Cardiopulmonary health status (CRF) appears to be a strong predictive factor not only for the prevalence of 2 common tumors, but also for prognosis-related factors. According to a recent study, men with the highest level of health had a 68% and 38% lower risk of developing lung and colorectal cancer, respectively, compared with men with the lowest level of health. Higher levels of health were also associated with a 14% reduction in cancer-specific mortality (hazard ratio [HR], 0.86; P < .001) and a 23% reduction in cardiovascular-specific mortality (HR, 0.77; P < .001). "It is generally accepted that health level is a powerful predictor of cardiovascular disease and survival, even more so than other risk factors including self-reported physical activity," according to Susan Lakoski, PhD, first author of the study and assistant professor of medicine at the University of Vermont, Burlington. "Unfortunately, however, little is known about the fact that level of health can also serve as a predictor of cancer incidence and cancer patient outcomes." "The importance of this is reflected in the identification of robust predictive markers, which are increasingly necessary as cancer incidence is expected to increase over the next 20 years." Dr. Lakoski. said, "It is predicted that patients will now have a longer survival expectancy until the risk of non-cancer related death, particularly cardiovascular and risk." Dr. Lakoski presented the findings at a press briefing prior to the opening of the American Society of Clinical Oncology (ASCO) 2013 Annual Meeting. In the absence of studies on the prognostic significance of CRF on cancer incidence or cause-specific mortality after cancer diagnosis in the male population, Dr. Lakoski and colleagues examined the relationship between CRF and the incidence of prostate, lung, or colorectal cancer in men, and between CRF and subsequent cause-specific mortality in men with a confirmed cancer diagnosis. The study cohort consisted of 17,049 men (mean age, 50 years) who had undergone a cardiovascular health evaluation at the Cooper Institute in Dallas, Texas, as part of a specialized preventive health visit. Health performance was recorded in a special health module called "Metabolic Equivalents" (MET). Based on their health performance, the parameters were divided into five groups. The health insurance records were then analyzed to screen for participants with lung, colorectal, or prostate cancer. The median time from the start of CRF evaluation to cancer and death was 20.2 ± 8.2 years and 24.4 ± 8.5 years, respectively. A total of 2885 men were diagnosed with prostate, lung or colorectal cancer during this period (2332 prostate cancer cases, 276 lung cancer cases, 277 lung cancer cases). There were 769 all-cause deaths during the study period, with 347 deaths due to cancer and 159 due to cardiovascular disease. "Health status did not have a significant effect on prostate cancer risk," Dr. Lakoski said, "and the study data were corrected for relevant risk factors, such as weight and age." Compared with men in the lowest CRF group, men in the highest CRF group had corrected risk ratios for lung, colorectal, and prostate cancers of 0.32 (95% confidence interval [CI], 0.20 - 0.51; P < .001), 0.62 (95% CI, 0.40 - 0.97; P = .05), and 1.13 (95% CI, 0.97 - 1.33; P = . 14). For men with cancer, both cancer-specific mortality and cardiovascular-specific mortality decreased with increasing CRF (P value < .001). For example, a small improvement in health (1-MET increase in CRF) was associated with a 14% reduction in cancer-specific mortality (HR, 0.86; 95% CI, 0.81 - 0.91; P < .001) and a 23% reduction in cardiovascular-specific mortality (HR, 0.77; 95% CI, 0.69 - 0.85; P < .001). The study authors also found that even non-obese men with lower levels of health were at increased risk for cancer and cardiovascular disease, and Dr. Lakoski concluded that health status was a strong independent predictor of lung and colorectal cancer in men and a robust predictor of cause-specific mortality in middle-aged and older men with lung and prostate cancer. According to him, "These results provide support for the application of preventive health screening whereby cancer risk as well as cancer prognosis can be determined." The study confirms for the first time that CRF is a strong independent predictor of cancer risk and prognosis, and FACP, ASCO President Sandra M. Swain, PhD, commented, "The interesting finding is that even if a man is not obese, his cancer risk is increased whenever he is in poor health." According to Dr. Swain, co-host of the press briefing, "This suggests that everyone would benefit from improved health,"