Linking Physical Activity to Breast Cancer via Sex Hormones, Part 1: The Effect of Physical Activity on Sex Steroid Hormones.

Christopher T V Swain, Ann E Drummond, Leonessa Boing, Roger L Milne, Dallas R English, Kristy A Brown, Eline H van Roekel, Suzanne C Dixon-Suen, Michael J Lynch, Melissa M Moore, Tom R Gaunt, 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):16-27

PMID: 34670800

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Abstract

The effect of physical activity on breast cancer risk may be partly mediated by sex steroid hormones. This review synthesized and appraised the evidence for an effect of physical activity on sex steroid hormones. Systematic searches were performed using MEDLINE (Ovid), EMBASE (Ovid), and SPORTDiscus to identify experimental studies and prospective cohort studies that examined physical activity and estrogens, progestins, and/or androgens, as well as sex hormone binding globulin (SHBG) and glucocorticoids in pre- and postmenopausal women. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the GRADE system was used to appraise quality of the evidence. Twenty-eight randomized controlled trials (RCT), 81 nonrandomized interventions, and six observational studies were included. Estrogens, progesterone, and androgens mostly decreased, and SHBG increased, in response to physical activity. Effect sizes were small, and evidence quality was graded moderate or high for each outcome. Reductions in select sex steroid hormones following exercise supports the biological plausibility of the first part of the physical activity-sex hormone-breast cancer pathway. The confirmed effect of physical activity on decreasing circulating sex steroid hormones supports its causal role in preventing breast cancer..

Address: Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.; Laboratory of Research in Leisure and Physical Activity, Santa Catarina State University, Florianópolis, Brazil.; 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.; Department of Medicine, Weill Cornell Medicine, New York, New York.; Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.; Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.; Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.; Nambour Heights Family Medical, Nambour, Queensland, Australia.; Medical Oncology, St Vincent's Hospital, Melbourne, Victoria, Australia.; Bristol Medical School, University of Bristol, Bristol, United Kingdom.; 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-21-0437

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MeSH Terms: Breast Neoplasms, Causality, Exercise, Female, Gonadal Steroid Hormones, Humans, Risk Factors