Lu Yani, John Esther M, Sullivan-Halley Jane, Vigen Cheryl, Gomez Scarlett Lin, Kwan Marilyn L, Caan Bette J, Lee Valerie S, Roh Janise M, Shariff-Marco Salma, Keegan Theresa H M, Kurian Allison W, Monroe Kristine R, Cheng Iona, Sposto Richard, Wu Anna H, Bernstein Leslie
Am J Epidemiol. 2015 Jun 15;181(12):944-55. doi: 10.1093/aje/kwu466. Epub 2015 Apr 29.
Recent epidemiologic evidence suggests that prediagnosis physical activity is associated with survival in women diagnosed with breast cancer. However, few data exist for racial/ethnic groups other than non-Latina whites. To examine the association between prediagnosis recreational physical activity and mortality by race/ethnicity, we pooled data from the California Breast Cancer Survivorship Consortium for 3 population-based case-control studies of breast cancer patients (n=4,608) diagnosed from 1994 to 2002 and followed up through 2010. Cox proportional hazards models provided estimates of the relative hazard ratio for mortality from all causes, breast cancer, and causes other than breast cancer associated with recent recreational physical activity (i.e., in the 10 years before diagnosis). Among 1,347 ascertained deaths, 826 (61%) were from breast cancer. Compared with women with the lowest level of recent recreational physical activity, those with the highest level had a marginally decreased risk of all-cause mortality (hazard ratio=0.88, 95% confidence interval: 0.76, 1.01) and a statistically significant decreased risk of mortality from causes other than breast cancer (hazard ratio=0.63, 95% confidence interval: 0.49, 0.80), and particularly from cardiovascular disease. No association was observed for breast cancer-specific mortality. These risk patterns did not differ by race/ethnicity (non-Latina white, African American, Latina, and Asian American). Our findings suggest that physical activity is beneficial for overall survival regardless of race/ethnicity.
近期的流行病学证据表明，乳腺癌确诊前的身体活动与乳腺癌女性患者的生存率相关。然而，除了非西班牙裔白人之外，其他种族/族裔群体的数据很少。为了研究确诊前的休闲身体活动与种族/族裔死亡率之间的关联，我们汇总了加利福尼亚乳腺癌幸存者联盟3项基于人群的乳腺癌患者病例对照研究的数据（n = 4608），这些患者于1994年至2002年被诊断出患有乳腺癌，并随访至2010年。Cox比例风险模型提供了与近期休闲身体活动（即诊断前10年）相关的全因死亡率、乳腺癌死亡率以及乳腺癌以外原因导致的死亡率的相对风险比估计值。在1347例已确定的死亡病例中，826例（61%）死于乳腺癌。与近期休闲身体活动水平最低的女性相比，活动水平最高的女性全因死亡率风险略有降低（风险比 = 0.88，95%置信区间：0.76, 1.01），且乳腺癌以外原因导致的死亡率风险有统计学显著降低（风险比 = 0.63，95%置信区间：0.49, 0.80），特别是心血管疾病导致的死亡率。未观察到乳腺癌特异性死亡率的关联。这些风险模式在种族/族裔（非西班牙裔白人、非裔美国人、拉丁裔和亚裔美国人）之间没有差异。我们的研究结果表明，无论种族/族裔如何，身体活动对总体生存都有益。
