University of Vermont

College of Medicine

Lakoski JAMA Oncology Study Links Mid-life Fitness with Cancer Incidence and Survival

Susan Lakoski, M.D.
Susan Lakoski, M.D. (Photo by: COM Design & Photography)

A study by University of Vermont Cancer Center researcher and clinician Susan Lakoski, M.D., and colleagues has found that higher levels of mid-life fitness provide a mortality benefit in older age even in the setting of a cancer diagnosis. Their findings appear in the March 26, 2015 edition of JAMA Oncology.

CRF has been shown to be an independent predictor of numerous chronic diseases, but has, thus far, received little attention as a predictor of cancer or survival of cancer. Lakoski’s study examines mid-life, cardiorespiratory fitness (CRF) and subsequent survival rates from prostate, lung, or colorectal cancers in men after age 65. She and the research team examined CRF data and health outcomes over time for a group of roughly 14,000 men, and found a strong inverse relationship between mid-life CRF and incidence of lung and colorectal cancer, but not prostate cancer. They also found an overall 32 percent risk reduction in all cancer-related deaths among men with high mid-life CRF who later developed lung, colorectal, or prostate cancers as compared to those with low CRF. In addition, researchers found that for those men who did develop cancer after age 65 but had high mid-life CRF, there was a 68 percent reduction in cardiovascular death as compared to men with low CRF.

Prediction of cause-specific mortality after a cancer diagnosis is becoming increasingly important, say researchers. Individuals diagnosed with certain forms of cancer now have sufficient survival to be at risk for non-cancer competing causes of mortality, primarily cardiovascular disease (CVD), due to the chronic and late-effects of cancer treatment. Given that cancer and CVD account for the majority of deaths in the U.S., and that cancer incidence is projected to increase by approximately 45 percent over the next two decades (largely due to an aging population), these findings have significant public health implications.

“The predictive value of CRF on cancer incidence, as well mortality associated with cancer survival, will provide medical professionals with a quantitative and modifiable risk factor,” says Lakoski, who is assistant professor of medicine and director of the Cardiovascular Prevention Program for Cancer Patients at UVM and the UVM Medical Center. CRF is highly reproducible and objectively assessed, her study cites, and is a more “potent marker” of mortality than physical activity, which is largely gathered through self-reported surveys.

Based on this and prior studies, Lakoski and colleagues contend that CRF should also be utilized more frequently in the cancer prevention setting and anticipate future research in the area of CRF and cancer prevention.

Please contact Sarah Keblin (contact information listed above), for advanced copies of the study. Please honor the embargo, which expires at 11 AM on Thursday, March 26, 2015.