The association of lifetime physical inactivity with head and neck cancer: a hospital-based case-control analysis

Eur Arch Otorhinolaryngol. 2017 Oct;274(10):3773-3780. doi: 10.1007/s00405-017-4688-3. Epub 2017 Aug 5.

Abstract

Despite mounting epidemiological evidence suggesting an inverse association between recreational physical activity and cancer risk, evidence associated with head and neck cancer is scant. We conducted a case-control analysis to examine the associations of lifetime physical inactivity with the risk of head and neck squamous cell carcinoma (HNSCC). We utilized data from the Patient Epidemiology Data System at Roswell Park Cancer Institute (RPCI). Participants included 246 patients with HNSCC and 504 cancer-free controls who received medical services at RPCI between 1990 and 1998. Participants were considered physically inactive if they did not participate in any regular, weekly recreational physical activity throughout their lifetime, prior to diagnosis. Multivariate logistic regression models were utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) representing the association between lifetime physical inactivity and HNSCC risk. We observed a significant positive association between recreational physical inactivity and HNSCC risk (OR = 2.73, 95% CI 1.87-3.99, p < 0.001). In subgroup analyses by body mass index (BMI) (underweight/normal-weight: OR = 3.40, 95% CI 1.89-6.12, p < 0.001; overweight/obese: OR = 2.40, 95% CI 1.43-4.02, p < 0.001) and smoking status (former smoker: OR = 3.12, 95% CI 1.89-5.14, p < 0.001; never smoker: OR = 2.71, 95% CI 1.21-6.05, p = 0.020; current smoker: OR = 1.61, 95% CI 0.66-3.95, p = 0.300), significant positive associations were also observed. Results of the current analyses suggest that lifetime physical inactivity associates with HNSCC independent of BMI. In addition, physical inactivity may be a modifiable risk factor among never smokers. These data add to the growing body of evidence suggesting that physical inactivity may be an independent risk factor for cancer.

Keywords: Cancer epidemiology; Head and neck cancer; Physical activity; Physical inactivity; Recreational physical activity.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Carcinoma, Squamous Cell* / epidemiology
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / physiopathology
  • Case-Control Studies
  • Exercise / physiology*
  • Female
  • Head and Neck Neoplasms* / epidemiology
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / physiopathology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Obesity* / diagnosis
  • Obesity* / epidemiology
  • Obesity* / physiopathology
  • Odds Ratio
  • Recreation / physiology
  • Risk Assessment
  • Risk Factors
  • Smoking / epidemiology
  • Squamous Cell Carcinoma of Head and Neck
  • Statistics as Topic
  • United States / epidemiology