Lope Virginia, Martín Miguel, Castelló Adela, Casla Soraya, Ruiz Amparo, Baena-Cañada Jose Manuel, Casas Ana Mª, Calvo Lourdes, Bermejo Begoña, Muñoz Montserrat, Ramos Manuel, de Juan-Ferré Ana, Jara Carlos, Antón Antonio, Jimeno Mª Ángeles, Lluch Ana, Antolín Silvia, García-Sáenz José Ángel, Estévez Purificación, Arriola-Arellano Esperanza, Gavilá Joaquín, Pérez-Gómez Beatriz, Carrasco Eva, Pollán Marina
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain.
Medical Oncology Unit, Hospital Clínico Universitario San Carlos, Madrid, Spain; Health Research Institute Gregorio Marañón, Universidad Complutense, Madrid, Spain.
Gynecol Oncol. 2017 Mar;144(3):577-585. doi: 10.1016/j.ygyno.2016.12.014. Epub 2017 Jan 3.
To examine the influence of physical activity on breast cancer risk and evaluate whether adherence to international recommendations is associated with a decreased risk.
This is a multicenter matched case-control study where 698 pairs completed a physical activity questionnaire. Recreational physical activity during the last year was quantified in metabolic equivalent hours per week (MET-h/week) and categorized in activities of moderate (3.0-5.9 MET) and vigorous (>6 MET) intensity. The adherence to World Cancer Research Fund and the American Institute for Cancer Research recommendation was also assessed. The association with breast cancer risk, overall and by pathologic subtype, was evaluated using conditional and multinomial logistic regression models.
Mean MET-h/week was 16.6 among cases and 20.4 among controls. Premenopausal breast cancer risk decreased by 5% (P=0.007) for every 6 MET-h/week increase in energy expenditure. By contrast, postmenopausal women needed to do more intense exercise to observe benefits. The protection was more pronounced for nulliparous women, as well as for hormone receptor positive and HER2+ tumors. Physically inactive women displayed a 71% increased risk when compared with those who met the international recommendation (P=0.001). Finally, women who were inactive during the previous year, regardless of the overall physical activity reported in previous periods, showed an increased risk when compared to always active women.
Women who report adherence to international physical activity recommendations entail a significant decrease in risk for all pathologic breast cancer subtypes. This is of particular interest in Spain, where a significant increase in overweight and obesity in recent decades is observed.
研究身体活动对乳腺癌风险的影响，并评估遵循国际建议是否与风险降低相关。
这是一项多中心匹配病例对照研究，698对参与者完成了身体活动问卷。去年的休闲身体活动以每周代谢当量小时数（MET-h/周）进行量化，并分为中等强度（3.0-5.9 MET）和高强度（>6 MET）活动。还评估了对世界癌症研究基金会和美国癌症研究所建议的遵循情况。使用条件和多项逻辑回归模型评估与乳腺癌风险的总体关联以及按病理亚型的关联。
病例组的平均MET-h/周为16.6，对照组为20.4。能量消耗每增加6 MET-h/周，绝经前乳腺癌风险降低5%（P=0.007）。相比之下，绝经后女性需要进行更剧烈的运动才能观察到益处。对于未生育女性以及激素受体阳性和HER2+肿瘤，这种保护作用更为明显。与遵循国际建议的女性相比，身体不活动的女性风险增加71%（P=0.001）。最后，与始终活跃的女性相比，上一年不活动的女性，无论之前报告的总体身体活动情况如何，风险都有所增加。
报告遵循国际身体活动建议的女性，所有病理类型乳腺癌亚型的风险均显著降低。在西班牙，近几十年来超重和肥胖显著增加，这一点尤其值得关注。
