Breast Cancer Research and Treatment

, Volume 145, Issue 2, pp 545–552

Associations between anthropometric characteristics, physical activity, and breast cancer risk in a Canadian cohort

  • Chelsea Catsburg
  • Victoria A. Kirsh
  • Colin L. Soskolne
  • Nancy Kreiger
  • Erin Bruce
  • Thi Ho
  • Scott T. Leatherdale
  • Thomas E. Rohan
Epidemiology

Abstract

Obesity, physical inactivity, and sedentary behavior, concomitants of the modern environment, are potentially modifiable breast cancer risk factors. This study investigated the association of anthropometric measurements, physical activity and sedentary behavior, with the risk of incident, invasive breast cancer using a prospective cohort of women enrolled in the Canadian Study of Diet, Lifestyle and Health. Using a case-cohort design, an age-stratified subcohort of 3,320 women was created from 39,532 female participants who returned completed self-administered lifestyle and dietary questionnaires at baseline. A total of 1,097 incident breast cancer cases were identified from the entire cohort via linkage to the Canadian Cancer Registry. Cox regression models, modified to account for the case-cohort design, were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the association between anthropometric characteristics, physical activity, and the risk of breast cancer. Weight gain as an adult was positively associated with risk of post-menopausal breast cancer, with a 6 % increase in risk for every 5 kg gained since age 20 (HR 1.06; 95 % CI 1.01–1.11). Women who exercised more than 30.9 metabolic equivalent task (MET) hours per week had a 21 % decreased risk of breast cancer compared to women who exercised less than 3 MET hours per week (HR  0.79; 95 % CI 0.62–1.00), most evident in pre-menopausal women (HR  0.62; 95 % CI 0.43–0.90). As obesity reaches epidemic proportions and sedentary lifestyles have become more prevalent in modern populations, programs targeting adult weight gain and promoting physical activity may be beneficial with respect to reducing breast cancer morbidity.

Keywords

Physical activity Obesity Breast cancer Epidemiology Anthropometric measurements 

Supplementary material

10549_2014_2973_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 22 kb)

