Cardiorespiratory Fitness May Affect Prostate Cancer Outcomes

Men with higher levels of cardiorespiratory fitness (CRF) had higher rates of prostate cancer screening and incidence compared to those with lower CRF, according to a study. However, they had a lower risk of mortality following diagnosis, “suggesting that the cancers identified may be low‐risk with little impact on long‐term outcomes,” the researchers stated.

The study assessed data from the Henry Ford Exercise Testing Project, a retrospective cohort study comprised of men without cancer aged 40 to 70 years who, between 1995 and 2009, underwent physician‐referred exercise stress testing. CRF was measured per metabolic equivalents of task (METs), with the following groups established: <6 METs (reference), 6 to 9 METs, 10 to 11 METs, and ≥12 METs. The METs value was determined from the patient’s achieved peak work overload during a symptom limited, maximal exercise stress test.

Of 22,827 men included in the study, 739 developed prostate cancer; median follow-up was 7.5 years. Men in the highest category of METs were more likely than men in the lowest category of METs to undergo prostate-specific antigen (PSA) screening. When adjusting for PSA screening, fitness was correlated with higher prostate cancer incidence in men aged <55 years (P=0.02) and >55 years (P≤0.01), but it was not correlated with advanced prostate cancer. Men with prostate cancer with higher fitness had a 60% lower risk of all-cause mortality.

The study was published in Cancer.

Another study published in Cancer also used the Henry Ford Exercise Testing Project to evaluate the correlation between CRF and cancer, this time looking at lung and colorectal cancer outcomes. Between 1991 and 2009, 49,143 consecutive patients underwent clinician‐referred exercise stress testing. The same METs groups used in the present study were utilized in this one as well.

The mean age of this patient group was 54 ± 8 years, and about 46% of the cohort was female; median follow-up was 7.7 years. When adjusting for age, race, sex, body mass index, smoking history, and diabetes, patients in the highest METs category had a significantly reduced risk of lung cancer (hazard ratio [HR], 0.23; 95% confidence interval [CI], 0.14-0.36) as well as colorectal cancer (HR, 0.39; 95% CI, 0.23-0.66, with additional adjustment for aspirin and statin use). Even in patients who were diagnosed with lung or colorectal cancer, high fitness was associated with a lower risk of death, with HRs of 0.56 (95% CI, 0.32-1.00) and 0.11 (95% CI, 0.03-0.37), respectively.