Trajectories of physical activity, from young adulthood to older adulthood, and pancreatic cancer risk; a population-based case-control study in Ontario, Canada

Abstract

Background: There is inconsistent evidence on the association between physical activity and pancreatic cancer risk and few studies have investigated early life or life-course physical activity. The objective of this study was to evaluate the association between trajectories of physical activity across the life-course and pancreatic cancer risk.Methods: A population-based case-control study was conducted (2011-2013) using cases (n = 315) from the Ontario Pancreas Cancer Study and controls (n = 1254) from the Ontario Cancer Risk Factor Study. Self-reported recall of moderate and vigorous physical activity was measured at three time points: young adulthood (20s-30s), mid-adulthood (40s-50s) and older-adulthood (1 year prior to questionnaire completion). Physical activity trajectories were identified using latent class analysis. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from multivariable logistic regression adjusted for covariates: age, sex, race, alcohol, smoking, vegetable, fruit and meat consumption, and family history of pancreatic cancer. Results: Six life-course physical activity trajectories were identified: inactive at all ages (41.2%), low activity at all ages (31.9%), increasingly active (3.6%), high activity in young adulthood with substantial decrease (13.0%), high activity in young adulthood with slight decrease (5.0%), and persistent high activity (5.3%). Compared to the inactive at all ages trajectory, the associations between each trajectory and pancreatic cancer after confounder adjustment were: low activity at all ages (OR: 1.11; 95% CI: 0.75, 1.66), increasingly active (OR: 1.11; 95% CI: 0.56, 2.21), high activity in young adulthood with substantial decrease in older adulthood (OR: 0.76; 95% CI: 0.47, 1.23), high activity in young adulthood with slight decrease in older adulthood (OR: 0.98; 95% CI: 0.62, 1.53), and persistently high activity (OR: 1.50; 95% CI: 0.86, 2.62). When time periods were evaluated separately, the OR for the association between high moderate activity in the 20s-30s and pancreatic cancer was 0.89 (95% CI: 0.64, 1.25) and some sex differences were observed.Conclusion: Distinct life-course physical activity trajectories were identified, but there was no evidence that any of the trajectories were associated with pancreatic cancer. Future studies with larger sample sizes are needed to understand the associations between physical activity trajectories over the life-course and pancreatic cancer risk.

Prediagnostic BMI trajectories in relation to pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

“…In the PLCO Cancer Screening Trial, we did not find a significant association between lifetime BMI trajectory and pancreatic cancer risk. The results of the present study were similar to those of several previous studies [ 14 , 29 , 30 ]. Song et al evaluated body shape trajectory in early and middle life in relation to the risk of pancreatic cancer and other cancers in the Nurses' Health Study and Health Professionals Follow‐Up Study.…”

“…In the PLCO Cancer Screening Trial, we did not find a significant association between lifetime BMI trajectory and pancreatic cancer risk. The results of the present study were similar to those of several previous studies [14,29,30] for those in lean-moderate, lean-marked increase, medium-stable/ increase, and heavy-stable/increase trajectories [14]. In addition, there was not a significantly elevated risk of pancreatic cancer associated with overweight and obesity duration (per 10 years) in the observational study of the Women's Health Initiative [13] nor weight changes (per 5 kg increase) since age 20 years in the Shanghai Women's…”

“…However, little is known about the impact of lifetime physical activity trajectory on pancreatic cancer risk. A population‐based case–control study conducted in Ontario, Canada did not provide evidence that changes in moderate and vigorous physical activity across young adulthood, mid‐adulthood, and old‐adulthood were associated with pancreatic cancer risk [ 30 ]. A common weakness in most previous studies was that trajectories of weight, body shape, and physical activity were characterized by using self‐reported data collected at a small number of time points.…”

Trajectory of physical activity frequency and cancer risk: Findings from a population-based cohort study

“…The association between the trajectory of PA and cancer risk has not been well-explored. To date, only one case-control study has investigated the impact of PA trajectory on pancreatic cancer risk [7]. The trajectory of moderate and vigorous PA from the 20s to 50s age was identified, including six latent groups: persistent inactivity, low activity, increasingly active, high activity with substantial decrease, high activity with a slight decrease, and persistent high activity.…”

Physical Activity Trajectories During Adulthood and Incident Hypertension: A National Longitudinal Cohort Study

“…As PA varies over the life course [11], assessing within-person trajectories of PA over time would better characterize the association between PA and diseases. The existing literature on PA trajectories is mainly focused on cardiovascular disease (CVD), pancreatic cancer, and physical functioning [12][13][14][15], with limited investigations of the relationship between longterm PA trajectories and incident hypertension risk, especially in the Chinese population.…”