References

  1. 1.
    Shields M, Tremblay MS, Laviolette M, Craig CL, Janssen I, Connor Gorber S (2010) Fitness of Canadian adults: results from the 2007–2009 Canadian Health Measures Survey. Health Rep 21(1):21–35PubMedGoogle Scholar
  2. 2.
    Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ et al (2011) National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 377(9765):557–567PubMedCrossRefGoogle Scholar
  3. 3.
    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):207–215PubMedCrossRefGoogle Scholar
  4. 4.
    De Pergola G, Silvestris F (2013) Obesity as a major risk factor for cancer. J Obes 2013:291546PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Han D, Nie J, Bonner MR, McCann SE, Muti P, Trevisan M et al (2006) Lifetime adult weight gain, central adiposity, and the risk of pre- and postmenopausal breast cancer in the Western New York exposures and breast cancer study. Int J Cancer 119(12):2931–2937PubMedCrossRefGoogle Scholar
  6. 6.
    Cheraghi Z, Poorolajal J, Hashem T, Esmailnasab N, Doosti Irani A (2012) Effect of body mass index on breast cancer during premenopausal and postmenopausal periods: a meta-analysis. PLoS One 7(12):e51446PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Rose DP, Vona-Davis L (2010) Interaction between menopausal status and obesity in affecting breast cancer risk. Maturitas 66(1):33–38PubMedCrossRefGoogle Scholar
  8. 8.
    Key T, Appleby P, Barnes I, Reeves G, Endogenous H, Breast Cancer Collaborative G (2002) Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst 94(8):606–616PubMedCrossRefGoogle Scholar
  9. 9.
    Travis RC, Key TJ (2003) Oestrogen exposure and breast cancer risk. Breast Cancer Res 5(5):239–247PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Zain MM, Norman RJ (2008) Impact of obesity on female fertility and fertility treatment. Womens Health (Lond Engl) 4(2):183–194CrossRefGoogle Scholar
  11. 11.
    Eliassen AH, Missmer SA, Tworoger SS, Spiegelman D, Barbieri RL, Dowsett M et al (2006) Endogenous steroid hormone concentrations and risk of breast cancer among premenopausal women. J Natl Cancer Inst 98(19):1406–1415PubMedCrossRefGoogle Scholar
  12. 12.
    Hoffman-Goetz L, Apter D, Demark-Wahnefried W, Goran MI, McTiernan A, Reichman ME (1998) Possible mechanisms mediating an association between physical activity and breast cancer. Cancer 83(3 Suppl):621–628PubMedCrossRefGoogle Scholar
  13. 13.
    Thune I, Brenn T, Lund E, Gaard M (1997) Physical activity and the risk of breast cancer. N Engl J Med 336(18):1269–1275PubMedCrossRefGoogle Scholar
  14. 14.
    Coyle YM (2008) Physical activity as a negative modulator of estrogen-induced breast cancer. Cancer Causes Control 19(10):1021–1029PubMedCrossRefGoogle Scholar
  15. 15.
    Friedenreich CM (2010) The role of physical activity in breast cancer etiology. Semin Oncol 37(3):297–302PubMedCrossRefGoogle Scholar
  16. 16.
    Cohen SS, Matthews CE, Bradshaw PT, Lipworth L, Buchowski MS, Signorello LB et al (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 (Phila) 6(6):566–576CrossRefGoogle Scholar
  17. 17.
    Rohan TE, Soskolne CL, Carroll KK, Kreiger N (2007) The Canadian Study of Diet, Lifestyle, and Health: design and characteristics of a new cohort study of cancer risk. Cancer Detect Prev 31(1):12–17PubMedCrossRefGoogle Scholar
  18. 18.
    Hall S, Schulze K, Groome P, Mackillop W, Holowaty E (2006) Using cancer registry data for survival studies: the example of the Ontario Cancer Registry. J Clin Epidemiol 59(1):67–76PubMedCrossRefGoogle Scholar
  19. 19.
  20. 20.
    Barlow WE, Ichikawa L, Rosner D, Izumi S (1999) Analysis of case-cohort designs. J Clin Epidemiol 52(12):1165–1172PubMedCrossRefGoogle Scholar
  21. 21.
    Cai J, Zeng D (2004) Sample size/power calculation for case-cohort studies. Biometrics 60(4):1015–1024PubMedCrossRefGoogle Scholar
  22. 22.
    Rockhill B, Willett WC, Hunter DJ, Manson JE, Hankinson SE, Colditz GA (1999) A prospective study of recreational physical activity and breast cancer risk. Arch Intern Med 159(19):2290–2296PubMedCrossRefGoogle Scholar
  23. 23.
    Wolf AM, Hunter DJ, Colditz GA, Manson JE, Stampfer MJ, Corsano KA et al (1994) Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 23(5):991–999PubMedCrossRefGoogle Scholar
  24. 24.
    Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C et al (2011) 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc 43(8):1575–1581PubMedCrossRefGoogle Scholar
  25. 25.
