Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.
MRC Centre for Transplantation, King's College London, London, UK.
Int J Epidemiol. 2022 Jan 6;50(6):1914-1926. doi: 10.1093/ije/dyab032. Epub 2021 Mar 23.
The role of obesity and weight change in breast-cancer development is complex and incompletely understood. We investigated long-term weight change and breast-cancer risk by body mass index (BMI) at age 20 years, menopausal status, hormone replacement therapy (HRT) and hormone-receptor status.
Using data on weight collected at three different time points from women who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we investigated the association between weight change from age 20 years until middle adulthood and risk of breast cancer.
In total, 150 257 women with a median age of 51 years at cohort entry were followed for an average of 14 years (standard deviation = 3.9) during which 6532 breast-cancer cases occurred. Compared with women with stable weight (±2.5 kg), long-term weight gain >10 kg was positively associated with postmenopausal breast-cancer risk in women who were lean at age 20 [hazard ratio (HR) = 1.42; 95% confidence interval 1.22-1.65] in ever HRT users (HR = 1.23; 1.04-1.44), in never HRT users (HR = 1.40; 1.16-1.68) and in oestrogen-and-progesterone-receptor-positive (ER+PR+) breast cancer (HR = 1.46; 1.15-1.85).
Long-term weight gain was positively associated with postmenopausal breast cancer in women who were lean at age 20, both in HRT ever users and non-users, and hormone-receptor-positive breast cancer.
肥胖和体重变化在乳腺癌发展中的作用复杂且尚未完全阐明。我们通过 20 岁时的体重指数(BMI)、绝经状态、激素替代疗法(HRT)和激素受体状态研究了长期体重变化与乳腺癌风险的关系。
利用参加欧洲癌症与营养前瞻性调查(EPIC)研究的女性在三个不同时间点的体重数据,我们研究了从 20 岁到中年期间体重变化与乳腺癌风险之间的关系。
共有 150257 名女性入组,平均年龄为 51 岁,随访时间平均为 14 年(标准差=3.9),期间发生了 6532 例乳腺癌病例。与体重稳定(±2.5kg)的女性相比,20 岁时偏瘦的女性长期体重增加>10kg 与绝经后乳腺癌风险呈正相关,在 HRT 使用者(HR=1.42;95%置信区间 1.22-1.65)、从未使用 HRT 者(HR=1.40;1.16-1.68)和雌激素和孕激素受体阳性(ER+PR+)乳腺癌患者(HR=1.46;1.15-1.85)中均如此。
对于 20 岁时偏瘦的女性,长期体重增加与绝经后乳腺癌呈正相关,在 HRT 使用者和非使用者中以及激素受体阳性乳腺癌中均如此。