International Pooled Analysis of Leisure-Time Physical Activity and Premenopausal Breast Cancer in Women From 19 Cohorts

Iain R Timmins, 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, A Heather Eliassen, Olivia Fletcher, Agnès Fournier, Niclas Håkansson, Susan E Hankinson, Richard S Houlston, Corinne E Joshu, Victoria A KirshCari M Kitahara, Woon-Puay Koh, Martha S Linet, Hannah Lui Park, Brigid M Lynch, 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, Celine M Vachon, 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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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 ( P nonlinearity = .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]; P het = .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.

Original languageEnglish
Pages (from-to)927-939
Number of pages13
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume42
Issue number8
Early online date11 Dec 2023
DOIs
Publication statusPublished - 10 Mar 2024

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