Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
Cancer Epidemiol Biomarkers Prev. 2019 Jan;28(1):51-58. doi: 10.1158/1055-9965.EPI-18-0674. Epub 2018 Oct 17.
Recreational physical activity has been consistently associated with reduced breast cancer risk. Less is known about how family history of breast cancer affects the association and whether it varies by menopausal status.
The Sister Study is a cohort of 50,884 women who had a sister with breast cancer but no prior breast cancer themselves at enrollment. Women reported all recreational sport/exercise activities they participated in over the past 12 months. Hours/week and MET-hours/week of physical activity were considered in association with breast cancer risk. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated with Cox regression. Extent of family history, examined as a modifier, was characterized by a Bayesian score incorporating characteristics of the family structure.
During follow-up (average 8.4 years), 3,023 cases were diagnosed. Higher hours/week (HR = 0.77; 95% CI, 0.66-0.90) and MET-hours/week (HR = 0.75; 95% CI, 0.67-0.85) of physical activity were associated with reduced postmenopausal breast cancer risk. Hours/week and MET-hours/week were associated with suggestively increased premenopausal breast cancer risk (MET-hours/week HR = 1.25; 95% CI, 0.98-1.60). Associations did not vary with extent of family history. However, the increased risk in premenopausal women may be limited to those with stronger family history.
In women with a family history of breast cancer, physical activity was associated with reduced postmenopausal, but not premenopausal, breast cancer risk and was not modified by extent of family history.
This was the first study to examine the association between physical activity and breast cancer risk in a large population with a family history of breast cancer.
休闲体育活动与降低乳腺癌风险一直相关。但对于家族乳腺癌史如何影响这种关联,以及这种关联是否因绝经状态而异,人们知之甚少。
姐妹研究是一项队列研究,纳入了 50884 名女性,这些女性的姐妹患有乳腺癌,但她们自己在入组时没有乳腺癌。女性报告了过去 12 个月中所有参加的休闲运动/锻炼活动。以小时/周和代谢当量小时/周来考虑身体活动与乳腺癌风险的关联。使用 Cox 回归计算危险比(HR)和 95%置信区间(CI)。家族史的程度作为修饰因素进行检验,采用贝叶斯评分来描述,该评分综合了家族结构的特征。
在随访期间(平均 8.4 年),诊断出 3023 例病例。更高的小时/周(HR = 0.77;95%CI,0.66-0.90)和代谢当量小时/周(HR = 0.75;95%CI,0.67-0.85)与绝经后乳腺癌风险降低相关。小时/周和代谢当量小时/周与绝经前乳腺癌风险呈提示性增加相关(代谢当量小时/周 HR = 1.25;95%CI,0.98-1.60)。关联与家族史的程度无关。然而,绝经前女性的风险增加可能仅限于家族史较强的女性。
在有家族乳腺癌史的女性中,身体活动与绝经后乳腺癌风险降低相关,但与绝经前乳腺癌风险无关,且不受家族史程度的影响。
这是第一项在有家族乳腺癌史的大型人群中研究身体活动与乳腺癌风险之间关联的研究。