Linking Physical Activity to Breast Cancer via Sex Steroid Hormones, Part 2: The Effect of Sex Steroid Hormones on Breast Cancer Risk.

Ann E Drummond, Christopher T V Swain, Kristy A Brown, Suzanne C Dixon-Suen, Leonessa Boing, Eline H van Roekel, Melissa M Moore, Tom R Gaunt, Roger L Milne, Dallas R English, Richard M Martin, Sarah J Lewis, Brigid M Lynch

Journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2022;31(1):28-37

PMID: 34670801

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Abstract

We undertook a systematic review and appraised the evidence for an effect of circulating sex steroid hormones and sex hormone-binding globulin (SHBG) on breast cancer risk in pre- and postmenopausal women. Systematic searches identified prospective studies relevant to this review. Meta-analyses estimated breast cancer risk for women with the highest compared with the lowest level of sex hormones, and the DRMETA Stata package was used to graphically represent the shape of these associations. The ROBINS-E tool assessed risk of bias, and the GRADE system appraised the strength of evidence. In premenopausal women, there was little evidence that estrogens, progesterone, or SHBG were associated with breast cancer risk, whereas androgens showed a positive association. In postmenopausal women, higher estrogens and androgens were associated with an increase in breast cancer risk, whereas higher SHBG was inversely associated with risk. The strength of the evidence quality ranged from low to high for each hormone. Dose-response relationships between sex steroid hormone concentrations and breast cancer risk were most notable for postmenopausal women. These data support the plausibility of a role for sex steroid hormones in mediating the causal relationship between physical activity and the risk of breast cancer..

Address: Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.; Department of Medicine, Weill Cornell Medicine, New York, New York.; Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.; Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.; Laboratory of Research in Leisure and Physical Activity, Santa Catarina State University, Florianópolis, Brazil.; Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.; Medical Oncology, St Vincent's Hospital, Melbourne, Victoria, Australia.; Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.; Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.; Bristol Medical School, University of Bristol, Bristol, United Kingdom.; NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom.; Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia. [email protected].; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.

DOI: 10.1158/1055-9965.EPI-21-0438