July 16, 2015

Don’t just sit there, do something

The Herald’s story on sitting and cancer is actually not as good as the Daily Mail story it’s edited from. Neither one gives the journal or researchers (the paper is here). Both mention a previous study, but the Mail goes into more useful detail.

The basic finding is

Longer leisure-time spent sitting, after adjustment for physical activity, BMI and other factors, was associated with risk of total cancer in women (RR=1.10, 95% CI 1.04-1.17 for >6 hours vs. <3 hours per day), but not men (RR=1.00, 95% CI 0.96-1.05)

The lack of association in men was a surprise, and strongly suggests that the result for women shouldn’t be believed. It’s also notable that while the estimated associations with a few types of cancer look strong, the lower limits on the confidence intervals don’t look strong:

risk of multiple myeloma (RR=1.65, 95% CI 1.07-2.54), invasive breast cancer (RR=1.10, 95% CI 1.00-1.21), and ovarian cancer (RR=1.43, 95% CI 1.10-1.87).

Since the researchers looked at eighteen subsets of cancer in addition to all types combined, and these are the top three, the real lower limits are even lower.

The stories referred to previous research, published last year, which summarised many previous studies of sitting and cancer risk.  That’s good, but the summary wasn’t entirely accurate. From the Herald:

Previous research by the University of Regensburg in Germany found that spending too much time sitting raised the risk of bowel and lung cancer in both men and women.

In fact, the previous research didn’t look separately at men and women (or, at least, didn’t report doing so). While you would expect similar results in men and women, that study doesn’t address the question.

The Mail does have one apparently good contextual point

However, this previous study – which reviewed 43 other studies – did not find a link between sitting and a higher risk of breast and ovarian cancer. 

But when you look at the actual figures, there’s no real inconsistency between the two studies: they both report weak evidence of higher risk; it’s just a question of whether the lower end of the confidence interval happens to cross the ‘no difference’ line for a particular subset of cancers.

Overall, this is a pretty small risk difference to detect from observational data. If you didn’t already think that long periods of sitting could be bad for you, this wouldn’t be a reason to start.

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Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »