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Timmins IR, Jones ME, O'Brien KM, Adami HO, Aune D, Baglietto L, Bertrand KA, Brantley KD, Chen Y, Clague DeHart J, Clendenen TV, Dossus L, Eliassen AH, Fletcher O, Fournier A, Håkansson N, Hankinson SE, Houlston RS, Joshu CE, Kirsh VA, Kitahara CM, Koh WP, Linet MS, Park HL, Lynch BM, May AM, Mellemkjær L, Milne RL, Palmer JR, Ricceri F, Rohan TE, Ruddy KJ, Sánchez MJ, Shu XO, Smith-Byrne K, Steindorf K, Sund M, Vachon CM, Vatten LJ, Visvanathan K, Weiderpass E, Willett WC, Wolk A, Yuan JM, Zheng W, Nichols HB, Sandler DP, Swerdlow AJ, Schoemaker MJ. International Pooled Analysis of Leisure-Time Physical Activity and Premenopausal Breast Cancer in Women From 19 Cohorts. J Clin Oncol 2024; 42:927-939. [PMID: 38079601 PMCID: PMC10927335 DOI: 10.1200/jco.23.01101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/07/2023] [Accepted: 10/19/2023] [Indexed: 02/12/2024] Open
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 (Pnonlinearity = .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]; Phet = .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.
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Affiliation(s)
- Iain R. Timmins
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Statistical Innovation, AstraZeneca, Cambridge, United Kingdom
| | - Michael E. Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Katie M. O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Dagfinn Aune
- 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
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Kristen D. Brantley
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | | | - Tess V. Clendenen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - A. Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Agnès Fournier
- UVSQ, CESP, Gustave Roussy, Team “Exposome, Heredity, Cancer, and Health”, INSERM, Paris-Saclay University, Paris-South University, Villejuif, France
| | - Niclas Håkansson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susan E. Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA
| | - Richard S. Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Corinne E. Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Victoria A. Kirsh
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Woon-Puay Koh
- 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
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Hannah Lui Park
- Department of Pathology and Laboratory Medicine, Department of Epidemiology, UC Irvine School of Medicine, Irvine, CA
| | - Brigid M. Lynch
- 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
| | - Anne M. May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | - Roger L. Milne
- 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
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | | | - Fulvio Ricceri
- 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
| | | | | | - Maria-Jose Sánchez
- 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
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Karl Smith-Byrne
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Malin Sund
- Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Umeâ, Sweden
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Celine M. Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN
| | - Lars J. Vatten
- Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Walter C. Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Alicja Wolk
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jian-Min Yuan
- 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
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Hazel B. Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Anthony J. Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Division of Breast Cancer Research, The Institute of Cancer Research, London, United Kingdom
| | - Minouk J. Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Real World Solutions, IQVIA, Amsterdam, the Netherlands
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Tomida S, Koyama T, Ozaki E, Takashima N, Morita M, Sakaguchi K, Naoi Y, Nishida Y, Hara M, Hishida A, Tamura T, Okada R, Kubo Y, Otonari J, Ikezaki H, Nakamura Y, Kusakabe M, Tanoue S, Koriyama C, Koyanagi YN, Ito H, Suzuki S, Otani T, Miyagawa N, Okami Y, Arisawa K, Watanabe T, Kuriki K, Wakai K, Matsuo K. Seven-plus hours of daily sedentary time and the subsequent risk of breast cancer: Japan Multi-Institutional Collaborative Cohort Study. Cancer Sci 2024; 115:611-622. [PMID: 38041484 PMCID: PMC10859602 DOI: 10.1111/cas.16020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/15/2023] [Accepted: 11/06/2023] [Indexed: 12/03/2023] Open
Abstract
This study aimed to investigate the association between daily sedentary time and the risk of breast cancer (BC) in a large Japanese population. The participants were 36,023 women aged 35-69 years from the Japan Multi-Institutional Collaborative Cohort Study. Cox proportional hazards analysis was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for BC incidence in relation to time spent sedentarily (categorical variables: <7 and ≥7 hours/day [h/d]). Additionally, the associations of BC incidence to the joint effect of sedentary time with each component of physical activity, such as leisure-time metabolic equivalents (METs), frequency of leisure-time physical activity, and daily walking time, were examined. During 315,189 person-years of follow-up, 554 incident cases of BC were identified. When compared to participants who spent <7 h/d sedentary, those who spent ≥7 h/d sedentary have a significantly higher risk of BC (HR, 1.36; 95% CI, 1.07-1.71). The corresponding HRs among participants who spent ≥7 h/d sedentary with more physical activity, such as ≥1 h/d for leisure-time METs, ≥3 days/week of leisure-time physical activity, and ≥1 h/d of daily walking were 1.58 (95% CI, 1.11-2.25), 1.77 (95% CI, 1.20-2.61), and 1.42 (95% CI, 1.10-1.83), respectively, compared with those who spent <7 h/d sedentary. This study found that spending ≥7 h/d of sedentary time is associated with the risk of BC. Neither leisure-time physical activity nor walking had a BC-preventive effect in those with ≥7 h/d of sedentary time.
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Affiliation(s)
- Satomi Tomida
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naoyuki Takashima
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Midori Morita
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Sakaguchi
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasuto Naoi
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuichiro Nishida
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun Otonari
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Miho Kusakabe
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Shiroh Tanoue
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Chihaya Koriyama
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuriko N Koyanagi
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Yukiko Okami
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takeshi Watanabe
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Aichi, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Zhu JW, Charkhchi P, Adekunte S, Akbari MR. What Is Known about Breast Cancer in Young Women? Cancers (Basel) 2023; 15:cancers15061917. [PMID: 36980802 PMCID: PMC10047861 DOI: 10.3390/cancers15061917] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Breast cancer (BC) is the second leading cause of cancer-related death in women under the age of 40 years worldwide. In addition, the incidence of breast cancer in young women (BCYW) has been rising. Young women are not the focus of screening programs and BC in younger women tends to be diagnosed in more advanced stages. Such patients have worse clinical outcomes and treatment complications compared to older patients. BCYW has been associated with distinct tumour biology that confers a worse prognosis, including poor tumour differentiation, increased Ki-67 expression, and more hormone-receptor negative tumours compared to women >50 years of age. Pathogenic variants in cancer predisposition genes such as BRCA1/2 are more common in early-onset BC compared to late-onset BC. Despite all these differences, BCYW remains poorly understood with a gap in research regarding the risk factors, diagnosis, prognosis, and treatment. Age-specific clinical characteristics or outcomes data for young women are lacking, and most of the standard treatments used in this subpopulation currently are derived from older patients. More age-specific clinical data and treatment options are required. In this review, we discuss the epidemiology, clinicopathologic characteristics, outcomes, treatments, and special considerations of breast cancer in young women. We also underline future directions and highlight areas that require more attention in future studies.
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Affiliation(s)
- Jie Wei Zhu
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON M5G 2C4, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Parsa Charkhchi
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Shadia Adekunte
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Mohammad R Akbari
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON M5G 2C4, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
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4
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Azubuike SO, Hayes L, Sharp L, Alabi A, Oyesegun RA, McNally R. Physical activity and the risk of breast cancer among Nigerian women. Cancer Epidemiol 2022; 78:102163. [DOI: 10.1016/j.canep.2022.102163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/24/2022]
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Okazaki K, Ohira T, Sakai A, Shimabukuro M, Kazama JJ, Takahashi A, Nakano H, Hayashi F, Nagao M, Yasumura S, Ohto H, Kamiya K. Lifestyle Factors Associated with Undernutrition in Older People after the Great East Japan Earthquake: A Prospective Study in the Fukushima Health Management Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063399. [PMID: 35329088 PMCID: PMC8951088 DOI: 10.3390/ijerph19063399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/27/2023]
Abstract
We conducted a longitudinal examination to assess the relationship between lifestyle habits, including exercise habits, and the incidence of undernutrition after the Great East Japan Earthquake in March 2011. Of the 31,411 participants aged ≥60 years who lived in the municipalities’ evacuation areas before the disaster and had undergone health examinations, 17,622 persons with a body mass index of 20–25 kg/m2 were followed up through the FY 2017 (a mean follow-up of 6.9 years). The analysis involved 13,378 individuals who could be followed. The associations between undernutrition after the disaster and lifestyle factors were estimated via multivariable-adjusted analysis using the Cox proportional hazard regression model. The dependent variable was the proportion of undernutrition after the disaster, whereas independent variables included evacuation, exercise habits/physical activity, alcohol consumption, smoking, meals before bedtime, gastrointestinal surgery history, history of lifestyle-related diseases, and two or more subjective symptoms. In total, 1712 of the 13,378 participants were newly undernourished after the disaster. The statistically significant variables influencing the occurrence of undernutrition were non-evacuation (hazard ratio (HR), 1.31; 95% confidence index (CI) 1.17–1.47), poor exercise habits (HR, 1.14; 95% CI 1.03–1.50), and poor physical activity (HR, 1.12; 95% CI 1.01–1.25). Other significant related variables were drinking habits, surgical history, lifestyle-related diseases, and two or more subjective symptoms. These results suggest that regular exercise and/or physical activity might be important in preventing undernutrition following a disaster, regardless of sex, other lifestyle habits, or past medical history.
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Affiliation(s)
- Kanako Okazaki
- Department of Physical Therapy, Fukushima Medical University School of Medical Sciences, Fukushima 960-8516, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
- Correspondence: ; Tel.: +81-(24)-5471762
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Junichiro J. Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan
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Sari GN, Eshak ES, Shirai K, Fujino Y, Tamakoshi A, Iso H. Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study. BMC Public Health 2020; 20:1106. [PMID: 32664915 PMCID: PMC7362447 DOI: 10.1186/s12889-020-09134-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast cancer represented the leading cause of cancer deaths among women in Japan. Although physical activity has been reported protective against breast cancer, scientific evidence is limited on the risk of breast cancer according to job category or occupational activity in Japanese. Our objective was to examine the association of job category and occupational activity with breast cancer incidence in Japanese female workers using the data from the Japan Collaborative Cohort (JACC) Study. METHODS A prospective cohort study involving 19,041 women aged 40-79 years who have reported their occupational data and followed-up from 1988 to 2009. All variables were assessed by a self-administered questionnaire. Cancer incidence data were obtained from 24 areas of the JACC study through cancer population data registration, or review of hospital records. The Cox proportional hazard models were operated to calculate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). RESULTS There were 138 incident cases of breast cancer during 13.3 years median follow-up period. Office workers compared with manual workers were at a higher risk of breast cancer after adjusting for reproductive health factors and physical activity indicators; the multivariable HR (95% CI) was 1.65 (1.07-2.55). Also, women who had mainly a sitting position during work compared with those moving during work had the higher risk: the multivariable HR (95%CI) of 1.45 (1.01-2.12). The excess risk of breast cancer was observed for office workers when time spent in walking was < 30 min/ day; HR (95% CI) was 1.11 (1.01-1.23), and for women mainly at a sitting position during work when time spent in walking was 30-59 min or < 30 min/day; HRs (95% CIs) were 1.87 (1.07-3.27) and 1.74 (1.07-2.83), respectively. CONCLUSION The job category and occupational activity were associated with risk of breast cancer incidence. A high risk was observed in office workers and in women with a sitting position during work. These observed increased risks were evident in women with less daily walking activity.
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Affiliation(s)
- Gita Nirmala Sari
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
- Health Polytechnic of Jakarta III, Ministry of Health, Jakarta, Indonesia
| | - Ehab Salah Eshak
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
- Department of Public Health, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
| | - Yoshihisa Fujino
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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World Cancer Research Fund International: Continuous Update Project-systematic literature review and meta-analysis of observational cohort studies on physical activity, sedentary behavior, adiposity, and weight change and breast cancer risk. Cancer Causes Control 2019; 30:1183-1200. [PMID: 31471762 DOI: 10.1007/s10552-019-01223-w] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/16/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of the present study was to systematically review the complex associations between energy balance-related factors and breast cancer risk, for which previous evidence has suggested different associations in the life course of women and by hormone receptor (HR) status of the tumor. METHODS Relevant publications on adulthood physical activity, sedentary behavior, body mass index (BMI), waist and hip circumferences, waist-to-hip ratio, and weight change and pre- and postmenopausal breast cancer risk were identified in PubMed up to 30 April 2017. Random-effects meta-analyses were conducted to summarize the relative risks across studies. RESULTS One hundred and twenty-six observational cohort studies comprising over 22,900 premenopausal and 103,000 postmenopausal breast cancer cases were meta-analyzed. Higher physical activity was inversely associated with both pre- and postmenopausal breast cancers, whereas increased sitting time was positively associated with postmenopausal breast cancer. Although higher early adult BMI (ages 18-30 years) was inversely associated with pre- and postmenopausal breast cancers, adult weight gain and greater body adiposity increased breast cancer risk in postmenopausal women, and the increased risk was evident for HR+ but not HR- breast cancers, and among never but not current users of postmenopausal hormones. The evidence was less consistent in premenopausal women. There were no associations with adult weight gain, inverse associations with adult BMI (study baseline) and hip circumference, and non-significant associations with waist circumference and waist-to-hip ratio that were reverted to positive associations on average in studies accounting for BMI. No significant associations were observed for HR-defined premenopausal breast cancers. CONCLUSION Better understanding on the impact of these factors on pre- and postmenopausal breast cancers and their subtypes along the life course is needed.
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Kim Y, Sharp S, Hwang S, Jee SH. Exercise and incidence of myocardial infarction, stroke, hypertension, type 2 diabetes and site-specific cancers: prospective cohort study of 257 854 adults in South Korea. BMJ Open 2019; 9:e025590. [PMID: 30872551 PMCID: PMC6430026 DOI: 10.1136/bmjopen-2018-025590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/05/2018] [Accepted: 12/19/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The objective of this study was to examine the longitudinal associations of exercise frequency with the incidence of myocardial infarction, stroke, hypertension, type 2 diabetes and 10 different cancer outcomes. DESIGN A prospective cohort study. SETTING Physical examination data linked with the entire South Korean population's health insurance system: from 2002 to 2015. PARTICIPANTS 257 854 South Korean adults who provided up to 7 repeat measures of exercise (defined as exercises causing sweat) and confounders. PRIMARY OUTCOME MEASURES Each disease incidence was defined using both fatal and non-fatal health records (a median follow-up period of 13 years). RESULTS Compared with no exercise category, the middle categories of exercise frequency (3-4 or 5-6 times/week) showed the lowest risk of myocardial infarction (HR 0.79; 95% CI 0.70 to 0.90), stroke (HR 0.80; 95% CI 0.73 to 0.89), hypertension (HR 0.86; 95% CI 0.85 to 0.88), type 2 diabetes (HR 0.87; 95% CI 0.84 to 0.89), stomach (HR 0.87; 95% CI 0.79 to 0.96), lung (HR 0.80; 95% CI 0.71 to 0.91), liver (HR 0.85; 95% CI 0.75 to 0.98) and head and neck cancers (HR 0.76; 95% CI 0.63 to 0.93; for 1-2 times/week), exhibiting J-shaped associations. There was, in general, little evidence of effect modification by body mass index, smoking, alcohol consumption, family history of disease and sex in these associations. CONCLUSIONS Moderate levels of sweat-inducing exercise showed the lowest risk of myocardial infarction, stroke, hypertension, type 2 diabetes, stomach, lung, liver and head and neck cancers. Public health and lifestyle interventions should, therefore, promote moderate levels of sweat-causing exercise as a behavioural prevention strategy for non-communicable diseases in a wider population of East Asians.
