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Physical Activity and Risk of Breast Cancer: A Meta-Analysis of 38 Cohort Studies in 45 Study Reports.
Value Health 2019; 22(1):104-128VH

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.

Authors+Show Affiliations

School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China.School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China.School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China.School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China.School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China. Electronic address: 723906547@qq.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

30661625

Citation

Chen, Xuyu, et al. "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, vol. 22, no. 1, 2019, pp. 104-128.
Chen X, Wang Q, Zhang Y, et al. Physical Activity and Risk of Breast Cancer: A Meta-Analysis of 38 Cohort Studies in 45 Study Reports. Value Health. 2019;22(1):104-128.
Chen, X., Wang, Q., Zhang, Y., Xie, Q., & Tan, X. (2019). 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, 22(1), pp. 104-128. doi:10.1016/j.jval.2018.06.020.
Chen X, et al. Physical Activity and Risk of Breast Cancer: a Meta-Analysis of 38 Cohort Studies in 45 Study Reports. Value Health. 2019;22(1):104-128. PubMed PMID: 30661625.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physical Activity and Risk of Breast Cancer: A Meta-Analysis of 38 Cohort Studies in 45 Study Reports. AU - Chen,Xuyu, AU - Wang,Qiru, AU - Zhang,Yanan, AU - Xie,Qian, AU - Tan,Xiaodong, Y1 - 2018/12/14/ PY - 2018/02/28/received PY - 2018/06/22/revised PY - 2018/06/28/accepted PY - 2019/1/22/entrez PY - 2019/1/22/pubmed PY - 2019/3/15/medline KW - breast cancer KW - meta-analysis KW - physical activity KW - systematic review SP - 104 EP - 128 JF - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research JO - Value Health VL - 22 IS - 1 N2 - 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. SN - 1524-4733 UR - https://www.unboundmedicine.com/medline/citation/30661625/Physical_Activity_and_Risk_of_Breast_Cancer:_A_Meta_Analysis_of_38_Cohort_Studies_in_45_Study_Reports_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1098-3015(18)32322-2 DB - PRIME DP - Unbound Medicine ER -