Maximal oxygen consumption may be useful as a predictor of cancer and mortality risk

1. In a Swedish cohort, lower cardiorespiratory fitness (CRF) as measured by maximal oxygen consumption (Vo2max) was found to be associated with a greater incidence of colon, lung, and prostate cancer in a 9.6 year period.

2. In patients diagnosed with cancer, greater CRF was additionally found to be associated with lower mortality risk, though the strength of this correlation was affected by factors such as underlying cancer diagnosis and demographic factors.

Evidence Rating: 2 (Good) 

Although cardiorespiratory fitness (CRF) levels is a recognized and important risk factor for cancer incidence and death, the true quantitative effects are often poorly generalized. Using maximal oxygen consumption (Vo2max) as millimeters per minute per kilogram) as a measure for CRF, data retrieved from the health profile assessment database for 177,709 Swedish men (age range, 18-75 years; mean [SD] age, 42 [11] years; mean [SD] body mass index, 26 [3.8]) were analyzed to further address this gap in literature. CRF was stratified as a continuous variable into 4 groups (very low (≤25 mL/min/kg), low (>25-35 mL/min/kg), moderate (>35-45 mL/min/kg), and high CRF (>45 mL/min/kg)). At a mean follow-up of 9.6 years, 2700 cases of either colon, lung, or prostate cancer had occurred, and of those cases, 500 had resulted in death. Patients who had developed cancer in this time period had a lower mean estimated Vo2max than those without cancer (P < .001 for colon cancer, P = .01 for lung cancer, and P < .001 for prostate cancer). Patients who died of cancers also had a lower mean CRF. Higher estimated Vo2max was associated with significantly lower risk of colon and lung cancer incidence, but with increased risk for prostate cancer incidence. There was a significant association between higher Vo2max and decreased risk for colon, lung, and prostate cancer-related deaths. When adjusting for lifestyle habits, colon cancer incidence and prostate cancer mortality remained significantly reduced in those with moderate or high CRF. For lung cancer, there was significantly decreased incidence and mortality for low, medium, and high CRF groups compared to the very low CRF group. Age did modify the associations, with decreased risk with higher CRF for lung cancer incidence and death evident only in men ≥ 60 years. Overall, although this study presents some promising evidence for CRF as a potential protective factor against certain cancers, limitations include a potentially homogenous population (voluntary participation and inclusion of only those who are employed) and lack of generalizability to other types of cancers. 

Click to read the study in JAMA Network Open

Image: PD

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