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Affiliation(s)
- Youngwon Kim
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Stephen Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Semi Hwang
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Sun Ha Jee
- Epidemiology, Graduate School of Public Health, Yonsei University, Seoul, South Korea
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Chen X, Wang Q, Zhang Y, Xie Q, Tan X. Physical Activity and Risk of Breast Cancer: A Meta-Analysis of 38 Cohort Studies in 45 Study Reports. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:104-128. [PMID: 30661625 DOI: 10.1016/j.jval.2018.06.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/22/2018] [Accepted: 06/28/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES 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). Dose-response 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 I2 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/m2 (0.88; 95% CI 0.83-0.93) was close to that for subjects with body mass index of more than 25 kg/m2 (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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Affiliation(s)
- Xuyu Chen
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Qiru Wang
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Yanan Zhang
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Qian Xie
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Xiaodong Tan
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China.
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Hardefeldt PJ, Penninkilampi R, Edirimanne S, Eslick GD. Physical Activity and Weight Loss Reduce the Risk of Breast Cancer: A Meta-analysis of 139 Prospective and Retrospective Studies. Clin Breast Cancer 2018; 18:e601-e612. [DOI: 10.1016/j.clbc.2017.10.010] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 09/21/2017] [Accepted: 10/11/2017] [Indexed: 12/17/2022]
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Nitta J, Nojima M, Ohnishi H, Mori M, Wakai K, Suzuki S, Fujino Y, Lin Y, Tamakoshi K, Tamakoshi A. Weight Gain and Alcohol Drinking Associations with Breast Cancer Risk in Japanese Postmenopausal Women - Results from the Japan Collaborative Cohort (JACC) Study. Asian Pac J Cancer Prev 2016; 17:1437-43. [DOI: 10.7314/apjcp.2016.17.3.1437] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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12
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The Japanese Breast Cancer Society clinical practice guidelines for epidemiology and prevention of breast cancer, 2015 edition. Breast Cancer 2016; 23:343-56. [DOI: 10.1007/s12282-016-0673-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 12/27/2015] [Indexed: 12/13/2022]
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13
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Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies. Eur J Cancer 2015; 52:138-54. [PMID: 26687833 DOI: 10.1016/j.ejca.2015.10.063] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 10/12/2015] [Accepted: 10/26/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lower risk of breast cancer has been reported among physically active women, but the risk in women using hormone replacement therapy (HRT) appears to be higher. We quantified the association between physical activity and breast cancer, and we examined the influence that HRT use and other risk factors had on this association. METHODS After a systematic literature search, prospective studies were meta-analysed using random-effect models applied on highest versus lowest level of physical activity. Dose-response analyses were conducted with studies reporting physical activity either in hours per week or in hours of metabolic equivalent per week (MET-h/week). RESULTS The literature search identified 38 independent prospective studies published between 1987 and 2014 that included 116,304 breast cancer cases. Compared to the lowest level of physical activity, the highest level was associated with a summary relative risk (SRR) of 0.88 (95% confidence interval [CI] 0.85, 0.90) for all breast cancer, 0.89 (95% CI 0.83, 0.95) for ER+/PR+ breast cancer and 0.80 (95% CI 0.69, 0.92) for ER-/PR- breast cancer. Risk reductions were not influenced by the type of physical activity (occupational or non-occupational), adiposity, and menopausal status. Risk reductions increased with increasing amounts of physical activity without threshold effect. In six studies, the SRR was 0.78 (95% CI 0.70, 0.87) in women who never used HRT and 0.97 (95% CI 0.88, 1.07) in women who ever used HRT, without heterogeneity in results. Findings indicate that a physically inactive women engaging in at least 150 min per week of vigorous physical activity would reduce their lifetime risk of breast cancer by 9%, a reduction that might be two times greater in women who never used HRT. CONCLUSION Increasing physical activity is associated with meaningful reductions in the risk of breast cancer, but in women who ever used HRT, the preventative effect of physical activity seems to be cancelled out.
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Lee C, Lee JC, Park B, Bae J, Lim MH, Kang D, Yoo KY, Park SK, Kim Y, Kim S. Computational Discrimination of Breast Cancer for Korean Women Based on Epidemiologic Data Only. J Korean Med Sci 2015; 30:1025-34. [PMID: 26240478 PMCID: PMC4520931 DOI: 10.3346/jkms.2015.30.8.1025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 04/09/2015] [Indexed: 11/20/2022] Open
Abstract
Breast cancer is the second leading cancer for Korean women and its incidence rate has been increasing annually. If early diagnosis were implemented with epidemiologic data, the women could easily assess breast cancer risk using internet. National Cancer Institute in the United States has released a Web-based Breast Cancer Risk Assessment Tool based on Gail model. However, it is inapplicable directly to Korean women since breast cancer risk is dependent on race. Also, it shows low accuracy (58%-59%). In this study, breast cancer discrimination models for Korean women are developed using only epidemiological case-control data (n = 4,574). The models are configured by different classification techniques: support vector machine, artificial neural network, and Bayesian network. A 1,000-time repeated random sub-sampling validation is performed for diverse parameter conditions, respectively. The performance is evaluated and compared as an area under the receiver operating characteristic curve (AUC). According to age group and classification techniques, AUC, accuracy, sensitivity, specificity, and calculation time of all models were calculated and compared. Although the support vector machine took the longest calculation time, the highest classification performance has been achieved in the case of women older than 50 yr (AUC = 64%). The proposed model is dependent on demographic characteristics, reproductive factors, and lifestyle habits without using any clinical or genetic test. It is expected that the model could be implemented as a web-based discrimination tool for breast cancer. This tool can encourage potential breast cancer prone women to go the hospital for diagnostic tests.
