The association of lifetime physical inactivity with head and neck cancer: a hospital-based case–control analysis

Abstract

Objective Despite mounting epidemiological evidence suggesting an inverse association between recreational physical activity and cancer risk, evidence associated with head and neck cancer is scant. We conducted a case-control analysis to examine the associations of lifetime physical inactivity with the risk of head and neck squamous cell carcinoma (HNSCC). Methods We utilized data from the Patient Epidemiology Data System at Roswell Park Cancer Institute (RPCI). Participants included 246 patients with HNSCC and 504 cancer-free controls who received medical services at RPCI between 1990 and 1998. Participants were considered physically inactive if they did not participate in any regular, weekly recreational physical activity throughout their lifetime, prior to diagnosis. Multivariate logistic regression models were utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) representing the association between lifetime physical inactivity and HNSCC risk. Results We observed a significant positive association between recreational physical inactivity and HNSCC risk (OR=2.73, 95% CI: 1.87–3.99, p<0.001). In subgroup analyses by body mass index (BMI) (underweight/normal-weight: OR=3.40, 95% CI: 1.89–6.12, p<0.001; overweight/obese: OR=2.40, 95% CI: 1.43–4.02, p<0.001) and smoking status (former smoker: OR=3.12, 95% CI: 1.89–5.14, p<0.001; never smoker: OR=2.71, 95% CI: 1.21–6.05, p=0.020; current smoker: OR=1.61, 95% CI: 0.66–3.95, p=0.300) significant positive associations were also observed. Conclusion Results of the current analyses suggest that lifetime physical inactivity associates with HNSCC independent of BMI. In addition, physical inactivity may be a modifiable risk factor among never smokers. These data add to the growing body of evidence suggesting that physical inactivity may be an independent risk factor for cancer.

Physical inactivity and head and neck cancer mortality

“…Only one study has evaluated the association between physical inactivity and risk of HNC. This study reported an overall increased risk of HNC among physically inactive individuals that persisted in never‐ and former‐smokers 19 . Studies examining the association of physical activity and risk of HNC have demonstrated an inverse association, with one showing a decrease of 40% when increasing activity to three or more hours per week 23,24 …”

“…This study reported an overall increased risk of HNC among physically inactive individuals that persisted in never-and former-smokers. 19 Studies examining the association of physical activity and risk of HNC have demonstrated an inverse association, with one showing a decrease of 40% when increasing activity to three or more hours per week. 23,24 To our knowledge, no studies have systematically evaluated the impact of pre-diagnosis physical activity on HNC survival.…”

“…In 1990, a section assessing recreational physical activity was added to the questionnaire. Details regarding the content and administration of the PEDS questionnaire have been previously described 19 …”

“…Details regarding the content and administration of the PEDS questionnaire have been previously described. 19…”

“…This association remained positive in never-and former-smokers. 19 Although physical inactivity has been identified as a risk factor for HNC, no studies to our knowledge have investigated whether physical inactivity may be associated with HNC mortality. As such, we systematically evaluated for an association between self-reported physical inactivity and mortality among 305 patients diagnosed with HNC at Roswell Park Comprehensive Cancer Center (RPCCC).…”