Background Non-exercise estimated cardiorespiratory fitness(NEE-CRF)has been shown to be associated with mortality,although its association with cancer incidence is unknown.The study aimed to assess the prospective as...Background Non-exercise estimated cardiorespiratory fitness(NEE-CRF)has been shown to be associated with mortality,although its association with cancer incidence is unknown.The study aimed to assess the prospective association between NEE-CRF and cancer incidence in a large cohort of men and women.Methods The National Institutes of Health-American Association of Retired Persons diet and health study is a prospective cohort that included 402,548 participants aged 50–71 years who were free from cancer at baseline(1995–1996)(men(n=238,835)and women(n=163,713))and were followed until December 31,2015.The exposure variable was NEE-CRF expressed in metabolic equivalents.NEE-CRF was estimated using a validated equation of self-reported predictors on demographics and lifestyle behaviors derived from baseline questionnaires.Primary outcomes were total cancer incidence and incidence of prostate,breast,lung,and colorectal cancers.Cox proportional hazards models were analyzed for the association between NEE-CRF and cancer incidence outcomes adjusted for established cancer risk factors.Results During 13.7±3.2 years of follow-up(mean±SD),64,344 men and 31,315 women developed a new cancer.For every 1-metabolic equivalent higher NEE-CRF,the hazard ratios and 95%confidence intervals(95%CIs)were 0.96(95%CI:0.94–0.97)and 0.88(95%CI:0.84–0.92)of total and colorectal cancer incidence among men,and 0.95(95%CI:0.93–0.97)and 0.94(95%CI:0.91–0.97)of total and breast cancer incidence among women,respectively(all p<0.001).NEE-CRF was not associated with incidence of prostate and lung cancers in men or colorectal and lung cancers in women.Conclusion These results suggest that higher CRF levels,as assessed by the applied non-exercise estimated method,may provide preventive benefits against the development of cancer,while low CRF could potentially serve as a modifiable cancer risk factor.Integrating NEE-CRF into screening paradigms and referring low-fit individuals to improve CRF could complement the public health prevention strategy against cancer.展开更多
AIM To identify the clinicopathological characteristics of pT1 N0 esophageal squamous cell carcinoma(ESCC) that are associated with tumor recurrence. METHODS We reviewed 216 pT1 N0 thoracic ESCC cases who underwent es...AIM To identify the clinicopathological characteristics of pT1 N0 esophageal squamous cell carcinoma(ESCC) that are associated with tumor recurrence. METHODS We reviewed 216 pT1 N0 thoracic ESCC cases who underwent esophagectomy and thoracoabdominal two-field lymphadenectomy without preoperative chemoradiotherapy. After excluding those cases with clinical follow-up recorded fewer than 3 mo and those who died within 3 mo of surgery, we included 199 cases in the current analysis. Overall survival and recurrencefree survival were assessed by the Kaplan-Meier method, and clinicopathological characteristics associated with any recurrence or distant recurrence were evaluated using univariate and multivariate Cox proportional hazards models. Early recurrence(≤ 24 mo) and correlated parameters were assessed using univariate and multivariate logistic regression models.RESULTS Forty-seven(24%) patients had a recurrence at 3 to 178(median, 33) mo. The 5-year recurrence-free survival rate was 80.7%. None of 13 asymptomatic cases had a recurrence. Preoperative clinical symptoms, upper thoracic location, ulcerative or intraluminal mass macroscopic tumor type, tumor invasion depth level, basaloid histology, angiolymphatic invasion, tumor thickness, submucosal invasion thickness, diameter of the largest single tongue of invasion, and complete negative aberrant p53 expression were significantly related to tumor recurrence and/or recurrence-free survival. Upper thoracic tumor location, angiolymphatic invasion, and submucosal invasion thickness were independent predictors of tumor recurrence(Hazard ratios = 3.26, 3.42, and 2.06, P < 0.001, P < 0.001, and P = 0.002, respectively), and a nomogram for predicting recurrence-free survival with these three predictors was constructed. Upper thoracic tumor location and angiolymphatic invasion were independent predictors of distant recurrence. Upper thoracic tumor location, angiolymphatic invasion, submucosal invasion thickness, and diameter of the largest single tongue of invasion were independent predictors of early recurrence.CONCLUSION These results should be useful for designing optimal individual follow-up and therapy for patients with T1 N0 ESCC.展开更多
Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific...Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial(NIT)cohort.Methods:Body weight of 21,028 healthy residents of Linxian,Henan province,aged 40-69 years was measured two times from 1986 to 1991.Outcome events were prospectively collected up to 2016.Weight maintenance group(weight change<2 kg)or stable normal weight group was treated as the reference.Cox proportional hazard model was performed to calculate hazard ratios(HRs)and 95%confidence intervals(95%CIs)to estimate the risk of mortality.Results:A total of 21,028 subjects were included in the final analysis.Compared with the weight maintenance group,subjects with weight loss≥2 kg had an increased risk of death from all-cause(HR_(All-cause)=1.14,95%CI:1.09-1.19,P<0.001),cancer(HR_(Cancer)=1.12,95%CI:1.03-1.21,P=0.009),and heart disease(HR_(Heart diseases)=1.21,95%CI:1.11-1.31,P<0.001),whereas subjects with weight gain≥5 kg had 11%(HR_(Cancer)=0.89,95%CI:0.79-0.99,P=0.033)lower risk of cancer mortality and 23%higher risk of stroke mortality(HR_(Stroke)=1.23,95%CI:1.12-1.34,P<0.001).For the change of weight status,both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death(HR_(Overweight to normal)=1.18,95%CI:1.09-1.27;HR_(Becoming underweight)=1.35,95%CI:1.25-1.46)and cancer death(HR_(Overweight to normal)=1.20,95%CI:1.04-1.39;HR_(Becoming underweight)=1.44,95%CI:1.24-1.67),while stable overweight could increase the risk of total death(HR_(Stable overweight)=1.11,95%CI:1.05-1.17)and death from stroke(HR_(Stable overweight)=1.44,95%CI:1.33-1.56).Interaction effects were observed between age and weight change on cancer mortality,as well as between baseline BMI and weight change on all-cause,heart disease,and stroke mortality(all P_(interaction)<0.01).Conclusions:Weight loss was associated with an increased risk of all-cause,cancer,and heart disease mortality,whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality.Efforts of weight management should be taken to improve health status.Trial registration:https://classic.clinicaltrials.gov/,NCT00342654.展开更多
Gastric cancer is the third leading cause of cancer death,with a to-tal of over 1 million new cases each year,1 with the largest fraction of cases occurring in Asia.Within China,the overall gastric cancer rate is esti...Gastric cancer is the third leading cause of cancer death,with a to-tal of over 1 million new cases each year,1 with the largest fraction of cases occurring in Asia.Within China,the overall gastric cancer rate is estimated to be 19×105,with rates higher in rural(22×10^(5))versus ur-ban areas(16×10^(5))^(2) and this represents about half the global burden.Although global gastric cancer rates are decreasing,countries with high rates have growing elderly populations,so the number of gastric cancer cases is forecast to continue increasing.展开更多
Dear Editor,Prostate cancer is the second most common cancer among men worldwide and leading cancer in incidence among men in the United States(US).In 2018,the US had over 190,000 new prostate cancer cases,accounting ...Dear Editor,Prostate cancer is the second most common cancer among men worldwide and leading cancer in incidence among men in the United States(US).In 2018,the US had over 190,000 new prostate cancer cases,accounting for almost 1 in 5 new male cancer diagnoses[1].A recent review of dietary factors in relation to prostate cancer risk did not find evidence regarding nut consumption as neither a risk nor protective factor,though it has been hypothesized to be associated with a decreased cancer risk through multi-ple mechanisms[2].展开更多
基金supported (in part) by the Intramural Research Program of the NIH,National Cancer Institute
文摘Background Non-exercise estimated cardiorespiratory fitness(NEE-CRF)has been shown to be associated with mortality,although its association with cancer incidence is unknown.The study aimed to assess the prospective association between NEE-CRF and cancer incidence in a large cohort of men and women.Methods The National Institutes of Health-American Association of Retired Persons diet and health study is a prospective cohort that included 402,548 participants aged 50–71 years who were free from cancer at baseline(1995–1996)(men(n=238,835)and women(n=163,713))and were followed until December 31,2015.The exposure variable was NEE-CRF expressed in metabolic equivalents.NEE-CRF was estimated using a validated equation of self-reported predictors on demographics and lifestyle behaviors derived from baseline questionnaires.Primary outcomes were total cancer incidence and incidence of prostate,breast,lung,and colorectal cancers.Cox proportional hazards models were analyzed for the association between NEE-CRF and cancer incidence outcomes adjusted for established cancer risk factors.Results During 13.7±3.2 years of follow-up(mean±SD),64,344 men and 31,315 women developed a new cancer.For every 1-metabolic equivalent higher NEE-CRF,the hazard ratios and 95%confidence intervals(95%CIs)were 0.96(95%CI:0.94–0.97)and 0.88(95%CI:0.84–0.92)of total and colorectal cancer incidence among men,and 0.95(95%CI:0.93–0.97)and 0.94(95%CI:0.91–0.97)of total and breast cancer incidence among women,respectively(all p<0.001).NEE-CRF was not associated with incidence of prostate and lung cancers in men or colorectal and lung cancers in women.Conclusion These results suggest that higher CRF levels,as assessed by the applied non-exercise estimated method,may provide preventive benefits against the development of cancer,while low CRF could potentially serve as a modifiable cancer risk factor.Integrating NEE-CRF into screening paradigms and referring low-fit individuals to improve CRF could complement the public health prevention strategy against cancer.
