Gram I T, Funkhouser E, Tabar L
Institute of Community Medicine, University of Tromsø, Norway.
Cancer Epidemiol Biomarkers Prev. 1999 Feb;8(2):117-22.
High-risk mammographic patterns may be used as a surrogate end point for breast cancer in etiologic research as well as in prevention studies. Physical activity may be one of the few modifiable risk factors for breast cancer. We examined the relationship between physical activity and mammographic patterns among 2720 Norwegian women, ages 40-56 years, who participated in both the Second and Third Tromsø studies. Epidemiologic data were obtained through questionnaires. Two questions from the Second Tromsø study and five questions from the Third elicited information on physical activity. The mammograms were categorized into five groups based on anatomical-mammographic correlations. For analysis, patterns I through III were combined into a low-risk group and patterns IV and V into a high-risk group. Odds ratios that were adjusted for age, education, menopausal status, body mass index, parity, age at menarche, oral contraceptive use, and alcohol intake, with 95% confidence intervals, were estimated using logistic regression. Women who reported moderate physical activity, i.e., more than 2 h/week, were 20% less likely (odds ratio, 0.8; 95% confidence interval, 0.6-1.1) to have high-risk mammographic patterns compared with those who reported being inactive. This relationship remains consistent when stratified by menopausal status, parity, and tertiles of body mass index. However, all of the associations between various measures of physical activity and high-risk patterns found in this study are weak with confidence intervals that include 1.0. Thus, chance is a reasonable explanation for the weak associations found. The relationship between physical activity and high-risk patterns should be examined further as a means to explore the biologic mechanisms relating physical activity to breast cancer risk.
在病因学研究以及预防研究中,高危乳腺钼靶影像特征可作为乳腺癌的替代终点。身体活动可能是乳腺癌为数不多的可改变风险因素之一。我们在2720名年龄在40至56岁之间、同时参与了第二次和第三次特罗姆瑟研究的挪威女性中,研究了身体活动与乳腺钼靶影像特征之间的关系。通过问卷调查获取流行病学数据。第二次特罗姆瑟研究中的两个问题以及第三次研究中的五个问题引出了关于身体活动的信息。根据解剖学与乳腺钼靶影像的相关性,将乳腺钼靶影像分为五组。为进行分析,将I至III型合并为低风险组,IV型和V型合并为高风险组。使用逻辑回归估计经年龄、教育程度、绝经状态、体重指数、生育情况、初潮年龄、口服避孕药使用情况和酒精摄入量调整后的比值比及其95%置信区间。报告有中等强度身体活动(即每周超过2小时)的女性,与报告不活动的女性相比,出现高危乳腺钼靶影像特征的可能性低20%(比值比为0.8;95%置信区间为0.6至1.1)。按绝经状态、生育情况和体重指数三分位数分层时,这种关系仍然一致。然而,本研究中发现的各种身体活动测量指标与高危影像特征之间的所有关联都很弱,置信区间包含1.0。因此,偶然因素是所发现的弱关联的一个合理的解释。身体活动与高危影像特征之间的关系应进一步研究,作为探索身体活动与乳腺癌风险之间生物学机制的一种手段。