Stahr Shelbie D, Runnells Gail A, Rogers Lora J, McElfish Pearl A, Kadlubar Susan A, Su L Joseph
Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, Little Rock, AR, USA.
University of Arkansas Medical Sciences Northwest, Fayetteville, AR, USA.
Transl Cancer Res. 2019 Jul;8(Suppl 4):S366-S377. doi: 10.21037/tcr.2019.06.18.
Physical activity has been identified as a modifiable risk factor for breast cancer. Varying definitions of physical activity have made the evaluation difficult to analyze. In a state with high prevalence of obesity and elevated rates of breast cancer incidence and mortality, physical activity may be an important element for risk reduction. Women's participation in physical activity and the relation to breast cancer incidence has rarely been determined in the southern states where obesity are prevalent.
Associations between various levels of physical activity and incident breast cancer cases among 21,665 subjects residing in Arkansas from 2007-2018 were completed. Multivariate logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI), adjusting for various risk factors such as age, alcohol use, education, region, ethnicity, age at menarche, ever had children, and history of breastfeeding and family history of breast cancer. Stratification on menopausal status was performed to observe any breast cancer differences within the different biological pathways.
Among premenopausal subjects, inverse associations were observed among increase time in walking (OR =0.63, 95% CI: 0.36-1.11 and OR =0.47, 95% CI: 0.26-0.83) and overall weekly physical activity (OR =0.89, 95% CI: 0.50-1.57 and OR =0.52, 95% CI: 0.30-0.90) and breast cancer. No association was evident between the risk for breast cancer and physical activity among postmenopausal subjects. The relationship between physical activity and risk for breast cancer differed between menopausal statuses. The most apparent association was seen among premenopausal subjects with an increase in walking (P=0.01).
Although physical activity has been demonstrated to have a beneficial effect on breast cancer prevention among postmenopausal women, results from this study do not sufficiently support the hypothesis in this population. Results varied among menopausal status as well as among different definitions of physical activity. Further investigation is needed to identify factors contributing to de-attenuating the relationships.
体育活动已被确定为乳腺癌的一个可改变的风险因素。体育活动的不同定义使得评估难以分析。在一个肥胖患病率高且乳腺癌发病率和死亡率上升的州,体育活动可能是降低风险的一个重要因素。在肥胖普遍的南部各州,很少确定女性参与体育活动及其与乳腺癌发病率的关系。
完成了2007年至2018年居住在阿肯色州的21665名受试者中不同水平体育活动与乳腺癌发病病例之间的关联研究。采用多因素logistic回归来估计比值比(OR)和95%置信区间(95%CI),并对年龄、饮酒、教育程度、地区、种族、初潮年龄、是否生育、母乳喂养史和乳腺癌家族史等各种风险因素进行校正。对绝经状态进行分层,以观察不同生物学途径内的任何乳腺癌差异。
在绝经前受试者中,步行时间增加(OR=0.63,95%CI:0.36-1.11和OR=0.47,95%CI:0.26-0.83)以及总体每周体育活动量(OR=0.89,95%CI:0.50-1.57和OR=0.52,95%CI:0.30-0.90)与乳腺癌呈负相关。绝经后受试者中,体育活动与乳腺癌风险之间无明显关联。绝经状态不同,体育活动与乳腺癌风险之间的关系也不同。在绝经前受试者中,步行增加与乳腺癌风险的关联最为明显(P=0.01)。
虽然体育活动已被证明对绝经后女性预防乳腺癌有有益作用,但本研究结果不足以支持该人群中的这一假设。结果在绝经状态以及体育活动的不同定义之间存在差异。需要进一步调查以确定导致关系减弱的因素。