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Mark R. Goldstein, MD
Crozer-Chester Medical Center Upland, Pa

JAMA. 1990;263(15):2047.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Blair et al¹ provide evidence that low levels of physical fitness, defined by treadmill exercise performance, are a risk factor for future cardiovascular mortality, cancer mortality, and all-cause mortality in a population of predominantly white, middle-aged men and women. They suggest that if all unfit persons became fit there would be a significant reduction in the death rate.

The observed decrease in cancer mortality is intriguing. Possibly preclinical cancer can influence performance on the treadmill by humoral, metabolic, and/or other factors. If so, the exclusion from analysis of cancer deaths that occur within 4 years of baseline should eliminate the probability of a confounding preclinical cancer effect. If most cancer mortality occurred during the first few years after treadmill testing, it would be suggestive of the poor treadmill performance that results from a preclinical cancer effect. Perhaps the authors can provide data on cancer mortality in . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Don Riesenberg, MD, Senior Editor.

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