Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland.
Cancer Registry Zurich, Zug, Schaffhausen, and Schwyz, University Hospital Zurich, Zurich, Switzerland.
Int J Cancer. 2022 Nov 15;151(10):1674-1683. doi: 10.1002/ijc.34183. Epub 2022 Jul 8.
A health-conscious lifestyle may protect against breast cancer in situ. However, breast cancer in situ is mainly detected by screening, and many studies lack information on screening participation. Thus, we evaluated the association between prediagnostic lifestyle and risk of breast cancer in situ, accounting for screening participation at recruitment. A score reflecting the adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations was constructed, using the recommendations on healthy body weight, physical activity, consumption of plant-based foods, red and processed meat, alcohol and avoidance of sugar. Cox proportional hazards regression models were used to investigate the association between the lifestyle score and breast cancer in situ risk, while accounting for important confounders. The lifestyle score was not significantly associated with breast cancer in situ risk (HR = 0.96, 95% CI = 0.91-1.03) in the overall cohort. In participants not reporting dietary changes in the past 5 years, the lifestyle score was inversely associated with breast cancer in situ risk (HR = 0.92, 95% CI = 0.85-0.99). In those reporting dietary changes in the past 5 years due to illness or other reasons, the lifestyle score was not associated with breast cancer in situ risk (HR = 1.04, 95% CI = 0.94-1.15). Lifestyle was inversely associated with breast cancer in situ risk in women not reporting recent changes in their dietary habits. This inverse association is consistent with inverse associations reported in previous studies. Our findings suggest that breast cancer in situ and invasive breast cancer share a similar risk factor profile.
健康的生活方式可能有助于预防原位乳腺癌。然而，原位乳腺癌主要通过筛查发现，许多研究缺乏关于筛查参与的信息。因此，我们评估了在考虑到招募时的筛查参与情况的情况下，预先确定的生活方式与原位乳腺癌风险之间的关联。使用关于健康体重、身体活动、植物性食物、红色和加工肉类、酒精和避免糖的建议，构建了反映对世界癌症研究基金会/美国癌症研究所癌症预防建议的依从性的评分。使用 Cox 比例风险回归模型，在考虑重要混杂因素的情况下，研究了生活方式评分与原位乳腺癌风险之间的关联。生活方式评分与整体队列中的原位乳腺癌风险无显著相关性（HR = 0.96，95%CI = 0.91-1.03）。在过去 5 年内未报告饮食变化的参与者中，生活方式评分与原位乳腺癌风险呈负相关（HR = 0.92，95%CI = 0.85-0.99）。在过去 5 年内因疾病或其他原因报告饮食变化的参与者中，生活方式评分与原位乳腺癌风险无关（HR = 1.04，95%CI = 0.94-1.15）。在未报告近期饮食习惯变化的女性中，生活方式与原位乳腺癌风险呈负相关。这种负相关与之前研究报告的负相关一致。我们的研究结果表明，原位乳腺癌和浸润性乳腺癌具有相似的危险因素特征。
