Borch Kristin Benjaminsen, Lund Eiliv, Braaten Tonje, Weiderpass Elisabete
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø 9037, N-Norway.
J Negat Results Biomed. 2014 Mar 1;13:3. doi: 10.1186/1477-5751-13-3.
The relationship between physical activity (PA) throughout life and the risk of postmenopausal breast cancer overall and by estrogen receptor (ER) and progesterone receptor (PR) status, has been reported, but without consistent results. The present study aimed to investigate PA from young age to adulthood in participants of the Norwegian Women and Cancer (NOWAC) Study, in order to determine whether changes in PA level affect the risk of postmenopausal breast cancer.
1767 invasive breast cancer cases were identified among 80,202 postmenopausal participants of the NOWAC Study during 8.2 years of median follow-up. PA levels at age 14 years, 30 years and at cohort enrollment were obtained via a self-administered questionnaire. Multivariate Cox proportional hazard regression models were used to estimate relative risks and 95% confidence intervals of the risk of postmenopausal breast cancer overall and by ER/PR status.
Risk of postmenopausal breast cancer overall and by ER/PR status was not associated with physical activity level at enrollment. Women with a low PA level at age 30 had an increased risk of ER+/PR + breast tumors (P for trend = 0.04) compared to women with a moderate physical activity level at age 30. Women with a low physical activity level at all three periods of life had a 20% significantly reduced risk of postmenopausal breast cancer, as well as a reduced risk of ER+/PR + and ER+/PR- breast tumors, compared with women who maintained a moderate physical activity level. However, when analyses were corrected for multiple tests, the result was no longer statistically significant. The findings were consistent over strata of age, body mass index and use of hormone replacement therapy.
The study results from this large Norwegian cohort do not support an association between physical activity at different periods of life and the risk of postmenopausal breast cancer.
一生中的身体活动(PA)与绝经后乳腺癌总体风险以及按雌激素受体(ER)和孕激素受体(PR)状态分类的风险之间的关系已有报道,但结果并不一致。本研究旨在调查挪威女性与癌症(NOWAC)研究参与者从年轻时到成年期的PA情况,以确定PA水平的变化是否会影响绝经后乳腺癌的风险。
在NOWAC研究的80202名绝经后参与者中,经过8.2年的中位随访,确定了1767例浸润性乳腺癌病例。通过自我管理问卷获取14岁、30岁时以及队列入组时的PA水平。使用多变量Cox比例风险回归模型来估计绝经后乳腺癌总体风险以及按ER/PR状态分类的风险的相对风险和95%置信区间。
绝经后乳腺癌总体风险以及按ER/PR状态分类的风险与入组时的身体活动水平无关。与30岁时身体活动水平中等的女性相比,30岁时PA水平低的女性患ER+/PR +乳腺肿瘤的风险增加(趋势P值 = 0.04)。与保持中等身体活动水平的女性相比,在生命的所有三个阶段PA水平低的女性绝经后乳腺癌风险显著降低20%,同时ER+/PR +和ER+/PR-乳腺肿瘤的风险也降低。然而,在对多次检验进行校正后,结果不再具有统计学意义。这些发现在年龄、体重指数和激素替代疗法使用的分层中是一致的。
这项来自挪威大型队列的研究结果不支持生命不同阶段的身体活动与绝经后乳腺癌风险之间存在关联。