Giovanna Masala1, Benedetta Bendinelli2, Melania Assedi2, Daniela Occhini2, Ines Zanna2, Sabina Sieri3, Claudia Agnoli3, Carlotta Sacerdote4, Fulvio Ricceri4,5, Amalia Mattiello6, Salvatore Panico6, Rosario Tumino7, Graziella Frasca8, Calogero Saieva2, Domenico Palli2. 1. Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Ponte Nuovo Palazzina 28 A "Mario Fiori" Via delle Oblate 4, 50141, Florence, Italy. g.masala@ispo.toscana.it. 2. Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Ponte Nuovo Palazzina 28 A "Mario Fiori" Via delle Oblate 4, 50141, Florence, Italy. 3. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 20133, Milan, Italy. 4. Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Via Santena 7, 10126, Turin, Italy. 5. Unit of Epidemiology, Regional Health Service ASL TO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy. 6. Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Via Pansini 5, 80131, Naples, Italy. 7. Cancer Registry and Histopatology Unit, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Via Dante 109, 97100, Ragusa, Italy. 8. Cancer Registry, ASP Ragusa, Via Dante 109, 97100, Ragusa, Italy.
Abstract
PURPOSE: Breast cancer (BC) is the most frequent cancer among women in developed countries. Physical activity (PA), body mass index (BMI), and alcohol intake have been identified as relevant lifestyle modifiable risk factors for post-menopausal BC. We aimed to evaluate the role of these factors in modulating post-menopausal BC risk and to estimate the proportion of BC cases attributable to low PA, high BMI, and alcohol taking into account non-modifiable factors. METHODS: In the Italian section of the EPIC study, 15,010 post-menopausal women were recruited and provided information about dietary and lifestyle habits including PA, smoking, reproductive history, and anthropometric measurements. During 14.8 years of median follow-up, 672 incident BC cases (607 invasive and 65 in situ) were identified. RESULTS: In multivariate models, inverse associations with BC risk emerged for increasing level of total (p trend 0.02), leisure time (p trend 0.04), and occupational (p trend 0.007) PA. High BMI (HR 1.21; 95% CI 1.02-1.43 and HR 1.33; 95% CI 1.06-1.65 for overweight and obesity, respectively) and alcohol consumption higher than 10 g/day (HR 1.30; 95% CI 1.09-1.54) were associated with BC risk. We estimated that 30% (95% CI 8-50%) of post-menopausal BC cases would be avoided through an increase of leisure time PA, a BMI below 25.0, and consuming no more than one drink/day. CONCLUSIONS: This large study carried out in Mediterranean women confirms the role of PA, BMI, and alcohol consumption in modulating post-menopausal BC risk and supports the potential benefits obtainable by modifying these lifestyle factors.
PURPOSE:Breast cancer (BC) is the most frequent cancer among women in developed countries. Physical activity (PA), body mass index (BMI), and alcohol intake have been identified as relevant lifestyle modifiable risk factors for post-menopausal BC. We aimed to evaluate the role of these factors in modulating post-menopausal BC risk and to estimate the proportion of BC cases attributable to low PA, high BMI, and alcohol taking into account non-modifiable factors. METHODS: In the Italian section of the EPIC study, 15,010 post-menopausal women were recruited and provided information about dietary and lifestyle habits including PA, smoking, reproductive history, and anthropometric measurements. During 14.8 years of median follow-up, 672 incident BC cases (607 invasive and 65 in situ) were identified. RESULTS: In multivariate models, inverse associations with BC risk emerged for increasing level of total (p trend 0.02), leisure time (p trend 0.04), and occupational (p trend 0.007) PA. High BMI (HR 1.21; 95% CI 1.02-1.43 and HR 1.33; 95% CI 1.06-1.65 for overweight and obesity, respectively) and alcohol consumption higher than 10 g/day (HR 1.30; 95% CI 1.09-1.54) were associated with BC risk. We estimated that 30% (95% CI 8-50%) of post-menopausal BC cases would be avoided through an increase of leisure time PA, a BMI below 25.0, and consuming no more than one drink/day. CONCLUSIONS: This large study carried out in Mediterranean women confirms the role of PA, BMI, and alcohol consumption in modulating post-menopausal BC risk and supports the potential benefits obtainable by modifying these lifestyle factors.
Entities:
Keywords:
Alcohol; Body mass index; Physical activity; Population attributable risk; Post-menopausal breast cancer; Prospective study
Authors: Anne McTiernan; Christine M Friedenreich; Peter T Katzmarzyk; Kenneth E Powell; Richard Macko; David Buchner; Linda S Pescatello; Bonny Bloodgood; Bethany Tennant; Alison Vaux-Bjerke; Stephanie M George; Richard P Troiano; Katrina L Piercy Journal: Med Sci Sports Exerc Date: 2019-06 Impact factor: 5.411