Does sedentary lifestyle increases the odds of prostate cancer in Pakistani men?
Abstract
Objective: To determine relationship between level of physical activity and the odds of prostate cancer among Pakistani men.
Background: Prostate cancer is the most commonly diagnosed malignancy among men in Europe and North America, however its incidence in increasing in Asia and Africa. Age adjusted incidence rate in Pakistan is though comparatively low (5.3 per 100,000), but in recent years, more cases are being reported by oncology units of most teaching hospitals in major cities in Pakistan. Although increasing age, genetic factors and race have been established as the main predictors, however influence of environmental issues and lifestyle has found to be strongly related to prostate cancer risk in developed countries. Data on prostate cancer risk among Pakistani men in relation to the level of their physical activities are scarce.
Methods: In this case control study, 195 histologically confirmed cases of adenocarcinoma of prostate were recruited from Shaukat Khanum Memorial Cancer Hospital and Institute of Nuclear Medicine and Oncology Lahore. Total of 390 Controls were randomly selected from four major teaching hospitals in Lahore and Peshawar. Data was collected using a pre-tested interview form. Odds ratio was used as the measure of strength of association computed using unconditional logistic regression.
Results: Based on an index computed using weighted scores allocated to leisure time exercise, activities at work place and household activities, only 08 (4.1%) cases and 89(22.8%) controls were classified as being highly active, where as 81(41.5%) cases and 167(42.8%) controls were categorized as moderately active. Difference was significant statistically [?2= 37.68 at 1 df; p<0.001] indicating a strong relationship between level of physical activity and the risk of prostate cancer. Unadjusted odds ratio comparing the odds that cases had moderate activity with controls [OR 0.61; 95% CI. 0.42-0.88] showed a significant association (p=0.009). When adjusted this estimates against age, ethnicity, socio-economic status, smoking status and dietary patterns, the observed relationship persists [OR 0.28; 95% CI.0.11-0.72; p=0.008]. As regards highly active cases versus controls, the adjusted odds ratio was 0.05 [95% CI.0.01-0.26; p=0.001] indicative of protective effect of increased physical activity level against prostate cancer risk.
Conclusion: Pakistani men with sedentary lifestyle have higher odds of prostate cancer comparatively after adjustment of socioeconomic status, height, red meat consumption and smoking status.
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