Association between pre-diagnosis recreational physical activity and risk of breast cancer recurrence: the California Teachers Study

IF 2.2 4区医学 Q3 ONCOLOGY

Cancer Causes & Control Pub Date : 2024-04-13 DOI:10.1007/s10552-024-01870-8

Dan Lin, Cheryl L. Thompson, Alaina Demalis, Rebecca Derbes, Laila Al-Shaar, Emma S. Spielfogel, Kathleen M. Sturgeon

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引用次数: 0

Abstract

Purpose

Studies have reported inverse associations of pre-diagnosis recreational physical activity (RPA) level with all-cause and breast cancer (BCa)-specific mortality among BCa patients. However, the association between pre-diagnosis RPA level and BCa recurrence is unclear. We investigated the association between pre-diagnosis RPA level and risk of BCa recurrence in the California Teachers Study (CTS).

Methods

Stage I–IIIb BCa survivors (n = 6,479) were followed with median of 7.4 years, and 474 BCa recurrence cases were identified. Long-term (from high school to age at baseline questionnaire, or, age 55 years, whichever was younger) and baseline (past 3 years reported at baseline questionnaire) pre-diagnosis RPA levels were converted to metabolic equivalent of task-hours per week (MET-hrs/wk). Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of BCa recurrence overall and by estrogen receptor (ER)/progesterone receptor (PR) status.

Results

Long-term RPA was not associated with BCa recurrence risk (p_trend = 0.99). The inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was marginally significant (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.79, 95% CI = 0.60–1.03; p_trend = 0.07). However, the association became non-significant after adjusting for post-diagnosis RPA (p_trend = 0.65). An inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was observed in ER−PR− cases (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.31, 95% CI = 0.13–0.72; p_trend = 0.04), but not in ER+ or PR+ cases (p_trend = 0.97).

Conclusions

Our data indicates that the benefit of baseline RPA on BCa recurrence may differ by tumor characteristics. This information may be particularly important for populations at higher risk of ER−PR− BCa.

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诊断前休闲体育活动与乳腺癌复发风险之间的关系：加州教师研究

目的有研究报告称，诊断前娱乐性体力活动（RPA）水平与 BCa 患者的全因死亡率和乳腺癌（BCa）特异性死亡率呈负相关。然而，诊断前休闲体育活动水平与乳腺癌复发之间的关系尚不清楚。我们在加利福尼亚教师研究（CTS）中调查了诊断前 RPA 水平与 BCa 复发风险之间的关系。将长期（从高中到基线问卷调查时的年龄，或 55 岁，以年龄较小者为准）和基线（基线问卷调查时报告的过去 3 年）诊断前的 RPA 水平转换为每周任务小时的代谢当量（MET-hrs/wk）。多变量 Cox 比例危险模型估算了 BCa 复发风险的总体危险比 (HRs) 和 95% 置信区间 (CIs)，并按雌激素受体 (ER)/ 孕激素受体 (PR) 状态进行了分类。结果长期 RPA 与 BCa 复发风险无关（ptrend = 0.99）。诊断前基线 RPA 水平与 BCa 复发风险之间的反比关系略微显著（≥26.0 vs. <3.4 MET-hrs/wk：HR = 0.79，95% CI = 0.60-1.03；ptrend = 0.07）。然而，在调整诊断后 RPA 后，这一关联变得不显著（ptrend = 0.65）。在ER-PR-病例（≥26.0 vs. <3.4MET-hrs/wk：HR = 0.31，95% CI = 0.13-0.72；ptrend = 0.04）中观察到诊断前基线RPA水平与BCa复发风险呈反向关系，但在ER+或PR+病例中却没有观察到这种关系（ptrend = 0.97）。我们的数据表明，基线 RPA 对 BCa 复发的益处可能因肿瘤特征而异，这一信息对 ER-PR- BCa 风险较高的人群尤为重要。

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来源期刊

Cancer Causes & Control 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.90

自引率

4.30%

发文量

130

审稿时长

6.6 months

期刊介绍： Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach. The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues. The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts. Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.