The Physical Activity Paradox In Lung Cancer: A Systematic Review And Meta-Analysis

Objective: To deliver a systematic review of the literature synthesizing data on the association of occupational physical activity with lung cancer risk in observational studies. Design: Systematic review with meta-analysis. Data Source: A literature search was performed in electronic databases of PubMed/Medline and Embase. Eligibility criteria for selecting studies: We screened for peer-reviewed articles from prospective cohort and case-control studies assessing the association of occupational physical activity with lung cancer risk. A sex-specific meta-analysis assessed the association of high (compared to low) level occupational physical activity with lung cancer risk, estimating the relative risk (RR) and odds ratio (OR) with a 95% confidence interval (CI). Results: The systematic search identified 2065 articles, among which, 13 journal articles met the inclusion criteria. The meta-analysis adjusted for age, status and/or intensity of smoking, with a pooled sample size of 623,741 participants (men: 263,530; women: 358,589). A random-effect model of four prospective and four case-control studies indicated that men who engage in high-level occupational physical activity had a 16% higher risk (OR 1.16, 95% CI 1.00 to 1.35) of lung cancer than those engaging in low-level occupational physical activity. There was no association observed among women (RR=1.05, 95% CI 0.81 to 1.36) based on three available studies (prospective cohort: n=2; case-control: n=1). Conclusions: Findings from the review suggest a higher risk of lung cancer among men reported high-level occupational physical activity. Further prospective studies incorporating rigorous measures of domain-specific physical activity and other occupational exposures are needed to elucidate this association. Citation Format: Benny Rana, Liang Hu, Andrew Harper, Chao Cao, Cheryl Peters, Darren Brenner, Lin Yang. The physical activity paradox in lung cancer: A systematic review and meta-analysis [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3497.