Characteristics of the 15 cohort studies and eight case–control studies of physical activity and hematologic cancer risk included in the meta-analysis
Authors, year, gender | Study region | Subjects | Cases | Hematologic cancer subtype | PA: domain, timing in life | RR (95% CI), high vs. low PA | Low PA defined as | High PA defined as | Adjustment factors (excluding sex) | QS (%) |
---|---|---|---|---|---|---|---|---|---|---|
Cohort studies (N = 15) | ||||||||||
Birmann et al., 2007 | ||||||||||
Men | North America | 46,960 | 86 | MM | RPA, consistent | 0.80 (0.50–1.50) | <2 h/wk PA | ≥7 h/wk PA | Updated age, BMI | 73 |
Women | 89,663 | 129 | 0.50 (0.20–1.40) | 73 | ||||||
Blair et al., 2005 | ||||||||||
Women | North America | 37,083 | 95 | MM | RPA, recent | 0.88 (0.51–1.49) | Low PA | High PA | — | 48 |
Cerhan et al., 2002 Women | North America | 37,932 | 252 | NHL | RPA, past | 0.83 (0.59–1.11) | Low PA | High PA | Age | 60 |
61 | Leukemia | 0.91 (0.45–1.67) | 60 | |||||||
Hofmann et al., 2013 | ||||||||||
Men | North America | 291,471 | 319 | MM | RPA, recent | 1.10 (0.82–1.48) | <16.25 MET-h/wk | ≥50 MET-h/wk | Age (at baseline), race, age-specific BMI | 65 |
Women | 193,578 | 152 | MM | 1.43 (0.90–2.26) | 65 | |||||
Kabat et al., 2012 | ||||||||||
Women | North America | 157,852 | 285 | CLL/SLL | RPA, recent | 1.03 (0.70–1.51) | 0 h/wk strenuous PA | ≥2 h/wk strenuous PA | Age, smoking, servings of alcohol per week, education, ethnicity, BMI enrollment in the observational study, treatment arm assignment in the clinical trials | 82 |
1,071 | NHL | 0.97 (0.79–1.20) | 82 | |||||||
286 | DLBCL | 0.89 (0.59–1.36) | 82 | |||||||
205 | FL | 1.25 (0.81–1.94) | 82 | |||||||
Kabat et al., 2013 | ||||||||||
Men and women combined | North America | 493,188 | 178 | Leukemia | TPA, recent | 0.70 (0.49–0.99) | <1 time/wk VPA | ≥3 times/wk VPA | Age, BMI, smoking intensity, years of education | 62 |
Khan et al., 2006 | ||||||||||
Men | Asia | 46,157 | 35 | MM | RPA, recent | 0.44 (0.21–0.93) | <30 min walking/d | ≥1 hour walking/day | Age | 64 |
Women | 63,541 | 31 | MM | 0.58 (0.26–1.27) | 64 | |||||
Lim et al., 2007 | ||||||||||
Men and women combined | North America | 465,858 | 234 | CLL/SLL | TPA, recent | 0.80 (0.51–1.25) | PA <1 time/wk | PA ≥5 times/wk | Age, race, education, BMI, caloric intake | 65 |
1,340 | NHL | 0.97 (0.81–1.16) | 65 | |||||||
343 | DLBCL | 0.87 (0.61–1.25) | 65 | |||||||
257 | FL | 0.96 (0.63–1.46) | 65 | |||||||
56 | HL | 1.60 (0.72–3.54) | PA <1 time/wk | PA 3–4 times/wk | 65 | |||||
Lu et al., 2009 | ||||||||||
Women | North America | 121,216 | 124 | CLL/SLL | RPA, recent | 1.50 (0.86–2.63) | 0–0.50 h/wk/y strenuous PA plus MPA | ≥4 h/wk/y strenuous PA plus MPA | Age, height, weight at cohort entry, age at menarche long-term strenuous PA plus MPA | 61 |
574 | NHL | 1.11 (0.86–1.44) | 61 | |||||||
155 | DLBCL | 1.00 (0.62–1.62) | 61 | |||||||
121 | FL | 1.01 (0.57–1.79) | 61 | |||||||
Ma et al., 2010 | ||||||||||