基金the National Natural Science Foundation of China,No.81402463CAMS Innovation Fund for Medical Sciences(CIFMS),No.2016-I2M-1-001 and No.2016-I2M-3-005the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences,No.2016ZX310178 and No.2017PT32001
文摘AIM To identify the clinicopathological characteristics of pT1 N0 esophageal squamous cell carcinoma(ESCC) that are associated with tumor recurrence. METHODS We reviewed 216 pT1 N0 thoracic ESCC cases who underwent esophagectomy and thoracoabdominal two-field lymphadenectomy without preoperative chemoradiotherapy. After excluding those cases with clinical follow-up recorded fewer than 3 mo and those who died within 3 mo of surgery, we included 199 cases in the current analysis. Overall survival and recurrencefree survival were assessed by the Kaplan-Meier method, and clinicopathological characteristics associated with any recurrence or distant recurrence were evaluated using univariate and multivariate Cox proportional hazards models. Early recurrence(≤ 24 mo) and correlated parameters were assessed using univariate and multivariate logistic regression models.RESULTS Forty-seven(24%) patients had a recurrence at 3 to 178(median, 33) mo. The 5-year recurrence-free survival rate was 80.7%. None of 13 asymptomatic cases had a recurrence. Preoperative clinical symptoms, upper thoracic location, ulcerative or intraluminal mass macroscopic tumor type, tumor invasion depth level, basaloid histology, angiolymphatic invasion, tumor thickness, submucosal invasion thickness, diameter of the largest single tongue of invasion, and complete negative aberrant p53 expression were significantly related to tumor recurrence and/or recurrence-free survival. Upper thoracic tumor location, angiolymphatic invasion, and submucosal invasion thickness were independent predictors of tumor recurrence(Hazard ratios = 3.26, 3.42, and 2.06, P < 0.001, P < 0.001, and P = 0.002, respectively), and a nomogram for predicting recurrence-free survival with these three predictors was constructed. Upper thoracic tumor location and angiolymphatic invasion were independent predictors of distant recurrence. Upper thoracic tumor location, angiolymphatic invasion, submucosal invasion thickness, and diameter of the largest single tongue of invasion were independent predictors of early recurrence.CONCLUSION These results should be useful for designing optimal individual follow-up and therapy for patients with T1 N0 ESCC.
基金National Cancer Institute contract(No.75N91022C00059)
文摘Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial(NIT)cohort.Methods:Body weight of 21,028 healthy residents of Linxian,Henan province,aged 40-69 years was measured two times from 1986 to 1991.Outcome events were prospectively collected up to 2016.Weight maintenance group(weight change<2 kg)or stable normal weight group was treated as the reference.Cox proportional hazard model was performed to calculate hazard ratios(HRs)and 95%confidence intervals(95%CIs)to estimate the risk of mortality.Results:A total of 21,028 subjects were included in the final analysis.Compared with the weight maintenance group,subjects with weight loss≥2 kg had an increased risk of death from all-cause(HR_(All-cause)=1.14,95%CI:1.09-1.19,P<0.001),cancer(HR_(Cancer)=1.12,95%CI:1.03-1.21,P=0.009),and heart disease(HR_(Heart diseases)=1.21,95%CI:1.11-1.31,P<0.001),whereas subjects with weight gain≥5 kg had 11%(HR_(Cancer)=0.89,95%CI:0.79-0.99,P=0.033)lower risk of cancer mortality and 23%higher risk of stroke mortality(HR_(Stroke)=1.23,95%CI:1.12-1.34,P<0.001).For the change of weight status,both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death(HR_(Overweight to normal)=1.18,95%CI:1.09-1.27;HR_(Becoming underweight)=1.35,95%CI:1.25-1.46)and cancer death(HR_(Overweight to normal)=1.20,95%CI:1.04-1.39;HR_(Becoming underweight)=1.44,95%CI:1.24-1.67),while stable overweight could increase the risk of total death(HR_(Stable overweight)=1.11,95%CI:1.05-1.17)and death from stroke(HR_(Stable overweight)=1.44,95%CI:1.33-1.56).Interaction effects were observed between age and weight change on cancer mortality,as well as between baseline BMI and weight change on all-cause,heart disease,and stroke mortality(all P_(interaction)<0.01).Conclusions:Weight loss was associated with an increased risk of all-cause,cancer,and heart disease mortality,whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality.Efforts of weight management should be taken to improve health status.Trial registration:https://classic.clinicaltrials.gov/,NCT00342654.
文摘Gastric cancer is the third leading cause of cancer death,with a to-tal of over 1 million new cases each year,1 with the largest fraction of cases occurring in Asia.Within China,the overall gastric cancer rate is estimated to be 19×105,with rates higher in rural(22×10^(5))versus ur-ban areas(16×10^(5))^(2) and this represents about half the global burden.Although global gastric cancer rates are decreasing,countries with high rates have growing elderly populations,so the number of gastric cancer cases is forecast to continue increasing.
基金supported in part by the Intramural Research Program of the US National Institutes of Health,National Cancer Institute.
文摘Dear Editor,Prostate cancer is the second most common cancer among men worldwide and leading cancer in incidence among men in the United States(US).In 2018,the US had over 190,000 new prostate cancer cases,accounting for almost 1 in 5 new male cancer diagnoses[1].A recent review of dietary factors in relation to prostate cancer risk did not find evidence regarding nut consumption as neither a risk nor protective factor,though it has been hypothesized to be associated with a decreased cancer risk through multi-ple mechanisms[2].
