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Association between physical activity and early-stage gastric cancer: A cross-sectional study of the Wuwei cohort
Hao Yuan, Qin Sun, Zhe Wang, Xi-Dong Fang, Jing Yang, Zhi-Yu Wu, Xin-Hong Cheng, Ya Zheng, Yong-Ning Zhou
Hao Yuan, Qin Sun, Xi-Dong Fang, Zhi-Yu Wu, Xin-Hong Cheng, The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China
Hao Yuan, Qin Sun, Xi-Dong Fang, Jing Yang, Zhi-Yu Wu, Xin-Hong Cheng, Ya Zheng, Yong-Ning Zhou, Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Hao Yuan, Qin Sun, Xi-Dong Fang, Jing Yang, Zhi-Yu Wu, Xin-Hong Cheng, Ya Zheng, Yong-Ning Zhou, Gansu Province Clinical Research Center for Digestive Diseases, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Zhe Wang, Department of Nephrology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Co-first authors: Hao Yuan and Qin Sun.
Co-corresponding authors: Ya Zheng and Yong-Ning Zhou.
Author contributions: Yuan H and Sun Q contributed to study conceptualization and design, and wrote the main manuscript text as co-first authors; Wang Z, Fang XD, Yang J, Wu ZY, and Cheng XH contributed to data analysis; Zheng Y and Zhou YN supervised the study; Yuan H, Zheng Y, and Zhou YN obtained funding; Zheng Y and Zhou YN made equal contributions as co-corresponding authors. All authors provided critical feedback and edits to revisions and approved the submission.
Supported by National Natural Science Foundation of China, No. 82160498; The Foundation of The First Hospital of Lanzhou University, China, No. ldyyyn2019-28; The Medical Innovation and Development Project of Lanzhou University, No. lzuyxcx-2022-41; Gansu Province Higher Education Project for Teaching Achievement Cultivation, No. 202314-16; and Natural Science Foundation of Gansu Province, No. 23JRRA0939.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of The First Hospital of Lanzhou University, No. LDYYLL2012001.
Informed consent statement: All participants signed a written informed consent.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Yong-Ning Zhou, Department of Gastroenterology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou 730000, Gansu Province, China.
zhouyn@lzu.edu.cn
Received: February 4, 2026
Revised: February 27, 2026
Accepted: April 3, 2026
Published online: July 15, 2026
Processing time: 152 Days and 18.8 Hours
BACKGROUND
Gastric cancer remains a major global burden, especially in China. While early detection improves prognosis, prevention requires identification of modifiable risk factors. Physical activity (PA) is protective against several cancers, but its association with early gastric cancer (EGC) is unclear. This study investigates this relationship using data from the Wuwei cohort.
AIM
To assess the association between PA and EGC risk.
METHODS
This cross-sectional study included 1829 adults (35-70 years) who underwent endoscopy with pathological diagnosis from the Wuwei cohort (2013-2016). PA was assessed using the International PA Questionnaire-Short Form and categorized into tertiles of total metabolic equivalent (MET)-minutes/week. High-grade dysplasia (HGD) and EGC were combined as the outcome. Multivariable logistic regression and restricted cubic spline models were applied to estimate adjusted odds ratios (ORs) and dose-response relationships.
RESULTS
Among 1829 participants, 170 had HGD/EGC (74 HGD and 96 EGC). Moderate PA (1368.5-3213 MET-minutes/week) was associated with lower odds of HGD/EGC compared with low activity [model 3: OR = 0.64, 95% confidence interval (CI): 0.43-0.95], corresponding to a risk difference of 3.1% (8.7% vs 11.8%). A significant trend across tertiles was observed (P = 0.047). Restricted cubic spline analysis demonstrated a non-linear inverse association, with the lowest risk at approximately 4200 MET-minutes/week. Stronger inverse associations were observed among males (high PA: OR = 0.58, 95%CI: 0.34-0.99), Helicobacter pylori-positive individuals (OR = 0.40, 95%CI: 0.19-0.83), and cardia lesions (OR = 0.27, 95%CI: 0.10-0.68).
CONCLUSION
Moderate PA is associated with lower odds of early gastric neoplasia, particularly among Helicobacter pylori-positive individuals, supporting a potential role in EGC prevention.
Core Tip: This cross-sectional analysis of 1829 adults from a high-risk Chinese population demonstrates that moderate physical activity (PA), assessed by the International PA Questionnaire-Short Form, is associated with lower odds of high-grade dysplasia and early gastric cancer. We observed a significant dose-response trend and a non-linear inverse association, with the lowest risk at intermediate activity levels. The inverse association is more pronounced among Helicobacter pylori-positive individuals and patients with cardia lesions. These findings suggest that moderate PA may play a role in early gastric carcinogenesis and prevention strategies.
