammation and fibrosis, even in the absence of weight loss. [14][15][16][17] However, whether this translates to long-term reductions in liver-related mortality is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Physical activity compared to adiposity and risk of liver-related mortality: Results from two prospective, nationwide cohorts

Simon

Kim

Luo

et al. 2020

Journal of Hepatology

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“…These experimental observations have been elegantly confirmed by recent data in humans. A landmark multinational cohort study (the European Prospective Investigation into Cancer and Nutrition Cohort, the EPIC Study) assessed the impact of vigorous physical activity on different types of liver cancer in more than 470 000 persons followed for a median of 14.9 months . The multivariate‐adjusted HR for HCC was 0.55 (95% CI 0.38‐0.80) in active compared to inactive participants.…”

Section: Progression To Hccmentioning

confidence: 99%

Natural history of NASH and HCC

Negro

2020

Liver International

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Widespread unhealthy dietary habits associated with a sedentary lifestyle have made NAFLD the most frequent chronic liver disease worldwide, with a global prevalence of ~25%. Although NAFLD is mainly considered to be a benign disease, it can progress to severe liver fibrosis and hepatocellular carcinoma (HCC), with the latter found in non‐cirrhotic livers in about 40% of cases. Factors favouring the progression of liver disease in NAFLD are only partially understood. Male sex, older age and Caucasian ethnicity have frequently been identified as factors accelerating the progression of fibrosis in NAFLD, although data are not consistent. Host genetic variants appear to be very important, especially in the gene coding for the patatin‐like phospholipase domain‐containing 3 (PNPLA3), and they may also play a role in the development of HCC, independent of activity and the extent of liver damage. However, the most important factors affecting disease progression are found in the metabolic syndrome, that is, obesity, type 2 diabetes and arterial hypertension. This mini‐review will discuss the contribution of these factors to NAFLD‐associated morbidity, emphasizing the importance of preventive measures such as physical activity and weight control in view of the current pandemic of the metabolic syndrome.

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Association between physical activity and risk of hepatobiliary cancers: A multinational cohort study

Cited by 63 publications

References 37 publications

Global incidence trends in primary liver cancer by age at diagnosis, sex, region, and etiology, 1990‐2017

Global incidence trends in primary liver cancer by age at diagnosis, sex, region, and etiology, 1990‐2017

Physical activity compared to adiposity and risk of liver-related mortality: Results from two prospective, nationwide cohorts

Natural history of NASH and HCC

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