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Affiliation(s)
- Chiwon Lee
- The Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, Korea
| | - Jung Chan Lee
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
| | - Boyoung Park
- Graduate School of Cancer Science and Policy and National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jonghee Bae
- Korea Aerospace Research Institute, Dajeon, Korea
| | - Min Hyuk Lim
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Keun-Young Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Youdan Kim
- Department of Mechanical and Aerospace Engineering, Seoul National University College of Engineering, Seoul, Korea
- Institute of Advanced Aerospace Technology, Department of Mechanical and Aerospace Engineering, Seoul National University, Seoul, Korea
| | - Sungwan Kim
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
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Kim Y, Yoo KY, Goodman MT. Differences in Incidence, Mortality and Survival of Breast Cancer by Regions and Countries in Asia and Contributing Factors. Asian Pac J Cancer Prev 2015; 16:2857-70. [DOI: 10.7314/apjcp.2015.16.7.2857] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Taira N, Arai M, Ikeda M, Iwasaki M, Okamura H, Takamatsu K, Yamamoto S, Ohsumi S, Mukai H. The Japanese Breast Cancer Society clinical practice guideline for epidemiology and prevention of breast cancer. Breast Cancer 2014; 22:16-27. [DOI: 10.1007/s12282-014-0555-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/14/2014] [Indexed: 12/29/2022]
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Takahashi H, Washio M, Kiyohara C, Tada Y, Asami T, Ide S, Atsumi T, Kobashi G, Yamamoto M, Horiuchi T. Psychological stress in a Japanese population with systemic lupus erythematosus: Finding from KYSS study. Mod Rheumatol 2013; 24:448-52. [DOI: 10.3109/14397595.2013.843745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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18
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Suzuki S, Kojima M, Tokudome S, Mori M, Sakauchi F, Wakai K, Fujino Y, Lin Y, Kikuchi S, Tamakoshi K, Tamakoshi A. Obesity/weight gain and breast cancer risk: findings from the Japan collaborative cohort study for the evaluation of cancer risk. J Epidemiol 2013; 23:139-45. [PMID: 23438695 PMCID: PMC3700246 DOI: 10.2188/jea.je20120102] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We analyzed data from the Japan Collaborative Cohort Study (36 164 women aged 40-79 years at baseline in 1988-1990 with no previous diagnosis of breast cancer and available information on weight and height) to examine the association between baseline body mass index (BMI)/weight gain from age 20 years and breast cancer risk in a non-Western population. METHODS The participants were followed prospectively from enrollment until 1999-2003 (median follow-up: 12.3 years). During follow-up, breast cancer incidence was mainly confirmed through record linkage to population-based cancer registries. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% CIs for the association between breast cancer risk and body size. RESULTS In 397 644.1 person-years of follow-up, we identified 234 breast cancer cases. Among postmenopausal women, the adjusted HR increased with BMI, with a significant linear trend (P < 0.0001). Risk was significantly increased among women with a BMI of 24 or higher (HR: 1.50, 95% CI: 1.09-2.08 for BMI of 24-28.9, and 2.13, 1.09-4.16 for BMI ≥ 29) as compared with women with a BMI of 20 to 23.9. Weight gain after age 20 years and consequent overweight/obesity were combined risk factors for postmenopausal breast cancer risk. This combined effect was stronger among women aged 60 years or older. However, the HRs were not significant in premenopausal women. CONCLUSIONS Our findings support the hypothesis that weight gain and consequent overweight/obesity are combined risk factors for breast cancer among postmenopausal women, particularly those aged 60 years or older.
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Affiliation(s)
- Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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Wu Y, Zhang D, Kang S. Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast Cancer Res Treat 2012; 137:869-82. [PMID: 23274845 DOI: 10.1007/s10549-012-2396-7] [Citation(s) in RCA: 264] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 12/18/2012] [Indexed: 12/28/2022]
Abstract
We conducted a meta-analysis to summarize the evidence from prospective studies regarding the association between physical activity and breast cancer risk. A comprehensive search was conducted to identify eligible studies. The fixed or random effect model was used based on heterogeneity test. The dose-response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression. Overall, 31 studies with 63,786 cases were included, and the combined relative risk (RR) with 95 % CI of breast cancer was 0.88 (0.85-0.91). In subgroup analysis by activity type, data from 27 studies including 37,568 cases for non-occupational activity (including recreational activity and household activity) and seven studies including 28,268 cases for occupational activity were used, and the RR (95 % CI) of breast cancer was 0.87 (0.83-0.91) and 0.90 (0.83-0.97), respectively. The inverse association was consistent among all subgroups analyses. Stronger association was found for subjects with BMI <25 kg/m(2) [0.72 (0.65-0.81)], premenopausal women [0.77 (0.72-0.84)], and estrogen and progesterone receptor-negative breast cancer [0.80 (0.73-0.87)]. Dose-response analysis suggested that the risk of breast cancer decreased by 2 % (P < 0.00) for every 25 metabolic equivalent (MET)-h/week increment in non-occupational physical activity, 3 % (P < 0.00) for every 10 MET-h/week (roughly equivalent to 4 h/week of walking in 2 miles/h or 1 h/week of running in 6 miles/h) increment in recreational activity, and 5 % (P < 0.00) for every 2 h/week increment in moderate plus vigorous recreational activity, respectively. Physical activity could significantly reduce the risk of breast cancer.
