Table 1.

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, genderStudy regionSubjectsCasesHematologic cancer subtypePA: domain, timing in lifeRR (95% CI), high vs. low PALow PA defined asHigh PA defined asAdjustment factors (excluding sex)QS (%)
Cohort studies (N = 15)
 Birmann et al., 2007
  MenNorth America46,96086MMRPA, consistent0.80 (0.50–1.50)<2 h/wk PA≥7 h/wk PAUpdated age, BMI73
  Women89,6631290.50 (0.20–1.40)73
 Blair et al., 2005
  WomenNorth America37,08395MMRPA, recent0.88 (0.51–1.49)Low PAHigh PA48
 Cerhan et al., 2002 WomenNorth America37,932252NHLRPA, past0.83 (0.59–1.11)Low PAHigh PAAge60
61Leukemia0.91 (0.45–1.67)60
 Hofmann et al., 2013
  MenNorth America291,471319MMRPA, recent1.10 (0.82–1.48)<16.25 MET-h/wk≥50 MET-h/wkAge (at baseline), race, age-specific BMI65
  Women193,578152MM1.43 (0.90–2.26)65
 Kabat et al., 2012
  WomenNorth America157,852285CLL/SLLRPA, recent1.03 (0.70–1.51)0 h/wk strenuous PA≥2 h/wk strenuous PAAge, smoking, servings of alcohol per week, education, ethnicity, BMI enrollment in the observational study, treatment arm assignment in the clinical trials82
1,071NHL0.97 (0.79–1.20)82
286DLBCL0.89 (0.59–1.36)82
205FL1.25 (0.81–1.94)82
 Kabat et al., 2013
  Men and women combinedNorth America493,188178LeukemiaTPA, recent0.70 (0.49–0.99)<1 time/wk VPA≥3 times/wk VPAAge, BMI, smoking intensity, years of education62
 Khan et al., 2006
  MenAsia46,15735MMRPA, recent0.44 (0.21–0.93)<30 min walking/d≥1 hour walking/dayAge64
  Women63,54131MM0.58 (0.26–1.27)64
 Lim et al., 2007
  Men and women combinedNorth America465,858234CLL/SLLTPA, recent0.80 (0.51–1.25)PA <1 time/wkPA ≥5 times/wkAge, race, education, BMI, caloric intake65
1,340NHL0.97 (0.81–1.16)65
343DLBCL0.87 (0.61–1.25)65
257FL0.96 (0.63–1.46)65
56HL1.60 (0.72–3.54)PA <1 time/wkPA 3–4 times/wk65
 Lu et al., 2009
  WomenNorth America121,216124CLL/SLLRPA, recent1.50 (0.86–2.63)0–0.50 h/wk/y strenuous PA plus MPA≥4 h/wk/y strenuous PA plus MPAAge, height, weight at cohort entry, age at menarche long-term strenuous PA plus MPA61
574NHL1.11 (0.86–1.44)61
155DLBCL1.00 (0.62–1.62)61
121FL1.01 (0.57–1.79)61
 Ma et al., 2010
  Men and women combinedNorth America491,163338LeukemiaRPA, recent1.09 (0.84–1.41)<3 times/mo VPA≥3 times/wk VPAAge, smoking status, total energy intake69
 Paffenbarger et al., 1992
  Men and women combinedNorth America56,68386NHLRPA, past0.67 (0.40–1.13)<5 hours of VPA per week≥5 hours of VPA per weekAge57
52HL0.73 (0.38–1.39)57
81Leukemia0.84 (0.45–1.58)57
 Pukkala et al., 2000
  MenEurope2,2696NHLOPA, past0.78 (0.29–1.70)General populationInclusion in athletic group5-year age groups57
3HL1.33 (0.27–3.88)57
5Leukemia0.51 (0.17–1.19)57
7MM1.39 (0.56–2.85)57
 Soll-Johanning et al., 2004
  MenEurope14,56844LeukemiaOPA, past1.08 (0.78–1.45)Copenhagen populationMail carrierAge, calendar period45
 Teras et al., 2012
  MenNorth America69,849271CLL/SLLRPA, recent0.95 (0.62–1.46)≤0 MET-h/wk≥17.5 MET-h/wkAge at baseline, family history of hematopoietic cancer, education, smoking status, alcohol intake, BMI, height, sitting time65
1,139NHL1.02 (0.82–1.26)65
238DLBCL1.14 (0.70–1.88)65