    Langholz B, Jiao J (2007) Computational methods for case-cohort studies. Comput Stat Data Anal 51(8):3737–3748CrossRefGoogle Scholar
  26. 26.
    World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894(i–xii):1–253Google Scholar
  27. 27.
    Rinaldi S, Key TJ, Peeters PH, Lahmann PH, Lukanova A, Dossus L et al (2006) Anthropometric measures, endogenous sex steroids and breast cancer risk in postmenopausal women: a study within the EPIC cohort. Int J Cancer 118(11):2832–2839PubMedCrossRefGoogle Scholar
  28. 28.
    Nelson LR, Bulun SE (2001) Estrogen production and action. J Am Acad Dermatol 45(3 Suppl):S116–S124PubMedCrossRefGoogle Scholar
  29. 29.
    Tchernof A, Despres JP (2000) Sex steroid hormones, sex hormone-binding globulin, and obesity in men and women. Horm Metab Res 32(11–12):526–536PubMedCrossRefGoogle Scholar
  30. 30.
    van den Brandt PA, Spiegelman D, Yaun SS, Adami HO, Beeson L, Folsom AR et al (2000) Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol 152(6):514–527PubMedCrossRefGoogle Scholar
  31. 31.
    Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E et al (2007) Mammographic density and the risk and detection of breast cancer. N Engl J Med 356(3):227–236PubMedCrossRefGoogle Scholar
  32. 32.
    Ballard-Barbash R, Schatzkin A, Taylor PR, Kahle LL (1990) Association of change in body mass with breast cancer. Cancer Res 50(7):2152–2155PubMedGoogle Scholar
  33. 33.
    Vrieling A, Buck K, Kaaks R, Chang-Claude J (2010) Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis. Breast Cancer Res Treat 123(3):641–649PubMedCrossRefGoogle Scholar
  34. 34.
    Feigelson HS, Jonas CR, Teras LR, Thun MJ, Calle EE (2004) Weight gain, body mass index, hormone replacement therapy, and postmenopausal breast cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev 13(2):220–224PubMedCrossRefGoogle Scholar
  35. 35.
    Huang Z, Hankinson SE, Colditz GA, Stampfer MJ, Hunter DJ, Manson JE et al (1997) Dual effects of weight and weight gain on breast cancer risk. JAMA 278(17):1407–1411PubMedCrossRefGoogle Scholar
  36. 36.
    Alsaker MD, Janszky I, Opdahl S, Vatten LJ, Romundstad PR (2013) Weight change in adulthood and risk of postmenopausal breast cancer: the HUNT study of Norway. Br J Cancer 109(5):1310–1317PubMedCrossRefGoogle Scholar
  37. 37.
    Bernstein L, Henderson BE, Hanisch R, Sullivan-Halley J, Ross RK (1994) Physical exercise and reduced risk of breast cancer in young women. J Natl Cancer Inst 86(18):1403–1408PubMedCrossRefGoogle Scholar
  38. 38.
    Bernstein L, Ross RK, Lobo RA, Hanisch R, Krailo MD, Henderson BE (1987) The effects of moderate physical activity on menstrual cycle patterns in adolescence: implications for breast cancer prevention. Br J Cancer 55(6):681–685PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    Harlow SD, Matanoski GM (1991) The association between weight, physical activity, and stress and variation in the length of the menstrual cycle. Am J Epidemiol 133(1):38–49PubMedGoogle Scholar
  40. 40.
    Campbell KL, McTiernan A (2007) Exercise and biomarkers for cancer prevention studies. J Nutr 137(1 Suppl):161S–169SPubMedGoogle Scholar
  41. 41.
    Frank L (2006) Exercise and insulin resistance. In: McTiernan A (ed) Cancer prevention and management through exercise and weight control. Taylor & Francis, Boca Raton, p 131Google Scholar
  42. 42.
    Friedenreich CM, Orenstein MR (2002) Physical activity and cancer prevention: etiologic evidence and biological mechanisms. J Nutr 132(11 Suppl):3456S–3464SPubMedGoogle Scholar
  43. 43.
    Patel AV, Bernstein L (2006) Physical activity and cancer incidence: Breast cancer. In: McTiernan A (ed) Cancer prevention and management through exercise and weight control. Taylor & Francis, Boca Raton, p 49Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Chelsea Catsburg
    • 1
  • Victoria A. Kirsh
    • 2
    • 3
  • Colin L. Soskolne
    • 4
    • 5
  • Nancy Kreiger
    • 2
    • 3
  • Erin Bruce
    • 6
  • Thi Ho
    • 2
  • Scott T. Leatherdale
    • 7
  • Thomas E. Rohan
    • 1
  1. 1.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA
  2. 2.Prevention and Cancer ControlCancer Care OntarioTorontoCanada
  3. 3.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  4. 4.University of AlbertaEdmontonCanada
  5. 5.Faculty of HealthUniversity of CanberraBruceAustralia
  6. 6.Faculty of MedicineUniversity of CalgaryCalgaryCanada
  7. 7.School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada

Personalised recommendations