International Pooled Analysis of Leisure-Time Physical Activity and Premenopausal Breast Cancer in Women From 19 Cohorts.
Celine M Vachon, Anne M May, Lene Mellemkjær, Roger L Milne, Julie R Palmer, Fulvio Ricceri, Thomas E Rohan, Kathryn J Ruddy, Maria-Jose Sánchez, Xiao-Ou Shu, Karl Smith-Byrne, Karen Steindorf, Malin Sund, Brigid M Lynch, Lars J Vatten, Kala Visvanathan, Elisabete Weiderpass, Walter C Willett, Alicja Wolk, Jian-Min Yuan, Wei Zheng, Hazel B Nichols, Dale P Sandler, Anthony J Swerdlow, Minouk J Schoemaker, A Heather Eliassen, Michael E Jones, Katie M O'Brien, Hans-Olov Adami, Dagfinn Aune, Laura Baglietto, Kimberly A Bertrand, Kristen D Brantley, Yu Chen, Jessica Clague DeHart, Tess V Clendenen, Laure Dossus, Iain R Timmins, Olivia Fletcher, Agnès Fournier, Niclas Håkansson, Susan E Hankinson, Richard S Houlston, Corinne E Joshu, Victoria A Kirsh, Cari M Kitahara, Woon-Puay Koh, Martha S Linet, Hannah Lui Park
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
2024;42(8):927-939
PMID: 38079601
Abstract
PURPOSE
There is strong evidence that leisure-time physical activity is protective against postmenopausal breast cancer risk but the association with premenopausal breast cancer is less clear. The purpose of this study was to examine the association of physical activity with the risk of developing premenopausal breast cancer.
METHODS
We pooled individual-level data on self-reported leisure-time physical activity across 19 cohort studies comprising 547,601 premenopausal women, with 10,231 incident cases of breast cancer. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% CIs for associations of leisure-time physical activity with breast cancer incidence. HRs for high versus low levels of activity were based on a comparison of risk at the 90th versus 10th percentiles of activity. We assessed the linearity of the relationship and examined subtype-specific associations and effect modification across strata of breast cancer risk factors, including adiposity.
RESULTS
Over a median 11.5 years of follow-up (IQR, 8.0-16.1 years), high versus low levels of leisure-time physical activity were associated with a 6% (HR, 0.94 [95% CI, 0.89 to 0.99]) and a 10% (HR, 0.90 [95% CI, 0.85 to 0.95]) reduction in breast cancer risk, before and after adjustment for BMI, respectively. Tests of nonlinearity suggested an approximately linear relationship ( = .94). The inverse association was particularly strong for human epidermal growth factor receptor 2-enriched breast cancer (HR, 0.57 [95% CI, 0.39 to 0.84]; = .07). Associations did not vary significantly across strata of breast cancer risk factors, including subgroups of adiposity.
CONCLUSION
This large, pooled analysis of cohort studies adds to evidence that engagement in higher levels of leisure-time physical activity may lead to reduced premenopausal breast cancer risk.
Address:
Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom.; Statistical Innovation, AstraZeneca, Cambridge, United Kingdom.; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC.; Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway.; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.; Department of Nutrition, Oslo New University College, Oslo, Norway.; Department of Research, The Cancer Registry of Norway, Oslo, Norway.; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.; Slone Epidemiology Center at Boston University, Boston, MA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.; Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY.; School of Community and Global Health, Claremont Graduate University, Claremont, CA.; Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.; The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom.; UVSQ, CESP, Gustave Roussy, Team "Exposome, Heredity, Cancer, and Health", INSERM, Paris-Saclay University, Paris-South University, Villejuif, France.; Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.; Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.; Ontario Institute for Cancer Research, Toronto, ON, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.; Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore.; Department of Pathology and Laboratory Medicine, Department of Epidemiology, UC Irvine School of Medicine, Irvine, CA.; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.; Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.; Danish Cancer Society Research Center, Copenhagen, Denmark.; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.; Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin, Turin, Italy.; Unit of Epidemiology, Regional Health Service ASL TO3, Turin, Italy.; Albert Einstein College of Medicine, Bronx, NY.; Department of Oncology, Mayo Clinic, Rochester, MN.; Escuela Andaluza de Salud Pública (EASP), Granada, Spain.; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.; Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN.; Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom.; Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.; Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Umeâ, Sweden.; Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.; Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN.; Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.; International Agency for Research on Cancer, World Health Organization, Lyon, France.; Division of Cancer Control and Population Sciences, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA.; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA.; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC.; Division of Breast Cancer Research, The Institute of Cancer Research, London, United Kingdom.; Real World Solutions, IQVIA, Amsterdam, the Netherlands.
Link outs
Free resources
Full Text Sources:
Medical:
Research Materials:
Subscription / membership required