143FL0.86 (0.49–1.51)65
211MM0.99 (0.60–1.64)65
  Women77,001211CLL/SLL0.73 (0.44–1.20)65
863NHL0.69 (0.54–0.89)65
197DLBCL0.71 (0.44–1.16)65
137FL0.77 (0.41–1.43)65
132MM0.54 (0.28–1.04)65
 van Veldhoven et al., 2011
  MenEurope127,353373NHLOPA, recent1.05 (0.46–2.41)Sedentary activitiesManual/heavy manual activitiesAge, center, hypertension, hyperlipidemia, education, diabetes67
NHLRPA, recent1.11 (0.49–2.52)<14.25 MET-h/wk≥45.75 MET-h/wk71
45DLBCLTPA, recent2.03 (0.38–10.79)InactiveActive75
45FL2.82 (0.52–15.23)75
77MM0.34 (0.05–2.14)75
  Women216,403402NHLRPA, recent1.25 (0.49–3.16)<14.25 MET-h/wk≥45.75 MET-h/wk71
NHLOPA, recent2.06 (0.65–6.51)Sedentary activitiesManual/heavy manual activities67
49DLBCLTPA, recent5.03 (1.19–21.33)InactiveActive75
49FL2.59 (0.54–12.38)75
88MM0.65 (0.14–3.16)75
Case–control studies (N = 8)
 Brownson et al., 1991
  MenNorth America17,147462NHLOPA, recent0.80 (0.60–1.30)PA required <20% of the timePA required >80% of the timeAge, smoking45
376Leukemia0.90 (0.60–1.40)45
 Cerhan et al., 2005
  Men and women combinedNorth America864458NHLRPA, recent0.83 (0.50–1.38)<30 METs/wk>1,080 METs/wkAge, race, study center, alcohol use, height, BMI58
458NHLOPA, recent0.98 (0.55–1.74)Mostly sittingMostly exercise49
 Kasim et al., 2009
  MenNorth America2,032390LeukemiaRPA, recent1.31 (0.93–1.85)<5.9 MET-h/wk≥38.8 MET-h/wk10-year age group, BMI, educational years, total fruits and vegetables consumption, occupational exposure to benzene and ionizing radiation58
  Women1,727263Leukemia0.97 (0.66–1.42)<5.6 MET-h/wk≥38.8 MET-h/wk58
 Keegan et al., 2006
  WomenNorth America441187HLRPA, recent0.56 (0.37–0.86)Nonparticipation in ≥2 times/wk strenuous PA for ≥1 mo≥2 times/wk strenuous PA for ≥1 moAge, 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 lymphoma63
 Kelly et al., 2012
  MenNorth America758184CLL/SLLRPA, recent1.71 (1.08–2.70)<615 METs/wk≥2,701 METs/wkAge, country of residence58
516NHL1.37 (0.98–1.92)58
88DLBCL1.19 (0.64–2.21)58
113FL0.96 (0.53–1.72)58
  Women59194CLL/SLL0.53 (0.27–1.06)58
358NHL0.71 (0.47–1.07)58
79DLBCL0.80 (0.38–1.69)58
109FL0.90 (0.49–1.67)58
 Pan et al., 2005
  MenNorth America2,211569NHLRPA, recent0.79 (0.59–1.05)<6.4 MET-h/wk≥37.4 MET-h/wkAge, province, education, smoking, alcohol drinking, exposure to certain chemicals, occupational exposure, BMI, total caloric intake, MPA67
  Women1,925461NHL0.59 (0.42–0.81)<6.1 MET-h/wk≥31.4 MET-h/wk67
 Parent et al., 2011
  MenNorth America748215NHLRPA, past1.17 (0.81–1.69)Sports or outdoor activities <1 time/wkSports or outdoor activities ≥1 time/wkAge, SES, educational level, ethnicity, respondent status, smoking, BMI, sports, outdoor activities75
54HL0.97 (0.45–2.08)75
215NHLOPA, consistent0.56 (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
54HL0.84 (0.17–4.23)66
 Zahm et al., 1999
  MenNorth America3,856985NHLOPA, recent1.00 (0.70–1.30)Energy expenditure <8 kJ/minEnergy expenditure >12 kJ/minAge, state of residence51
  Women854180NHL1.70 (0.20–11.50)Energy expenditure <5 kJ/minEnergy expenditure >8 kJ/min51

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.