Shi Joy, Kobayashi Lindsay C, Grundy Anne, Richardson Harriet, SenGupta Sandip K, Lohrisch Caroline A, Spinelli John J, Aronson Kristan J
Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, USA.
Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, MA, USA.
Breast Cancer Res Treat. 2017 Aug;165(1):201-213. doi: 10.1007/s10549-017-4323-4. Epub 2017 Jun 6.
To assess the relationship of moderate-to-vigorous physical activity (MVPA) in leisure-time, household, and occupational domains across the total lifetime and in four age periods with breast cancer risk, as defined by estrogen receptor (ER)/progesterone receptor (PR) status and ER/PR/human epidermal growth factor-2 (HER2) status, among post-menopausal women.
Data were from 692 women with incident breast cancer and 644 controls in the Canadian Breast Cancer Study, a case-control study of women aged 40-80 years in British Columbia and Ontario. Mean metabolic equivalent (MET)-hours/week for questionnaire-assessed leisure-time, household, and occupational MVPA were calculated for the total lifetime and four age periods (12-17, 18-34, 45-49, and ≥50 years). Odds ratios (ORs) for the relationships between domain-specific MVPA at each lifetime period and risks of ER/PR-defined and ER/PR/HER2-defined breast cancers were estimated using polytomous logistic regression. Trend tests for dose-response relationships were calculated for the ORs across increasing tertiles of mean MET-hours/week of MVPA.
Total lifetime leisure-time MVPA was associated with reduced risk of ER-/PR- breast cancer in a dose-response fashion (p = 0.014). In contrast, total lifetime household MVPA was associated with reduced risk of ER+ and/or PR+ breast cancer (p < 0.001). When further stratified by HER2 status, the effect of leisure-time MVPA appeared confined to HER2- breast cancers, and the effect of household MVPA did not differ according to HER2 status. Similar trends were observed when stratified by age period.
Lifetime leisure-time MVPA appeared to be associated with reduced risk of ER-/PR-/HER2- breast cancers and lifetime household MVPA was associated with reduced risk of ER+ and/or PR+ breast cancer, regardless of HER2 status.
评估绝经后女性一生中及四个年龄段在休闲、家务和职业领域的中度至剧烈身体活动(MVPA)与雌激素受体(ER)/孕激素受体(PR)状态及ER/PR/人表皮生长因子2(HER2)状态所定义的乳腺癌风险之间的关系。
数据来自加拿大乳腺癌研究中的692例乳腺癌确诊女性和644例对照,这是一项针对不列颠哥伦比亚省和安大略省40 - 80岁女性的病例对照研究。通过问卷调查计算出一生中及四个年龄段(12 - 17岁、18 - 34岁、45 - 49岁和≥50岁)休闲、家务和职业MVPA的平均代谢当量(MET)-小时/周。使用多分类逻辑回归估计每个生命阶段特定领域MVPA与ER/PR定义及ER/PR/HER2定义的乳腺癌风险之间的比值比(OR)。计算MVPA平均MET-小时/周递增三分位数的OR的剂量反应关系趋势检验。
一生中总的休闲时间MVPA与ER-/PR-乳腺癌风险降低呈剂量反应关系(p = 0.014)。相比之下,一生中总的家务MVPA与ER+和/或PR+乳腺癌风险降低相关(p < 0.001)。当按HER2状态进一步分层时,休闲时间MVPA的影响似乎仅限于HER2-乳腺癌,家务MVPA的影响在HER2状态方面无差异。按年龄阶段分层时观察到类似趋势。
一生中休闲时间MVPA似乎与ER-/PR-/HER2-乳腺癌风险降低相关,一生中家务MVPA与ER+和/或PR+乳腺癌风险降低相关,与HER2状态无关。