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A nationwide sibling-controlled cohort in Sweden followed 1,124,049 men assessed at mandatory military conscription examinations. Hazard ratios and 95% confidence intervals were estimated for overall cancer and 14 site-specific cancers through modelled flexible parametric regressions. Higher fitness increased prostate and non-melanoma skin cancer diagnoses in cohort analysis but attenuated to the null in full-sibling comparisons, while the lower risk of cancer mortality remained significant.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/adolescent-cardiorespiratory-fitness-and-risk-of-cancer-in-late-adulthood-nationwide-sibling-controlled-cohort-study/332232/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/adolescent-cardiorespiratory-fitness-and-risk-of-cancer-in-late-adulthood-nationwide-sibling-controlled-cohort-study/332232.png","ImageObject",300,407,{"name":92,"@type":93},"Aria","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study objective regarding adolescent cardiorespiratory fitness and cancer risk?","Question",{"text":112,"@type":113},"To determine whether increased risks of certain cancers associated with high cardiorespiratory fitness can be explained by increased detection and unobserved confounders.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the sibling-controlled analysis affect the association between fitness and cancer diagnoses?",{"text":117,"@type":113},"When comparing full siblings to control for shared behavioural, environmental, and genetic factors, the excess risk for prostate and skin cancer attenuated to the null.",{"name":119,"@type":110,"acceptedAnswer":120},"Did cancer mortality remain associated with fitness after controlling for shared confounders?",{"text":121,"@type":113},"Yes. The protective association with cancer mortality persisted and stayed statistically significant after controlling for shared confounders.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},332232,1790451232,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","medRxiv preprint doi: [https://doi.org/10.1101/2024.07.01.24309761](https://doi.org/10.1101/2024.07.01.24309761); this version posted July 3, 2024. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY-ND 4.0 International license .  \nResearch  \nAdolescent Cardiorespiratory Fitness and Risk of Cancer in Late Adulthood: Nationwide Sibling-Controlled Cohort Study  \nMarcel Ballin, associated researcher1,2, a, Daniel Berglind, associate professor2,3,4 , Pontus Henriksson, associate professor5 , Martin Neovius, professor6 , Anna Nordström, researcher7,8 , Francisco B. Ortega, professor9,10 , Elina Sillanpää, associate professor10,11 , Peter Nordström, professor1,b, Viktor H. Ahlqvist, postdoctoral researcher1,12,13,a,b  \n1 Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden.  \n2Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden.  \n3 Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.  \n4Center for Wellbeing, Welfare and Happiness, Stockholm School of Economics, Stockholm, Sweden.  \n5 Department of Health, Medicine and Caring Sciences, Linköping University, Linköping,  \nSweden.  \n6 Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.  \n7 Department of Medical Sciences, Uppsala University, Uppsala, Sweden.  \n8School of Sports Science, UiT The Arctic University of Norway, Tromsø, Norway.  \n9 Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; CIBEROBN, IS  \nCIII, Granada, Andalucía, Spain.  \n10 Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.  \n11Wellbeing Services County of Central Finland, Jyväskylä, Finland.  \n12 Department of Biomedicine, Aarhus University, Aarhus, Denmark.  \n13 Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.  \naDr. Ballin and Dr. Ahlqvist are joint corresponding authors.  \nbProf. Nordström and Dr. Ahlqvist are joint senior authors.  \n1  \nNOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.  \nmedRxiv preprint doi: [https://doi.org/10.1101/2024.07.01.24309761](https://doi.org/10.1101/2024.07.01.24309761); this version posted July 3, 2024. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY-ND 4.0 International license .  \nAbstract  \nObjective: To investigate whether the higher risks of certain cancers associated with high cardiorespiratory fitness can be explained by increased detection and unobserved confounders.  \nDesign: Nationwide sibling-controlled cohort study of adolescents.  \nSetting: Sweden.  \nParticipants: 1 124 049 men of which 477 453 were full siblings, who underwent mandatory military conscription examinations between 1972 and 1995 at a mean age of 18.3 years.  \nMain outcome measures: Hazard ratios (HR) and 95% confidence intervals (CI) of overall cancer diagnosis and cancer mortality, and 14 site-specific cancers (diagnosis or death), as recorded in the Swedish National Patient Register or Cause of Death Register until 31 December 2023, modelled using flexible parametric regressions.  \nResults: Participants were followed until a median (maximum) age of 55.9 (73 .5) years, during which 98 410 were diagnosed with cancer and 16 789 had a cancerrelated death (41 293 and 6908 among full siblings respectively) . The most common cancers were non-melanoma skin (27 105 diagnoses & 227 deaths) and prostate cancer (24 211 diagnoses & 869 deaths) . In cohort analysis, those in the highest quartile of car","cbCaib5JWh46w2tw","https://ap.wps.com/l/cbCaib5JWh46w2tw","pdf",303241,26,"English","# Objective\n# Design and Setting\n# Participants\n# Main Outcome Measures\n# Results\n## Cohort findings\n## Full-sibling controlled findings\n# Conclusions","[{\"question\":\"What was the study objective regarding adolescent cardiorespiratory fitness and cancer risk?\",\"answer\":\"To determine whether increased risks of certain cancers associated with high cardiorespiratory fitness can be explained by increased detection and unobserved confounders.\"},{\"question\":\"How did the sibling-controlled analysis affect the association between fitness and cancer diagnoses?\",\"answer\":\"When comparing full siblings to control for shared behavioural, environmental, and genetic factors, the excess risk for prostate and skin cancer attenuated to the null.\"},{\"question\":\"Did cancer mortality remain associated with fitness after controlling for shared confounders?\",\"answer\":\"Yes. The protective association with cancer mortality persisted and stayed statistically significant after controlling for shared confounders.\"}]","Adolescent Cardiorespiratory Fitness and Risk of Cancer in Late Adulthood: Nationwide Sibling-Controlled Cohort Study | PDF",1789997462,66]