To investigate the association between active commuting and incident cardiovascular disease (CVD), cancer, and all cause mortality. Prospective population based study. UK Biobank. 263 450 participants (106 674 (52%) women; mean age 52.6), recruited from 22 sites across the UK. The exposure variable was the mode of transport used (walking, cycling, mixed modenon-active (car or public transport)) to commute to and from work on a typical day. Incident (fatal and non-fatal) CVD and cancer, and deaths from CVD, cancer, or any causes. 2430 participants died (496 were related to CVD and 1126 to cancer) over a median of 5.0 years (interquartile range 4.3-5.5) follow-up. There were 3748 cancer and 1110 CVD events. In maximally adjusted models, commuting by cycle and by mixed mode including cycling were associated with lower risk of all cause mortality (cycling hazard ratio 0.59, 95% confidence interval 0.42 to 0.83, P=0.002; mixed mode cycling 0.76, 0.58 to 1.00, P<0.05), cancer incidence (cycling 0.55, 0.44 to 0.69, P<0.001; mixed mode cycling 0.64, 0.45 to 0.91, P=0.01), and cancer mortality (cycling 0.60, 0.40 to 0.90, P=0.01; mixed mode cycling 0.68, 0.57 to 0.81, P<0.001). Commuting by cycling and walking were associated with a lower risk of CVD incidence (cycling 0.54, 0.33 to 0.88, P=0.01; walking 0.73, 0.54 to 0.99, P=0.04) and CVD mortality (cycling 0.48, 0.25 to 0.92, P=0.03; walking 0.64, 0.45 to 0.91, P=0.01). No statistically significant associations were observed for walking commuting and all cause mortality or cancer outcomes. Mixed mode commuting including walking was not noticeably associated with any of the measured outcomes. Cycle commuting was associated with a lower risk of CVD, cancer, and all cause mortality. Walking commuting was associated with a lower risk of CVD independent of major measured confounding factors. Initiatives to encourage and support active commuting could reduce risk of death and the burden ofimportant chronic conditions.

OBJECTIVE:To investigate the association between physical activity (PA) and risk of mortality in a large middle-aged cohort stratified by inflammatory status.

PATIENTS AND METHODS:A total of 336,560 individuals (mean age, 39.7 years; 58% male) who underwent comprehensive health screenings were enrolled in this prospective cohort study. They were grouped according to self-reported PA level using a questionnaire: no regular PA with a sedentary lifestyle, regular but insufficient PA (below the guidelines), sufficient PA (concordant with the guidelines), and health-enhancing PA. Inflammation was assessed via high-sensitivity C-reactive protein (hsCRP) level. Study end points were all-cause, cardiovascular-related, and cancer-related mortality.

RESULTS:During the 1,976,882 person-years of follow-up (median follow-up duration, 6.17 years), 2062 deaths occurred. Compared with a sedentary lifestyle, the hazard ratios (95% CIs) on the multivariable Cox proportional hazards regression analyses for all-cause mortality by PA level were 0.95 (0.84-1.07), 0.85 (0.72-0.99), and 0.75 (0.60-0.93) (P for trend=.003), and those for cardiovascular- and cancer-related mortality were 0.95, 0.80, and 0.55 (P for trend=.05) and 0.82, 0.83, and 0.78 (P for trend=.01), respectively. Compared with participants with low hsCRP levels and any regular PA, those with high hsCRP levels and no regular PA had a significantly higher risk of mortality (1.59 [1.38-1.84]).

CONCLUSION:Higher PA levels were associated with a dose-dependent reduced risk of cardiovascular-related, cancer-related, and all-cause mortality. Individuals with high hsCRP levels and no regular PA had the highest risk of mortality.

PURPOSE:The Exercise for Health trials were randomised, controlled trials designed to evaluate an 8-month pragmatic exercise intervention, commencing 6 weeks post-surgery for women with newly diagnosed breast cancer residing in urban or rural/regional Australia. For these exploratory analyses, the primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively.

METHODS:Consenting urban- (n = 194) and rural/regional-residing women (n = 143) were randomised to exercise (intervention delivered face-to-face or by telephone) or usual care. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for survival outcomes (exercise group,n = 207, 65% urban women; usual care group, n = 130, 46% urban women).

RESULTS:After a median follow-up of 8.3 years, there were 11 (5.3%) deaths in the exercise group compared with 15 (11.5%) deaths in the usual care group (OS HR for the exercise group: 0.45, 95% CI 0.20-0.96; p = 0.04). DFS events for the exercise versus usual care group were 25 (12.1%) and 23 (17.7%), respectively (HR: 0.66, 95% CI 0.38-1.17; p = 0.16). HRs for OS favoured exercise irrespective of age, body mass index, stage of disease, intervention compliance, and physical activity levels at 12 months post-diagnosis, although were stronger (p < 0.05) for younger women, women with stage II + disease, women with 1 + comorbidity at time of diagnosis, higher intervention compliance and for those who met national physical activity guidelines at 12 months post-diagnosis.

CONCLUSION:An exercise intervention delivered during and beyond treatment for breast cancer, and that was designed to cater for all women irrespective of place of residence and access to health services, has clear potential to benefit survival. Trial numbers: ACT RN: 012606000233527; ACT RN: 12609000809235.

OBJECTIVE:To compare the effects of integrated Chinese-Western therapy versus Western therapy alone on the survival rate of patients with non-small-cell lung cancer (NSCLC) at middle-late stage and to evaluate prognostic factors.

METHODS:We selected 98 inpatients with middle-late stage NSCLC diagnosed from March 2009 to March 2011 and randomly divided them into two groups, with 49 cases in each group, and the clinical data were analyzed retrospectively. The control group was treated by the combined methods of Western Medicine, including chemotherapy, supportive treatment and symptomatic treatment. The observation group was treated by injection and prescriptions of Chinese medicine based on Traditional Chinese Medicine syndrome differentiation and by the same combined methods of western treatment used in the control group. After treatment, the survival rates of the patients were compared by the stage of cancer and evaluation of 24 prognostic factors analyzed by a Cox regression model, and the clinical data were statistically analyzed.

RESULTS:The survival rates of all patients were over 90.0% at 1 and 3 months after treatment with no significant differences between the two groups (P>0.05); In the observation group the survival rates at 6 months and 1 year were 93.4% and 42.8%, respectively, being superior to 85.6% and 18.3% in the control group (P<0.05). The median survival time in the observation group was superior to the control group (P<0.05); The effects of 24 prognostic factors were significantly better in the observation group than in the control group (P<0.05).

CONCLUSION:Integrated Chinese-western therapy can significantly improve the survival rate in patients with middle-late stage NSCLC and improve prognostic factors compared with western therapy alone.

OBJECTIVE:To investigate the association of running participation and the dose of running with the risk of all-cause, cardiovascular and cancer mortality.

DESIGN:Systematic review and meta-analysis.

DATA SOURCES:Journal articles, conference papers and doctoral theses indexed in Academic Search Ultimate, CINAHL, Health Source: Nursing/Academic Edition, MasterFILE Complete, Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus and Web of Science.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES:Prospective cohort studies on the association between running or jogging participation and the risk of all-cause, cardiovascular and/or cancer mortality in a non-clinical population of adults were included.

RESULTS:Fourteen studies from six prospective cohorts with a pooled sample of 232 149 participants were included. In total, 25 951 deaths were recorded during 5.5-35 year follow-ups. Our meta-analysis showed that running participation is associated with 27%, 30% and 23% lower risk of all-cause (pooled adjusted hazard ratio (HR)=0.73; 95% confidence interval (CI) 0.68 to 0.79), cardiovascular (HR=0.70; 95% CI 0.49 to 0.98) and cancer (HR=0.77; 95% CI 0.68 to 0.87) mortality, respectively, compared with no running. A meta-regression analysis showed no significant dose-response trends for weekly frequency, weekly duration, pace and the total volume of running.

CONCLUSION:Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity. Any amount of running, even just once a week, is better than no running, but higher doses of running may not necessarily be associated with greater mortality benefits.

BACKGROUND:Traditional Chinese medicine (TCM) has been widely applied for cancer care in China. There have been a large number of controlled clinical studies published in Chinese literature, yet no systematic searching and analysis has been done. This study summarizes the current evidence of controlled clinical studies of TCM for cancer.

METHODS:We searched all the controlled clinical studies of TCM therapies for all kinds of cancers published in Chinese in four main Chinese electronic databases from their inception to November 2011. We bibliometrically analyzed the included studies and assessed the reporting quality.

RESULTS:A total of 2964 reports (involving 253,434 cancer patients) including 2385 randomized controlled trials and 579 non-randomized controlled studies were included. The top seven cancer types treated were lung cancer, liver cancer, stomach cancer, breast cancer, esophagus cancer, colorectal cancer and nasopharyngeal cancer by both study numbers and case numbers. The majority of studies (72%) applied TCM therapy combined with conventional treatment, whilst fewer (28%) applied only TCM therapy in the experimental groups. Herbal medicine was the most frequently applied TCM therapy (2677 studies, 90.32%). The most frequently reported outcome was clinical symptom improvement (1667 studies, 56.24%) followed by biomarker indices (1270 studies, 42.85%), quality of life (1129 studies, 38.09%), chemo/radiotherapy induced side effects (1094 studies, 36.91%), tumor size (869 studies, 29.32%) and safety (547 studies, 18.45%). Completeness and adequacy of reporting appeared to improve with time.

CONCLUSIONS:Data from controlled clinical studies of TCM therapies in cancer treatment is substantial, and different therapies are applied either as monotherapy or in combination with conventional medicine. Reporting of controlled clinical studies should be improved based on the CONSORT and TREND Statements in future. Further studies should address the most frequently used TCM therapy for common cancers and outcome measures should address survival, relapse/metastasis and quality of life.