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体力活动与乳腺癌死亡率相关性的荟萃分析。

A Meta-analysis of the Association Between Physical Activity and Breast Cancer Mortality.

机构信息

Author Affiliation: Graduate School of Sport Science, Kyung Hee University, Republic of Korea.

出版信息

Cancer Nurs. 2019 Jul/Aug;42(4):271-285. doi: 10.1097/NCC.0000000000000580.

Abstract

BACKGROUND

There are conflicting data on the association between physical activity (PA) intensity and amount and prognosis of breast cancer. It is unknown whether increasing or decreasing PA is associated with all-cause mortality.

OBJECTIVE

The purpose of this study was to estimate the associations between PA and the risk of mortality.

METHODS

MEDLINE and EMBASE were used to find eligible studies published from January 1970 to March 2017 for this meta-analysis. We included 24 studies, with a total of 144 224 patients and follow-up periods ranging from 1.9 to 12.7 years. We categorized the amount of PA as low (<300 min/wk), moderate (300-500 min/wk), and high (>500 min/wk).

RESULTS

We found that high amounts of PA had an inverse relationship with breast-cancer-specific mortality and all-cause morality. Patients who decreased PA after diagnosis showed poorer all-cause mortality, whereas patients who increased PA postdiagnosis had a favorable association with all-cause mortality. Last, patients who met PA guidelines after diagnosis had a lower breast-cancer-specific mortality and all-cause mortality.

CONCLUSION

Physical activity may play a pivotal role in reducing the risk of death. Getting at least 300 min/wk of moderate-intensity PA will help improve the risk of breast cancer death.

IMPLICATIONS FOR PRACTICE

Participating in PA is an essential factor in breast cancer care that extends throughout the life span of cancer survivors. Higher levels of PA than current PA guidelines should be recommended to cancer patients.

摘要

背景

体力活动(PA)强度和量与乳腺癌预后的关系存在相互矛盾的数据。目前尚不清楚增加或减少 PA 是否与全因死亡率相关。

目的

本研究旨在评估 PA 与死亡率风险之间的关联。

方法

本荟萃分析使用 MEDLINE 和 EMBASE 检索了 1970 年 1 月至 2017 年 3 月发表的符合条件的研究。共纳入 24 项研究,总计 144224 例患者,随访时间 1.9-12.7 年。我们将 PA 量分为低(<300 分钟/周)、中(300-500 分钟/周)和高(>500 分钟/周)。

结果

我们发现高 PA 量与乳腺癌特异性死亡率和全因死亡率呈负相关。诊断后 PA 减少的患者全因死亡率较差,而诊断后 PA 增加的患者与全因死亡率呈有利关联。最后,诊断后符合 PA 指南的患者乳腺癌特异性死亡率和全因死亡率较低。

结论

体力活动可能在降低死亡风险方面发挥关键作用。每周至少进行 300 分钟中等强度的 PA 将有助于降低乳腺癌死亡风险。

实践意义

参与 PA 是癌症幸存者整个生命周期乳腺癌护理的重要因素。应向癌症患者推荐高于当前 PA 指南的 PA 水平。

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