Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies.

Pizot, Cécile; Boniol, Mathieu; Mullie, Patrick; Koechlin, Alice; Boniol, M.; Boyle, Peter; Autier, Philippe

doi:10.1200/jco.2015.33.15_suppl.1561

Cited by 14 publications

(19 citation statements)

References 15 publications

(15 reference statements)

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“…One cohort study, one nested case-control study and ten case-control studies showed that hypertension is associated with increased risk of breast cancer [63]. In addition, in our study, in contrast with literature, there was no signi cant association between the risk of breast cancer and either diabetes [64][65][66] or the physical activity [33,67] and or the smoking status [33,68]. But we found a signi cant association between the second-hand smoking and breast cancer, which shares similarity with ndings of Reynolds et al [69].…”

Section: Discussioncontrasting

confidence: 88%

Investigation Risk Factors for Breast Cancer in Women: A Case–Control Study in Arak, Iran

Pezeshki

Ansari

Rezaie

et al. 2020

Preprint

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BackgroundBreast cancer is the most common malignant in women globally. In Iran, breast cancer incidence rate is continuously increasing. This study aimed to investigate the risk factors for breast cancer in Iranian women.MethodsA hospital-based case-control study was conducted between September 2016 and July 2019 in Arak, Iran. The sample size was 400 breast cancer patients and 400 healthy women. Demographical records and risk factor related data were collected. Logistic regression analysis used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsData showed that among various factors, urban life (OR = 1.361, 95% CI 1.025–1.808, P = 0.033), height (OR = 3.347, 95% CI 2.0443–5.480, P = 0.000), BMI (OR = 0.397, 95% CI 0.273–0.577, P = 0.000), education level (OR = 7.048, 95% CI 3.985–12.467, P = 0.000), awareness level (OR = 0.507, 95% CI 0.349–0.736, P = 0.000), job status (OR = 0.321, 95% CI 0.122–0.846, P = 0.022), economic status (OR = 4.333, 95% CI 1.424–13.184, P = 0.010), early menarche (OR = 2.815, 95% CI 1.745–4.541, P = 0.000), Stillbirth status (OR = 1.935, 95% CI 1.087–3.446, P = 0.025), family history (OR = 10.281, 95% CI 3.628–29.134, P = 0.000), behavioral habits (OR = 0.554, 95% CI 0.386–0.796, P = 0.001), and second-hand smoking (OR = 1.472, 95% CI 1.108–1.955, P = 0.008) significantly were associated with an increased risk for breast cancer.ConclusionThe data suggest that lifestyle may have more impact on the incidence of breast cancer in Iranian women, suggesting change unhealthy lifestyle and screening for preventing breast cancer.

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Section: Discussioncontrasting

confidence: 88%

Investigation Risk Factors for Breast Cancer in Women: A Case–Control Study in Arak, Iran

Pezeshki

Ansari

Rezaie

et al. 2020

Preprint

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“…By comparison, we found no association between genetically determined, accelerometer-assessed physical activity and ER-breast cancer. In addition, we found no associations between genetically determined, self-reported physical activity and risks of breast or endometrial cancers.Our findings are largely consistent with previous prospective observational investigations of physical activity and risk of breast and endometrial cancers[4][5][6][7][8] . A large pooled analysis of 10 European and US cohort studies including 35,178 breast cancer cases reported a risk reduction of 10% comparing high versus low levels of self-reported physical activity (hazard ratio: 0.90; 95%: 0.87-0.93)22 .…”

supporting

confidence: 92%

“…The association between physical activity and risk of breast and endometrial cancers has received considerable attention in recent years, with umbrella reviews and meta-analyses of observational studies providing evidence for protective associations with both breast cancer [4][5][6] and endometrial cancer 2,6,7 . Those associations have been confirmed by reports of the World Cancer Research Fund 3 and the 2018 U.S.…”

Section: Introductionmentioning

confidence: 99%

“…A large pooled analysis of 10 European and US cohort studies including 35,178 breast cancer cases reported a risk reduction of 10% comparing high versus low levels of self-reported physical activity (hazard ratio: 0.90; 95%: 0.87-0.93)22 . Similarly, the most comprehensive available meta-analysis of self-reported physical activity and breast cancer comprising 38 prospective studies and 116,304 breast cancer cases found that the highest compared to the lowest level of physical activity was associated with a 12% risk reduction (relative risk: 0.88; 95%: 0.85-0.90)5 . In addition, high versus low self-reported physical activity was associated with a 11% reduced risk of ER+ breast cancer (relative risk: 0.89; 95% CI: 0.83-0.95)5 .…”

mentioning

confidence: 99%

“…Similarly, the most comprehensive available meta-analysis of self-reported physical activity and breast cancer comprising 38 prospective studies and 116,304 breast cancer cases found that the highest compared to the lowest level of physical activity was associated with a 12% risk reduction (relative risk: 0.88; 95%: 0.85-0.90)5 . In addition, high versus low self-reported physical activity was associated with a 11% reduced risk of ER+ breast cancer (relative risk: 0.89; 95% CI: 0.83-0.95)5 . A pooled analysis of nine cohort studies including 5,347 endometrial cancer cases reported a risk reduction of 21% (hazard ratio: 0.79; 95 CI: 0.68-0.92) for high versus low self-reported physical activity22 .…”

mentioning

confidence: 99%

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Physical activity and risk of breast and endometrial cancers: a Mendelian randomization study

