Abstract
Purpose
The objective of this study was to evaluate whether time spent sitting at work or watching television was associated with breast cancer risk among African American women.
Methods
The Black Women’s Health Study (analytic cohort = 46,734) is an ongoing prospective cohort study of African American women ages 21–69 at baseline (1995). Questionnaire data were used to estimate sedentary time. Total time spent sitting at work and watching television (individually and combined) at baseline and updated through follow-up (1995–2001) and breast cancer incidence (n = 2,041 incident cases, 1995–2013) was evaluated using proportional hazards regression.
Results
Higher total time spent sitting at baseline (≥10 vs. <5 h/day, HR 1.27, 95 % CI 1.06, 1.53) and updated through follow-up (≥10 vs. <5 h/day, HR 1.38, 95 % CI 1.14, 1.66) was associated with an increased breast cancer risk. Associations were stronger for hormone receptor-negative tumors (≥10 vs. <5 h/day, HR 1.70, 95 % CI 1.12, 2.55) compared to hormone receptor-positive tumors (≥10 vs. <5 h/day, HR 1.16, 95 % CI 0.88, 1.52), but tests for heterogeneity were not statistically significant (p heterogeneity = 0.31). Positive associations between total time spent sitting and breast cancer incidence did not differ by physical activity level or body composition measurements.
Conclusions
Our findings suggest that high sedentary time may increase risk for breast cancer among African American women.
Similar content being viewed by others
Abbreviations
- BWHS:
-
Black Women’s Health Study
- BMI:
-
Body mass index
- cm:
-
Centimeters
- CI:
-
Confidence intervals
- ER−:
-
Estrogen receptor negative
- ER+:
-
Estrogen receptor positive
- FFQ:
-
Food frequency questionnaire
- HR:
-
Hazard ratio
- HR−:
-
Hormone receptor negative
- HR+:
-
Hormone receptor positive
- HER2−:
-
Human epidermal growth factor 2 negative
- kcal:
-
Kilocalories
- kg:
-
Kilograms
- m:
-
Meters
- PR−:
-
Progesterone receptor negative
- PR+:
-
Progesterone receptor positive
- TV:
-
Television
- WHR:
-
Waist-to-hip ratio
References
Kohler BA, Sherman RL, Howlader N, Jemal A, Ryerson AB, Henry KA, Boscoe FP, Cronin KA, Lake A, Noone AM, Henley SJ, Eheman CR, Anderson RN, Penberthy L (2015) Annual Report to the Nation on the Status of Cancer, 1975–2011, Featuring Incidence of Breast Cancer Subtypes by Race/Ethnicity, Poverty, and State. J Natl Cancer Inst 107(6):djv048. doi:10.1093/jnci/djv048
Surveillance Research Program, Institute NC (2015) Fast Stats: An interactive tool for access to SEER cancer statistics. http://seer.cancer.gov/faststats. Accessed 4 Sept 2015
Amend K, Hicks D, Ambrosone CB (2006) Breast cancer in African-American women: differences in tumor biology from European-American women. Cancer Res 66(17):8327–8330. doi:10.1158/0008-5472.CAN-06-1927
World Cancer Research Fund/American Association for Cancer Research (2010) Contiuous Update Project Report. Food, Nutrition, Physical Activity, and the Prevention of Breast Cancer. http://www.wcrf.org/int/research-we-fund/continuous-update-project-findings-reports/breast-cancer. Accessed 3 Aug 2016
Chandran U, Hirshfield KM, Bandera EV (2012) The role of anthropometric and nutritional factors on breast cancer risk in African-American women. Public Health Nutr 15(4):738–748. doi:10.1017/S136898001100303X
Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP (2008) Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 167(7):875–881. doi:10.1093/aje/kwm390
Hooker SP, Hutto B, Zhu W, Blair SN, Colabianchi N, Vena JE, Rhodes D, Howard VJ (2015) Accelerometer measured sedentary behavior and physical activity in white and black adults: The REGARDS study. J Sci Med Sport. doi:10.1016/j.jsams.2015.04.006
Rhodes RE, Mark RS, Temmel CP (2012) Adult sedentary behavior: a systematic review. Am J Prev Med 42(3):e3–28. doi:10.1016/j.amepre.2011.10.020