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Affiliation(s)
- Yili Wu
- Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Dongzhou Road No. 38, Qingdao, Shandong, People's Republic of China
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Loprinzi PD, Cardinal BJ, Smit E, Winters-Stone KM. Physical activity and breast cancer risk. J Exerc Sci Fit 2012. [DOI: 10.1016/j.jesf.2012.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Xu YL, Sun Q, Shan GL, Zhang J, Liao HB, Li SY, Jiang J, Shao ZM, Jiang HC, Shen NC, Shi Y, Yu CZ, Zhang BN, Chen YH, Duan XN, Li B. A case-control study on risk factors of breast cancer in China. Arch Med Sci 2012; 8:303-9. [PMID: 22662004 PMCID: PMC3361043 DOI: 10.5114/aoms.2012.28558] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 12/21/2010] [Accepted: 01/11/2011] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION To screen the risk factors associated with breast cancer among Chinese women in order to evaluate the individual risk of developing breast cancer among women in China. MATERIAL AND METHODS A case-control study on 416 breast cancer patients and 1156 matched controls was conducted in 14 hospitals in 8 provinces of China in 2008. Controls were age- and region-matched to the cases. Clinicians conducted in-person interviews with the subjects to collect information on demographics and suspected risk factors for breast cancer that are known worldwide. Conditional logistic regression was used to derive odds ratios (OR) and 95% confidence intervals (CI) for the associations between risk factors and breast cancer. RESULTS Compared with matched controls, women with breast cancer were significantly more likely to have higher body mass index (BMI, OR = 4.07, 95% CI: 2.98-5.55), history of benign breast disease (BBD) biopsy (OR = 1.68, 95% CI: 1.19-2.38), older age of menarche (AOM) (OR = 1.41, 95% CI: 1.07-1.87), stress anticipation (SA), for grade 1-4, OR = 2.15, 95% CI: 1.26-3.66; for grade 5-9, OR = 3.48, 95% CI: 2.03-5.95) and menopause (OR = 2.22, 95% CI: 1.50-3.282) at the level of p < 0.05. Family history of breast cancer (FHBC) in first-degree relatives (OR = 1.66, 95% CI: 0.77-3.59) and use of oral contraceptives (OC) (OR = 1.59, 95% CI: 0.83-3.05) were associated with an increased risk of breast cancer at the level of p < 0.20. CONCLUSIONS Our results showed that BMI, history of BBD biopsy, older AOM, SA and menopause were associated with increased risk of breast cancer among Chinese women. The findings derived from the study provided some suggestions for population-based prevention and control of breast cancer in China.
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Affiliation(s)
- Ya-Li Xu
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Guang-Liang Shan
- Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Jin Zhang
- The Cancer Hospital, Tianjin Medical University, Tianjin, China
| | - Hai-Bo Liao
- YingBin Surgery Hospital of Yancheng, Jiangsu, China
| | - Shi-Yong Li
- The General Hospital, Beijing Military Area Command, Beijing, China
| | - Jun Jiang
- Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Zhi-Min Shao
- The Cancer Hospital, Fudan University, Shanghai, China
| | - Hong-Chuan Jiang
- Beijing ChaoYang Hospital, the Capital Medical University, Beijing, China
| | - Nian-Chun Shen
- Population and Family Planning Service Center of Zhuhai, Guangdong, China
| | - Yue Shi
- ShanXi Traditional Medicine Hospital, Shanxi, China
| | - Cheng-Ze Yu
- Chinese 307 Hospital the People's Liberation Army, Beijing, China
| | - Bao-Ning Zhang
- The Cancer Institute and Hospital, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan-Hua Chen
- Maternity and Child Care Center of Qinhuangdao, Hebei, China
| | | | - Bo Li
- Beijing Hospital, Ministry of Health, Beijing, China
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22
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Inumaru LE, Silveira EAD, Naves MMV. [Risk and protective factors for breast cancer: a systematic review]. CAD SAUDE PUBLICA 2012; 27:1259-70. [PMID: 21808811 DOI: 10.1590/s0102-311x2011000700002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 05/06/2011] [Indexed: 11/21/2022] Open
Abstract
This review aimed to investigate risk and protective factors for breast cancer and to analyze whether scientific evidence from the World Cancer Research Fund and American Institute for Cancer Research, published in 2007, was confirmed by new research. In May 2010 we reviewed cohort and case-control analytical studies from 2007 to 2010 in the PubMed, LILACS, and SciELO databases. We selected 27 articles (14 case-control and 13 cohort studies). Breastfeeding and physical activity were protective factors against breast cancer, and alcohol consumption was a risk factor. A direct proportional relationship was observed between larger waist circumference, weight throughout adulthood, and height and risk of breast cancer in postmenopausal women. The association between body fat and breast cancer is contradictory in both premenopausal and postmenopausal women. According to the accumulated evidence, breastfeeding and healthy lifestyle are the factors most strongly associated with breast cancer prevention.