Men and women combined | North America | 491,163 | 338 | Leukemia | RPA, recent | 1.09 (0.84–1.41) | <3 times/mo VPA | ≥3 times/wk VPA | Age, smoking status, total energy intake | 69 |
Paffenbarger et al., 1992 | ||||||||||
Men and women combined | North America | 56,683 | 86 | NHL | RPA, past | 0.67 (0.40–1.13) | <5 hours of VPA per week | ≥5 hours of VPA per week | Age | 57 |
52 | HL | 0.73 (0.38–1.39) | 57 | |||||||
81 | Leukemia | 0.84 (0.45–1.58) | 57 | |||||||
Pukkala et al., 2000 | ||||||||||
Men | Europe | 2,269 | 6 | NHL | OPA, past | 0.78 (0.29–1.70) | General population | Inclusion in athletic group | 5-year age groups | 57 |
3 | HL | 1.33 (0.27–3.88) | 57 | |||||||
5 | Leukemia | 0.51 (0.17–1.19) | 57 | |||||||
7 | MM | 1.39 (0.56–2.85) | 57 | |||||||
Soll-Johanning et al., 2004 | ||||||||||
Men | Europe | 14,568 | 44 | Leukemia | OPA, past | 1.08 (0.78–1.45) | Copenhagen population | Mail carrier | Age, calendar period | 45 |
Teras et al., 2012 | ||||||||||
Men | North America | 69,849 | 271 | CLL/SLL | RPA, recent | 0.95 (0.62–1.46) | ≤0 MET-h/wk | ≥17.5 MET-h/wk | Age at baseline, family history of hematopoietic cancer, education, smoking status, alcohol intake, BMI, height, sitting time | 65 |
1,139 | NHL | 1.02 (0.82–1.26) | 65 | |||||||
238 | DLBCL | 1.14 (0.70–1.88) | 65 | |||||||
143 | FL | 0.86 (0.49–1.51) | 65 | |||||||
211 | MM | 0.99 (0.60–1.64) | 65 | |||||||
Women | 77,001 | 211 | CLL/SLL | 0.73 (0.44–1.20) | 65 | |||||
863 | NHL | 0.69 (0.54–0.89) | 65 | |||||||
197 | DLBCL | 0.71 (0.44–1.16) | 65 | |||||||
137 | FL | 0.77 (0.41–1.43) | 65 | |||||||
132 | MM | 0.54 (0.28–1.04) | 65 | |||||||
van Veldhoven et al., 2011 | ||||||||||
Men | Europe | 127,353 | 373 | NHL | OPA, recent | 1.05 (0.46–2.41) | Sedentary activities | Manual/heavy manual activities | Age, center, hypertension, hyperlipidemia, education, diabetes | 67 |
NHL | RPA, recent | 1.11 (0.49–2.52) | <14.25 MET-h/wk | ≥45.75 MET-h/wk | 71 | |||||
45 | DLBCL | TPA, recent | 2.03 (0.38–10.79) | Inactive | Active | 75 | ||||
45 | FL | 2.82 (0.52–15.23) | 75 | |||||||
77 | MM | 0.34 (0.05–2.14) | 75 | |||||||
Women | 216,403 | 402 | NHL | RPA, recent | 1.25 (0.49–3.16) | <14.25 MET-h/wk | ≥45.75 MET-h/wk | 71 | ||
NHL | OPA, recent | 2.06 (0.65–6.51) | Sedentary activities | Manual/heavy manual activities | 67 | |||||
49 | DLBCL | TPA, recent | 5.03 (1.19–21.33) | Inactive | Active | 75 | ||||
49 | FL | 2.59 (0.54–12.38) | 75 | |||||||
88 | MM | 0.65 (0.14–3.16) | 75 | |||||||
Case–control studies (N = 8) | ||||||||||
Brownson et al., 1991 | ||||||||||
Men | North America | 17,147 | 462 | NHL | OPA, recent | 0.80 (0.60–1.30) | PA required <20% of the time | PA required >80% of the time | Age, smoking | 45 |
376 | Leukemia | 0.90 (0.60–1.40) | 45 | |||||||
Cerhan et al., 2005 | ||||||||||
Men and women combined | North America | 864 | 458 | NHL | RPA, recent | 0.83 (0.50–1.38) | <30 METs/wk | >1,080 METs/wk | Age, race, study center, alcohol use, height, BMI | 58 |
458 | NHL | OPA, recent | 0.98 (0.55–1.74) | Mostly sitting | Mostly exercise | 49 | ||||
Kasim et al., 2009 | ||||||||||