Lynch BM (2010) Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer Epidemiol Biomark Prev 19(11):2691–2709. doi:10.1158/1055-9965.EPI-10-0815
Zhou Y, Zhao H, Peng C (2015) Association of sedentary behavior with the risk of breast cancer in women: update meta-analysis of observational studies. Ann Epidemiol 25(9):687–697. doi:10.1016/j.annepidem.2015.05.007
Lynch BM, Friedenreich CM, Winkler EA, Healy GN, Vallance JK, Eakin EG, Owen N (2011) Associations of objectively assessed physical activity and sedentary time with biomarkers of breast cancer risk in postmenopausal women: findings from NHANES (2003–2006). Breast Cancer Res Treat 130(1):183–194. doi:10.1007/s10549-011-1559-2
Wiseman AJ, Lynch BM, Cameron AJ, Dunstan DW (2014) Associations of change in television viewing time with biomarkers of postmenopausal breast cancer risk: the Australian Diabetes, Obesity and Lifestyle Study. Cancer Causes Control 25(10):1309–1319. doi:10.1007/s10552-014-0433-z
Ekelund U, Brage S, Besson H, Sharp S, Wareham NJ (2008) Time spent being sedentary and weight gain in healthy adults: Reverse or bidirectional causality? Am J Clin Nutr 88(3):612–617
Golubic R, Wijndaele K, Sharp SJ, Simmons RK, Griffin SJ, Wareham NJ, Ekelund U, Brage S, ProActive Study G (2015) Physical activity, sedentary time and gain in overall and central body fat: 7-year follow-up of the ProActive trial cohort. Int J Obes (Lond) 39(1):142–148. doi:10.1038/ijo.2014.66
Lin TC, Courtney TK, Lombardi DA, Verma SK (2015) Association Between Sedentary Work and BMI in a U.S. National Longitudinal Survey. Am J Prev Med 49(6):e117–123. doi:10.1016/j.amepre.2015.07.024
Thorp AA, Owen N, Neuhaus M, Dunstan DW (2011) Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011. Am J Prev Med 41(2):207–215. doi:10.1016/j.amepre.2011.05.004
Rosenberg L, Palmer JR, Bethea TN, Ban Y, Kipping-Ruane K, Adams-Campbell LL (2014) A prospective study of physical activity and breast cancer incidence in African American women. Cancer Epidemiol Biomark Prev. doi:10.1158/1055-9965.EPI-14-0448
Rosenberg L, Adams-Campbell L, Palmer JR (1995) The Black Women’s Health Study: a follow-up study for causes and preventions of illness. J Am Med Womens Assoc 50(2):56–58
Carter-Nolan PL, Adams-Campbell LL, Makambi K, Lewis S, Palmer JR, Rosenberg L (2006) Validation of physical activity instruments: Black Women’s Health Study. Ethn Dis 16(4):943–947
Clark BK, Sugiyama T, Healy GN, Salmon J, Dunstan DW, Owen N (2009) Validity and reliability of measures of television viewing time and other non-occupational sedentary behaviour of adults: a review. Obes Rev: Off J Int Assoc Study Obes 10(1):7–16. doi:10.1111/j.1467-789X.2008.00508.x
Healy GN, Clark BK, Winkler EA, Gardiner PA, Brown WJ, Matthews CE (2011) Measurement of adults’ sedentary time in population-based studies. Am J Prev Med 41(2):216–227. doi:10.1016/j.amepre.2011.05.005
National Cancer Institute (2005) Diet*Calc analysis program, version 1.4.3. National Cancer Institute, Applied Research Program,. http://appliedresearch.cancer.gov/DHQ/dietcalc/. Accessed 29 April 2015
Andersen PK, Gill RD (1982) Cox regression-model for counting-processes - a large sample study. Ann Stat 10(4):1100–1120. doi:10.1214/Aos/1176345976
Palmer JR, Adams-Campbell LL, Boggs DA, Wise LA, Rosenberg L (2007) A prospective study of body size and breast cancer in black women. Cancer Epidemiol Biomark Prev 16(9):1795–1802. doi:10.1158/1055-9965.EPI-07-0336
World Health Organization (2016) BMI classification. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html. Accessed 26 Jan 2016
World Health Organization (2011) Waist Circumference and Waist-Hip Ratio. Report of a WHO Expert Consultation, Geneva, 8-11 December 2008. WHO Document Production Services, Geneva, Switzerland
