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American Journal of Epidemiology Advance Access originally published online on January 6, 2009
American Journal of Epidemiology 2009 169(5):542-553; doi:10.1093/aje/kwn371
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2009.

ORIGINAL CONTRIBUTIONS

Prospective Study of Physical Activity and Lung Cancer by Histologic Type in Current, Former, and Never Smokers

Michael F. Leitzmann, Corinna Koebnick, Christian C. Abnet, Neal D. Freedman, Yikyung Park, Albert Hollenbeck, Rachel Ballard-Barbash and Arthur Schatzkin

Correspondence to Dr. Michael F. Leitzmann, Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany (e-mail: michael.leitzmann{at}klinik.uni-regensburg.de).

Received for publication January 10, 2008. Accepted for publication October 23, 2008.

Increased physical activity has been associated with decreased lung cancer risk. However, no previous investigation has examined physical activity in relation to lung cancer histologic types by smoking status. The authors investigated these relations in the National Institutes of Health–AARP Diet and Health Study among 501,148 men and women aged 50–71 years at baseline in 1995–1996. During follow-up to 2003, 6,745 lung carcinomas occurred (14.8% small cell, 40.3% adenocarcinoma, 19.7% squamous cell, 6.1% undifferentiated large cell, 7.2% non-small cell not otherwise specified, and 11.8% carcinoma not otherwise specified). Among former smokers, the multivariate relative risks of small cell, adenocarcinoma, squamous cell, and undifferentiated large cell carcinomas comparing the highest with the lowest activity level (≥5 times/week vs. inactive) were 0.93 (95% confidence interval (CI): 0.67, 1.28), 0.79 (95% CI: 0.67, 0.94), 0.73 (95% CI: 0.57, 0.93), and 0.61 (95% CI: 0.38, 0.98), respectively. Among current smokers, corresponding values were 0.77 (95% CI: 0.58, 1.02), 0.76 (95% CI: 0.61, 0.95), 0.85 (95% CI: 0.65, 1.11), and 1.10 (95% CI: 0.69, 1.78). In contrast, physical activity was unrelated to lung carcinoma among never smokers (Pinteraction between physical activity and smoking for total lung carcinomas = 0.002). The inverse findings among former and current smokers in combination with the null results for physical activity among never smokers may point toward residual confounding by cigarette smoking as an explanation for the relations observed.

lung neoplasms; motor activity; neoplasms by histologic type; prospective studies; smoking

Abbreviations: CI, confidence interval; RR, relative risk; SD, standard deviation


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