Slide 1What is Lung Cancer?Lung Cancer MortalityLung Cancer IncidenceLung Cancer Incidence by Age and SexLung Cancer Risk FactorsSlide 7WHI continuedSlide 9PA and symptoms of lung cancer study continuedPA, WBC count, and Lung Cancer Sprague, B., et al. 2008PA, WBC count, and Lung Cancer continuedSlide 13Slide 14Relation between inflammatory markers and lung cancerLimitations of studiesReferencesThe Effects of Physical Activity on Lung CancerStudent1What is Lung Cancer?•Lung cancer- uncontrolled division of abnormal cells in one or both lungs, resulting in the formation and growth of a tumor•Three Types:1. Small cell lung cancer (SCLC)•10-15% of lung cancer is SCLC•Fast growing, spreads in early stages•Usually starts in the center of the chest in the bronchi2. Non-small cell lung cancer (NSCLC)•About 85% of lung cancer is NSCLC•Growth and spread rate varies based on the subtype•Adenocarcinoma, squamous cell carcinoma, and large cell carcinoma3. Lung Carcinoid Tumor•Fewer than 5% of lung cancer•Grows slowly, rarely spreads2Lung Cancer Mortality•Lung cancer is the leading cause of cancer death among both men and women•About 1 out of 4 cancer deaths are from lung cancer•The American Cancer Society estimates about 155,870 deaths from lung cancer in the US in 2017 (84,590 men and 71,280 women)•Lung cancer occurs mainly in older people•2 out of 3 people diagnosed with lung cancer are 65 years or older •Average age at diagnosis is 70 years old•Less than 2% of people diagnosed are under 45 years old•Mortality is highest from age 70-80 years old3Lung Cancer Incidence4Lung Cancer Incidence by Age and Sex5Lung Cancer Risk FactorsModifiable:•Smoking- the leading risk factor for developing lung cancer•According to the American Heart Association, 80% of all lung cancer deaths result due to smoking•Even secondhand smoke is thought to cause more than 7,000 deaths from lung cancer each yearNon-modifiable:•Age- the risk for developing lung cancer significantly increases with age, specifically age 45 and older•Sex- Men are at a slightly higher risk than women for developing and dying from lung cancer across all age groups6PA and sedentary behavior in relation to lung cancer: The Women’s Health Initiative (WHI) Wang, A., et al. 2016•Two parts: WHI- Observational Study and WHI- Clinical Trial prospective cohort of postmenopausal women participated in randomized, controlled clinical trials•129,401 postmenopausal women aged 50-79 years between 1993 and 1998 at 40 US clinical centers with life expectancy of at least 3 years•Average of 11.8 years of follow-up•Cox proportional hazard models used to assess relationship of baseline PA and sedentary behavior with lung cancer incidence and mortality•PA levels measured using MET-min/week and classified into groups of none (reference: <100 MET-min/week), low (100 to <500), medium (500 to <1,200), and high (>1,200) •Measurements and classifications made through self-reported questionnaires•Cancer incidence made by doctor diagnosis7WHI continued•Over the 11.8 years of follow-up, the WHI-OS and WHI-CT cohort reported 2,148 cases of lung cancer and 1,365 cases of lung cancer death•The incidence and mortality was classified per PA group as follows:•No PA: 581 cases (27.0%) AND 412 deaths (30.2%)•Low PA: 588 cases (27.4%) AND 382 deaths (28.0%)•Med PA: 535 cases (24.9%) AND 308 deaths (22.6%)•High PA: 444 cases (20.7%) AND 263 deaths (19.3%)•The study shows a correlation between higher PA level at baseline and lower lung cancer incidence and mortality•Increased PA after baseline was associated with lower mortality from NSCLC8Effects of PA on the symptoms of lung cancer survivors Lin, YY., Rau, KM., & Lin CC. 2015•6 month long longitudinal study •Collected data from lung cancer survivors treated medical centers in Taiwan•185 patients started the study and 143 patients made it through to the final assessment•All patients were over the age of 18 with an average age of 64 years and were at various stages of lung cancer treatment•Included baseline measurement and two follow-ups at intervals of 3 months using prospective self-reported questionnaires•Measurements of PA levels and various cancer symptoms such as fatigue and disturbed sleep were taken using the Godin Leisure-Time Exercise Questionnaire and Taiwanese version of the M.D. Anderson Symptom Inventory9PA and symptoms of lung cancer study continued•Significant difference in symptom severity between the moderate PA participants compared with those who did little to no PA regarding fatigue, drowsiness, and disturbed sleep•Used a generalized estimating equation (GEE) method to examine the association of PA intensity with symptom severity and symptom interference in daily life•Results of the GEE suggest that PA is vital in alleviating physical and psychological symptoms of lung cancer survivors 10PA, WBC count, and Lung CancerSprague, B., et al. 2008•Participants were selected from a private census of population in Beaver Dam, WI from September 1987 to May 1988•43 to 84 years old at time of census•4,926 participants, cohort of both sexes (2,166 men and 2,760 women)•Prospective assessment about participants (smoking, health history, PA, etc.) was gathered though self-reported questionnaires•Kilocalories per week was calculated using the measure of duration and intensity of PA such as number of blocks walked, stairs climbing, and other activities that worked up a sweat•Laboratory analyses were performed on venous blood samples collected at baseline11PA, WBC count, and Lung Cancer continued•134 cases of lung cancer diagnosed out of the 4,831 participants without history of lung cancer who survived at least 1 year after baseline•Average time between baseline a diagnosis was 8 years•Higher levels of PA at baseline were inversely related to lung cancer incidence•Reductions in risk with increasing PA index scores in both current and former/never smokers, but stronger with current12Lung cancer cumulative incidence according to total physical activity index13Lung cancer cumulative incidence according to total physical activity index•The x-axis depicts the time in years of the prospective study•The y-axis displays the cumulative incidence of lung cancer over the course of the study•The legend clarifies the identity of each line:•lower PA index (kcal/week)•medium PA (kcal/week)•high PA