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Affiliation(s)
- Lívia Emi Inumaru
- Faculdade de Nutrição, Universidade Federal de Goiás, Goiânia, Brasil
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23
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Abstract
Background: The influence of different types and intensities of physical activity on risk for breast cancer is unclear. Methods: In a prospective cohort of 73 049 Chinese women (40–70 years), who had worked outside the home, we studied breast cancer risk in relation to specific types of self-reported and work history-related physical activity, including adolescent and adult exercise and household activity and walking and cycling for transportation. Occupational sitting time and physical activity energy expenditure were assigned based on lifetime occupational histories. Results: In all, 717 incident breast cancer cases were diagnosed. Breast cancer risk was lower for women in the lowest quartile of average occupational sitting time and in the highest quartile of average occupational energy expenditure (adjusted hazard ratio (HR): 0.81 and 0.73, respectively, P⩽0.05). Adult exercise at or above the recommended level (8 metabolic equivalent (MET) h per week per year) was associated with lower risk (adjusted HR: 0.73, P<0.05) in post-menopausal women. Analysis of joint effects showed that having both an active job and exercise participation did not confer an additional benefit. Other common daily activities were not associated with lower risk. Interpretation: These findings suggest that both exercise and occupational activity are associated with lower breast cancer risk, which supports current health promotion campaigns promoting exercise.
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Iwasaki M, Tsugane S. Risk factors for breast cancer: epidemiological evidence from Japanese studies. Cancer Sci 2011; 102:1607-14. [PMID: 21624009 DOI: 10.1111/j.1349-7006.2011.01996.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Although our understanding of the etiology of breast cancer has improved, many well-known risk factors are not modifiable and present knowledge has proved insufficient to allow the disease to be overcome. Indeed, incidence and mortality among Japanese women have increased over the past three decades. Here, we review epidemiological evidence from our cohort and case-control studies among Japanese women in comparison with other published findings. Our studies confirm the important role of established factors derived primarily from Western populations, such as menstrual and reproductive factors, anthropometric factors, physical activity, and alcohol intake, in the development of breast cancer. In addition, we provide further evidence to better understand the role of traditional Japanese foods in the etiology of breast cancer. Our cohort study found that a higher intake of isoflavone and higher levels of plasma genistein, but not daidzein, were associated with a decreased risk of breast cancer. Our case-control studies reveal a dose-response pattern for these compounds; specifically, decreased risk as women move from "no" to "moderate" intake and leveling off thereafter. In addition, gene-environment interactions have been revealed in the effects of isoflavones. The evidence reviewed suggests that isoflavone has a protective effect against breast cancer in Asian populations. Conversely, our cohort study did not observe an inverse association between breast cancer risk and the intake of green tea and/or the plasma level of tea polyphenols, but we did find an association between increased risk and active and passive smoking. In conclusion, based on current knowledge, primary prevention according to individual lifestyle modification should focus on alcohol intake, weight control, physical activity, and tobacco smoking.
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Affiliation(s)
- Motoki Iwasaki
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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25
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Lynch BM, Neilson HK, Friedenreich CM. Physical activity and breast cancer prevention. Recent Results Cancer Res 2011; 186:13-42. [PMID: 21113759 DOI: 10.1007/978-3-642-04231-7_2] [Citation(s) in RCA: 138] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Breast cancer is the most commonly diagnosed invasive malignancy and the second leading cause of cancer death in women. This chapter considers epidemiologic evidence regarding the association between physical activity and breast cancer risk from 73 studies conducted around the world. Across these studies there was a 25% average risk reduction amongst physically active women as compared to the least active women. The associations were strongest for recreational activity, for activity sustained over the lifetime or done after menopause, and for activity that is of moderate to vigorous intensity and performed regularly. There is also some evidence for a stronger effect of physical activity amongst postmenopausal women, women who are normal weight, have no family history of breast cancer, and are parous. It is likely that physical activity is associated with decreased breast cancer risk via multiple interrelated biologic pathways that may involve adiposity, sex hormones, insulin resistance, adipokines, and chronic inflammation. Future research should include prospective observational epidemiologic studies relating proposed biomarkers to breast cancer risk and also randomized controlled trials to examine how physical activity influences the proposed biomarkers. Exercise trials will provide more clarity regarding the appropriate type, dose, and timing of activity that relate to breast cancer risk reduction.