Men | North America | 2,032 | 390 | Leukemia | RPA, recent | 1.31 (0.93–1.85) | <5.9 MET-h/wk | ≥38.8 MET-h/wk | 10-year age group, BMI, educational years, total fruits and vegetables consumption, occupational exposure to benzene and ionizing radiation | 58 |
Women | 1,727 | 263 | Leukemia | 0.97 (0.66–1.42) | <5.6 MET-h/wk | ≥38.8 MET-h/wk | 58 | |||
Keegan et al., 2006 | ||||||||||
Women | North America | 441 | 187 | HL | RPA, recent | 0.56 (0.37–0.86) | Nonparticipation in ≥2 times/wk strenuous PA for ≥1 mo | ≥2 times/wk strenuous PA for ≥1 mo | Age, race/ethnicity, education, Jewish upbringing, having a single room at age 11 years, living in a single family home at age 8 years, living in a rented family home at age 8 years, having ever nursed children, number of miscarriages, smoking status 1 year before diagnosis/interview, history of first or second degree relative with lymphoma | 63 |
Kelly et al., 2012 | ||||||||||
Men | North America | 758 | 184 | CLL/SLL | RPA, recent | 1.71 (1.08–2.70) | <615 METs/wk | ≥2,701 METs/wk | Age, country of residence | 58 |
516 | NHL | 1.37 (0.98–1.92) | 58 | |||||||
88 | DLBCL | 1.19 (0.64–2.21) | 58 | |||||||
113 | FL | 0.96 (0.53–1.72) | 58 | |||||||
Women | 591 | 94 | CLL/SLL | 0.53 (0.27–1.06) | 58 | |||||
358 | NHL | 0.71 (0.47–1.07) | 58 | |||||||
79 | DLBCL | 0.80 (0.38–1.69) | 58 | |||||||
109 | FL | 0.90 (0.49–1.67) | 58 | |||||||
Pan et al., 2005 | ||||||||||
Men | North America | 2,211 | 569 | NHL | RPA, recent | 0.79 (0.59–1.05) | <6.4 MET-h/wk | ≥37.4 MET-h/wk | Age, province, education, smoking, alcohol drinking, exposure to certain chemicals, occupational exposure, BMI, total caloric intake, MPA | 67 |
Women | 1,925 | 461 | NHL | 0.59 (0.42–0.81) | <6.1 MET-h/wk | ≥31.4 MET-h/wk | 67 | |||
Parent et al., 2011 | ||||||||||
Men | North America | 748 | 215 | NHL | RPA, past | 1.17 (0.81–1.69) | Sports or outdoor activities <1 time/wk | Sports or outdoor activities ≥1 time/wk | Age, SES, educational level, ethnicity, respondent status, smoking, BMI, sports, outdoor activities | 75 |
54 | HL | 0.97 (0.45–2.08) | 75 | |||||||
215 | NHL | OPA, consistent | 0.56 (0.26–1.20) | ≤1.5 MET (at least 75% of work years in sedentary jobs) | ≥4 METs (at least 75% of work years was spent in very active jobs) | 66 | ||||
54 | HL | 0.84 (0.17–4.23) | 66 | |||||||
Zahm et al., 1999 | ||||||||||
Men | North America | 3,856 | 985 | NHL | OPA, recent | 1.00 (0.70–1.30) | Energy expenditure <8 kJ/min | Energy expenditure >12 kJ/min | Age, state of residence | 51 |
Women | 854 | 180 | NHL | 1.70 (0.20–11.50) | Energy expenditure <5 kJ/min | Energy expenditure >8 kJ/min | 51 |
Abbreviations: CLL/SLL, chronic lymphocytic lymphoma/small lymphocytic lymphoma; DLBCL, diffuse large B-cell lymphoma; FL, follicular lymphoma; HL, Hodgkin lymphoma; MM, multiple myeloma; MPA, moderate physical activity; NHL, non-Hodgkin lymphoma; OPA, occupational physical activity; PA, physical activity; QS, quality score; RPA, recreational physical activity; SES, socioeconomic status; TPA, total physical activity; VPA, vigorous physical activity.