Baurecht

Leitzmann

O’Mara

et al. 2019

Preprint

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Importance: The causality of the association between physical activity and risk of breast and endometrial cancers is uncertain because available evidence is based exclusively on observational studies, which are potentially susceptible to confounding and reverse causation. Objective: To investigate whether increased physical activity is causally associated with decreased risk of breast and endometrial cancers, using a two-sample Mendelian randomization study design. Design, Setting, and Participants: Genome-wide association studies of physical activity, breast cancer, and endometrial cancer, published up to April 31, 2019, were identified using PubMed and the GWAS catalog. Twelve single nucleotide polymorphisms (SNP) known at P<5x10-8 to be associated with accelerometer-assessed or self-reported physical activity served as instrumental variables. Genetic summary data from four large consortia provided SNP-outcome associations [Breast Cancer Association Consortium; Discovery, Biology and Risk of Inherited Variants in Breast Cancer Consortium; Endometrial Cancer Association Consortium]. Main Outcomes and Measures: The primary outcomes were risk of breast cancer and risk of endometrial cancer. Secondary outcomes were estrogen receptor positive (ER+) and ER- breast cancers. Odds ratios (ORs) and 95% confidence intervals (CIs) per mean acceleration in milli-gravities of accelerometer-assessed physical activity and per one standard deviation (1-SD) increase in metabolic-equivalent (MET)-minutes/week of self-reported moderate-to-vigorous physical activity were computed using the inverse variance weighted method. A series of sensitivity analyses addressed the potential impact of heterogeneity, pleiotropy, and outliers. Results: Summary data were available for 122,977 breast cancers and 12,270 endometrial cancers. Genetic predisposition to increased accelerometer-assessed physical activity was associated with lower risk of breast and endometrial cancers. The associations (ORs [95% CI] per 1-SD increase in mean acceleration) were 0.88 (0.85-0.91) for breast cancer and 0.90 (0.83-0.97) for endometrial cancer. In addition, genetic predisposition to increased accelerometer-assessed physical activity was associated with lower risk of ER+ breast cancer. We found no evidence for an association between genetic predisposition to self-reported physical activity and risk of total breast cancer, breast cancer subtypes, or endometrial cancer. Conclusion and Relevance: This first Mendelian randomization study shows that objectively-assessed physical activity plays a causal role in protecting against breast and endometrial cancers.

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Physical Activity and Risk of Breast Cancer: A Meta-Analysis of 38 Cohort Studies in 45 Study Reports

et al. 2019

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To evaluate and quantify the association between physical activity (PA) and risk of breast cancer. Methods: A systematic review meta-analysis was conducted. The literature was independently and manually searched by 2 reviewers through 3 English databases (PubMed, Embase, and ISI Web of Science) for data till October 2017. The quality of included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. Fixed-effects models were used to estimate the pooled relative risk and 95% confidence intervals (95% CI). Doseeresponse analysis was chosen for quantifying the association between PA and risk of breast cancer. The Begg test and the Egger test were used to estimate potential publication bias. Heterogeneity between studies was evaluated with I 2 statistics. Results: The meta-analysis included 38 cohort studies published between 1994 and 2017, which included 68 416 breast cancer cases. The overall relative risk (ORR) for breast cancer was 0.87 (95% CI 0.84-0.90). The inverse association was consistent among all subgroup analyses. In subgroup analysis by menopausal status, the ORR of breast cancer was 0.83 (95% CI 0.79-0.87) for premenopausal status and 0.91 (95% CI 0.85-0.97) for postmenopausal status. In subgroup analysis by PA type, the ORR for total activity was 0.87 (95% CI 0.81-0.93), for recreational activity 0.88 (95% CI 0.85-0.91), for occupational activity 0.91 (95% CI 0.84-0.99), and for nonoccupational activity 0.87 (95% CI 0.83-0.92). The risk of breast cancer was significantly lower in people with exposure periods longer than 1 year and less than 5 years (ORR 0.62; 95% CI 0.46-0.78), followed by those with lifetime activity (ORR 0.81; 95% CI 0.69-0.93). The ORR for subjects with body mass index of less than 25 kg/m 2 (0.88; 95% CI 0.83-0.93) was close to that for subjects with body mass index of more than 25 kg/m 2 (0.87; 95% CI 0.77-0.97). A linear relationship was found between breast cancer risk and PA (recreational activity and total activity), and the ORR was reduced by 3% (95% CI 0.95-0.99) for every 10 metabolic equivalent of energy hours per week increment in recreational PA and by 2% (95% CI 0.97-0.99) for every 10 metabolic equivalent of energy hours per week increment in total PA. Conclusions: PA is significantly associated with a decrease in the risk of breast cancer.

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Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies.

Cited by 14 publications

References 15 publications

Investigation Risk Factors for Breast Cancer in Women: A Case–Control Study in Arak, Iran

Investigation Risk Factors for Breast Cancer in Women: A Case–Control Study in Arak, Iran

Physical activity and risk of breast and endometrial cancers: a Mendelian randomization study

Physical Activity and Risk of Breast Cancer: A Meta-Analysis of 38 Cohort Studies in 45 Study Reports

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