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Body mass index, physical activity, and television time in relation to mortality risk among endometrial cancer survivors in the NIH-AARP Diet and Health Study cohort.

ABSTRACT: PURPOSE:Endometrial cancer (EC) survivors are the second largest group of female cancer survivors in the USA, with high prevalence of obesity and physical inactivity. While higher pre-diagnosis body mass index (BMI) has been associated with higher all-cause and disease-specific mortality, pre-diagnosis physical activity has shown mixed evidence of an association with mortality. However, the association between BMI, physical activity, and TV viewing measured after diagnosis and mortality risk among EC survivors is unknown. METHODS:We identified 580 women with EC in the NIH-AARP Diet and Health Study who completed a post-diagnosis questionnaire on BMI, leisure time moderate- to vigorous-intensity physical activity (MVPA), and TV viewing. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS:With a median follow-up time of 7.1 years, we observed 91 total deaths. We found a positive association between BMI ([Formula: see text] = 2.14, 95% CI 1.08-4.24 and mortality, and no statistically significant association between TV viewing (HR5+ vs. <3 h/day = 1.46, 95% CI 0.86-2.46) and mortality nor MVPA with mortality (HR15+ vs. 0 MET h/week = 0.72, 95% CI 0.43-1.21) after adjusting for tumor characteristics and demographic factors. Further adjustment for lifestyle and health status attenuated BMI associations ([Formula: see text] = 1.47, 95% CI 0.71-3.07), but strengthened the association between TV viewing and mortality (HR5+ vs. <3 h/day = 2.28, 95% CI 1.05-4.95). CONCLUSIONS:Our results suggest that higher post-diagnosis BMI and TV viewing may be associated with higher mortality risk among EC patients, but that there may be complicated interrelationships between lifestyle factors of BMI, PA, and TV viewing and the mediating role of health status that need to be clarified.

SUBMITTER: Arem H

PROVIDER: S-EPMC5738914 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Body mass index, physical activity, and television time in relation to mortality risk among endometrial cancer survivors in the NIH-AARP Diet and Health Study cohort.

Arem Hannah H Pfeiffer Ruth M RM Moore Steven C SC Brinton Louise A LA Matthews Charles E CE

Cancer causes & control : CCC 20161011 11

<h4>Purpose</h4>Endometrial cancer (EC) survivors are the second largest group of female cancer survivors in the USA, with high prevalence of obesity and physical inactivity. While higher pre-diagnosis body mass index (BMI) has been associated with higher all-cause and disease-specific mortality, pre-diagnosis physical activity has shown mixed evidence of an association with mortality. However, the association between BMI, physical activity, and TV viewing measured after diagnosis and mortality ...[more]

PMID: 27730319

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Project description:BackgroundThere is limited evidence describing associations between cancer and function in diverse cancer types and its relationship with mortality. We investigated the relationship between cancer and poor ambulatory function and associations between ambulatory function and subsequent mortality.MethodsParticipants included 233,135 adults (n = 30,403 cancer and n = 202,732 cancer free) in the NIH-American Association of Retired Persons Diet and Health Study (1994-1996) who self-reported ambulatory function (e.g., walking pace and mobility disability: being unable to walk or walking at the slowest pace) in 2004-2006. Participants were followed for mortality from the assessment of ambulatory function through 2011. Multinomial logistic regression quantified the association between cancer and ambulatory function. We then explored the independent effects of walking pace and mobility disability in cancer survivors, and the joint effects of both a cancer diagnosis and poor ambulatory function on mortality using Cox proportional hazards models. Models explored type-specific associations across 15 cancer types.ResultsSurvivors had 42% greater odds of walking at the slowest pace [OR, 1.42 (confidence interval (CI), 1.30-1.54)] and 24% greater odds of mobility disability [OR, 1.24 (CI, 1.17-1.31)], compared with cancer-free participants, adjusting for baseline demographics, health indicators, and cancer type. Survivors reporting the slowest pace were at increased hazards than those who walked the fastest: all-cause mortality [HR, 2.22 (CI, 2.06-2.39)] and cancer mortality [HR, 2.12 (CI, 1.83-2.45)]. Similar trends emerged for mobility disability (HRs > 1.64). All-cause mortality associations were significant for more than nine cancer types.ConclusionsA diagnosis of cancer is associated with poorer ambulatory function, which is subsequently associated with increased mortality.ImpactWidespread efforts should target ambulatory function during cancer survivorship for survival benefits.

Dataset Information

Body mass index, physical activity, and television time in relation to mortality risk among endometrial cancer survivors in the NIH-AARP Diet and Health Study cohort.

Publications

Body mass index, physical activity, and television time in relation to mortality risk among endometrial cancer survivors in the NIH-AARP Diet and Health Study cohort.

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