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Affiliation(s)
- Brigid M Lynch
- Department of Population Health Research, Alberta Health Services-Cancer Care, 1331 29 St NW, Calgary, Alberta, Canada, T2N 4N2
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26
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Parks SK, Chiche J, Pouyssegur J. pH control mechanisms of tumor survival and growth. J Cell Physiol 2011; 226:299-308. [PMID: 20857482 DOI: 10.1002/jcp.22400] [Citation(s) in RCA: 263] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A distinguishing phenotype of solid tumors is the presence of an alkaline cellular feature despite the surrounding acidic microenvironment. This phenotypic characteristic of tumors, originally described by Otto Warburg, arises due to alterations in metabolism of solid tumors. Hypoxic regions of solid tumors develop due to poor vascularization and in turn regulate the expression of numerous genes via the transcription factor HIF-1. Ultimately, the tumor microenvironment directs the development of tumor cells adapted to survive in an acidic surrounding where normal cells perish. The provision of unique pH characteristics in tumor cells provides a defining trait that has led to the pursuit of treatments that target metabolism, hypoxia, and pH-related mechanisms to selectively kill cancer cells. Numerous studies over the past decade involving the cancer-specific carbonic anhydrase IX have re-kindled an interest in pH disruption-based therapies. Although an acidification of the intracellular compartment is established as a means to induce normal cell death, the defining role of acid-base disturbances in tumor physiology and survival remains unclear. The aim of this review is to summarize recent data relating to the specific role of pH regulation in tumor cell survival. We focus on membrane transport and enzyme studies in an attempt to elucidate their respective functions regarding tumor cell pH regulation. These data are discussed in the context of future directions for the field of tumor cell acid-base-related research.
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Affiliation(s)
- Scott K Parks
- Institute of Developmental Biology and Cancer Research, CNRS UMR 6543, University of Nice, Centre A. Lacassagne, Nice, France.
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27
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Smallbone K, Maini PK, Gatenby RA. Episodic, transient systemic acidosis delays evolution of the malignant phenotype: Possible mechanism for cancer prevention by increased physical activity. Biol Direct 2010; 5:22. [PMID: 20406440 PMCID: PMC2864239 DOI: 10.1186/1745-6150-5-22] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 04/20/2010] [Indexed: 12/26/2022] Open
Abstract
Background The transition from premalignant to invasive tumour growth is a prolonged multistep process governed by phenotypic adaptation to changing microenvironmental selection pressures. Cancer prevention strategies are required to interrupt or delay somatic evolution of the malignant invasive phenotype. Empirical studies have consistently demonstrated that increased physical activity is highly effective in reducing the risk of breast cancer but the mechanism is unknown. Results Here we propose the hypothesis that exercise-induced transient systemic acidosis will alter the in situ tumour microenvironment and delay tumour adaptation to regional hypoxia and acidosis in the later stages of carcinogenesis. We test this hypothesis using a hybrid cellular automaton approach. This model has been previously applied to somatic evolution on epithelial surfaces and demonstrated three phases of somatic evolution, with cancer cells escaping in turn from the constraints of limited space, nutrient supply and waste removal. In this paper we extend the model to test our hypothesis that transient systemic acidosis is sufficient to arrest, or at least delay, transition from in situ to invasive cancer. Conclusions Model simulations demonstrate that repeated episodes of transient systemic acidosis will interrupt critical evolutionary steps in the later stages of carcinogenesis resulting in substantial delay in the evolution to the invasive phenotype. Our results suggest transient systemic acidosis may mediate the observed reduction in cancer risk associated with increased physical activity. Reviewers This article was reviewed by Natalia Komarova (nominated by Marek Kimmel), Heiko Enderling (nominated by Marek Kimmel), Mark Little (nominated by Marek Kimmel) and Yang Kuang.
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Affiliation(s)
- Kieran Smallbone
- Manchester Centre for Integrative Systems Biology, Manchester Interdisciplinary Biocentre, 131 Princess Street, Manchester, M1 7DN, UK.
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Physical activity and the risk of breast cancer in BRCA1/2 mutation carriers. Breast Cancer Res Treat 2009; 120:235-44. [PMID: 19680614 DOI: 10.1007/s10549-009-0476-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Accepted: 07/10/2009] [Indexed: 01/12/2023]
Abstract
BRCA1/2 mutation carriers have a high lifetime risk of developing breast cancer. Differences in penetrance indicate that this risk may be influenced by lifestyle factors. Because physical activity is one of the few modifiable risk factors, it may provide a target to add to breast cancer prevention in this high-risk population. We examined the association between self-reported lifetime sports activity and breast cancer risk in a nationwide retrospective cohort study, including 725 carriers, of whom 218 had been diagnosed with breast cancer within 10 years prior to questionnaire completion. We found a nonsignificantly decreased risk for ever engaging in sports activity (HR = 0.84, 95%CI = 0.57-1.24). Among women who had participated in sports, a medium versus low level of intensity and duration (i.e., between 11.0 and 22.7 mean MET hours/week averaged over a lifetime) reduced the risk of breast cancer (HR = 0.59, 95%CI = 0.36-0.95); no dose-response trend was observed. For mean hours/week of sports activity, a nonsignificant trend was observed (HR(low versus never) = 0.93, 95%CI = 0.60-1.43; HR(medium versus never) = 0.81, 95%CI = 0.51-1.29; HR(high versus never) = 0.78, 95%CI = 0.48-1.29; p (trend overall) = 0.272; p (trend active women) = 0.487). For number of years of sports activity no significant associations were found. Among women active in sports before age 30, mean MET hours/week showed the strongest inverse association of all activity measures (HR(medium versus low) = 0.60, 95%CI = 0.38-0.96; HR(high versus low) = 0.58, 95%CI = 0.35-0.94; p (trend) = 0.053). Engaging in sports activity after age 30 was also inversely associated with breast cancer risk (HR = 0.63, 95%CI = 0.44-0.91). Our results indicate that sports activity may reduce the risk of breast cancer in BRCA1/2 mutation carriers.
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