Lunn M, McNeil D (1995) Applying Cox regression to competing risks. Biometrics 51(2):524–532
Wang M, Spiegelman D, Kuchiba A, Lochhead P, Kim S, Chan AT, Poole EM, Tamimi R, Tworoger SS, Giovannucci E, Rosner B, Ogino S (2016) Statistical methods for studying disease subtype heterogeneity. Stat Med 35(5):782–800. doi:10.1002/sim.6793
Schmid D, Leitzmann MF (2014) Television viewing and time spent sedentary in relation to cancer risk: a meta-analysis. J Natl Cancer Inst. doi:10.1093/jnci/dju098
Hansen AL, Wijndaele K, Owen N, Magliano DJ, Thorp AA, Shaw JE, Dunstan DW (2012) Adverse associations of increases in television viewing time with 5-year changes in glucose homoeostasis markers: the AusDiab study. Diabet Med 29(7):918–925. doi:10.1111/j.1464-5491.2012.03656.x
Helmerhorst HJ, Wijndaele K, Brage S, Wareham NJ, Ekelund U (2009) Objectively measured sedentary time may predict insulin resistance independent of moderate- and vigorous-intensity physical activity. Diabetes 58(8):1776–1779. doi:10.2337/db08-1773
Hildebrand JS, Gapstur SM, Campbell PT, Gaudet MM, Patel AV (2013) Recreational physical activity and leisure-time sitting in relation to postmenopausal breast cancer risk. Cancer Epidemiol Biomark Prev 22(10):1906–1912. doi:10.1158/1055-9965.EPI-13-0407
Cohen SS, Matthews CE, Bradshaw PT, Lipworth L, Buchowski MS, Signorello LB, Blot WJ (2013) Sedentary behavior, physical activity, and likelihood of breast cancer among Black and White women: a report from the Southern Community Cohort Study. Cancer Prev Res 6(6):566–576. doi:10.1158/1940-6207.CAPR-13-0045
World Health Organization (2010) Global Recommendations on Physical Activity for Health. World Health Organization, Switzerland
U.S. Department of Health and Human Services (2008) 2008 Physical Activity Guidelines for Americans. U.S. Department of Health and Human Services, Washington, DC
Healy GN, Dunstan DW, Salmon J, Shaw JE, Zimmet PZ, Owen N (2008) Television time and continuous metabolic risk in physically active adults. Med Sci Sports Exerc 40(4):639–645. doi:10.1249/MSS.0b013e3181607421
Owen N, Healy GN, Matthews CE, Dunstan DW (2010) Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev 38(3):105–113. doi:10.1097/JES.0b013e3181e373a2
Patel AV, Bernstein L, Deka A, Feigelson HS, Campbell PT, Gapstur SM, Colditz GA, Thun MJ (2010) Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol 172(4):419–429. doi:10.1093/aje/kwq155
Buchowski MS, Cohen SS, Matthews CE, Schlundt DG, Signorello LB, Hargreaves MK, Blot WJ (2010) Physical activity and obesity gap between black and white women in the southeastern U.S. Am J Prev Med 39(2):140–147. doi:10.1016/j.amepre.2010.03.025
United States’ National Cancer Institute (2008) Cancer Health Disparities. http://www.cancer.gov/about-nci/organization/crchd/cancer-health-disparities-fact-sheet. Accessed 6 July 2015
Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A, Thun M (2004) Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin 54(2):78–93
Acknowledgments
The authors have no conflicts of interest to disclose. This work was supported by National Cancer Institute grants R01 CA058420 (L. Rosenberg) and UM1 CA164974 (L. Rosenberg). SJON is supported by National Cancer Institute training grant 5T32CA009686-19 (A. Riegel). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA), and results reported do not necessarily represent their views. The authors are grateful to the participants and staff of the BWHS.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Nomura, S.J.O., Dash, C., Rosenberg, L. et al. Sedentary time and breast cancer incidence in African American women. Cancer Causes Control 27, 1239–1252 (2016). https://doi.org/10.1007/s10552-016-0803-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-016-0803-9