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Purpose: The objective was to explore the relationship of sun behavior patterns with the risk of developing non-Hodgkin lymphoma (NHL). Methods: Sun behavior information from Alberta's Tomorrow Project, CARTaGENE, and Ontario Health Study were utilized. The relationship between time in the sun during summer months and risk of NHL was assessed using Cox proportional hazard models with age as the time scale and adjustment for confounders. Cohorts were analyzed separately and hazard ratios (HR) pooled with random effects meta-analysis. Joint effects of time in the sun and use of sun protection were examined. Patterns of exposure were explored via combinations of weekday and weekend time in the sun. Results: During an average follow-up of 7.6 years, 205 NHL cases occurred among study participants (n = 79,803). Compared to < 30 min daily in the sun, we observed HRs of 0.84 (95% CI 0.55–1.28) for 30–59 min, 0.63 (95% CI 0.40–0.98) for 1–2 h, and 0.91 (95% CI 0.61–1.36) for > 2 h. There was suggestive evidence that > 2 h was protective against NHL with use of sun protection, but not without it. Compared to < 30 min daily, moderate exposure (30 min to 2 h on weekdays or weekend) was associated with a lower risk of NHL (HR 0.63, 95% CI 0.43–0.92), while intermittent (< 30 min on weekdays and > 2 h on weekends) and chronic (> 2 h daily) were not. Conclusion: This study provides evidence of a protective effect of moderate time spent in the sun on NHL risk. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify distinct clusters of individuals that exhibit unique patterns of modifiable lifestyle-related behaviours and to determine how these patterns are associated with the risk of developing colorectal cancer (CRC). The study consisted of 26,460 participants and 267 CRC cases from Alberta's Tomorrow Project. Exploratory latent class analysis of risk behaviours (obesity, physical inactivity, meat consumption, smoking, alcohol consumption, and fruit and vegetable consumption) and Cox proportional hazard models were utilized. Seven unique behavioural groups were identified, where the risk of CRC was 2.34 to 2.87 times greater for high risk groups compared to the low risk group. Sex-specific models identified higher risk groups among men (Hazard Ratios [HRs]: 3.15 to 3.89) than among women (HRs: 1.99 to 2.19). Targeting groups defined by clustering of behaviours could potentially lead to more effective prevention of CRC on a population level. [ABSTRACT FROM AUTHOR]

Background: Frailty among cardiac rehabilitation (CR) participants is associated with worse health outcomes. However, no literature synthesis has quantified the relationship between frailty and CR outcomes., Purpose: Examine frailty prevalence at CR admission, frailty changes during CR, and if frailty is associated with adverse outcomes following CR., Methods: We searched CINAHL, EMBASE, and MEDLINE for studies published from 2000-2023. Eligible studies included a validated frailty measure, published in English. Two reviewers independently screened articles and abstracted data. Outcome measures included admission frailty prevalence, frailty and physical function changes, and post-CR hospitalization and mortality., Results: Observational and randomized trials were meta-analyzed separately using inverse variance random-effects models. 34 peer reviewed articles (26 observational, 8 randomized trials; 19,360 participants) were included. Admission frailty prevalence was 46% [95% CI 29%, 62%] and 40% [95% CI 28%, 52%] as measured by Frailty Index and Kihon Checklist (14 studies) and Frailty Phenotype (11 studies), respectively. Frailty improved following CR participation (SMD; 0.68, 95% CI 0.37, 0.99; P<.0001; 6 studies). Observational studies meta-analysis revealed higher admission frailty increased participants' risk of all-cause mortality (Hazard ratio: 9.24, 95% CI 2.93, 29.16; P=.0001; 4 studies). Frailer participants at admission had worse physical health outcomes, but improved over the course of CR., Conclusions: High variability in frailty tools and CR designs was observed, and randomized controlled trials contributions were limited. The prevalence of frailty is high in CR and is associated with greater mortality risk; however, CR improves frailty and physical health outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Purpose: Despite a strong association between indoor tanning and the risk of cutaneous cancers, the relationship between indoor tanning and non-cutaneous cancers is unknown. Our objective was to estimate the association of indoor tanning with developing non-cutaneous cancers., Methods: We conducted a systematic literature review and meta-analysis of the association between indoor tanning and non-cutaneous cancer sites. Associations were estimated using random effects models. Heterogeneity was investigated through subgroup analyses and the Q-test and I 2 statistics., Results: From 15 identified studies, 33 effect estimates for 12 cancer sites were included in the review. Adjustment for sun exposure was a significant source of heterogeneity in the association of indoor tanning and non-cutaneous cancer risk (meta-regression p = 0.0043). When restricting to studies that adjusted for solar ultraviolet radiation (7 studies and 19 effect estimates) a potential increased risk was observed among ever users of indoor tanning devices with the risk of hematologic malignancies (pooled relative risk = 1.11; 95% CI 0.96-1.28), with differing effects observed by hematologic types and subtypes of non-Hodgkin lymphoma. No association was observed among solid non-cutaneous cancers (pooled relative risk = 0.98; 95% CI 0.94-1.19). Neither study design nor geographical region was significant sources of heterogeneity in these associations., Conclusion: When controlling for sun exposure, indoor tanning does not protect against solid non-cutaneous cancers and may increase the risk of some hematologic malignancies. Given the well-established relationship with skin cancer and potential relationship with hematologic malignancies, efforts to reduce the use of indoor tanning devices should continue.