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British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Apr;84(7):994–1001. doi: 10.1054/bjoc.2000.1671

Lifetime physical activity and breast cancer risk in the Shanghai Breast Cancer Study

C E Matthews 1, X-O Shu 1,2,4, F Jin 3, Q Dai 1,3,4, J R Hebert 1, Z-X Ruan 3, Y-T Gao 3, W Zheng 1,4
PMCID: PMC2363839  PMID: 11286483

Abstract

Overall physical activity in adolescence and adulthood, and changes in activity over the lifespan were analysed by in-person interviews among 1459 women newly diagnosed with breast cancer and 1556 age-matched controls in urban Shanghai. Physical activity from exercise and sports, household, and transportation (walking and cycling) was assessed in adolescence (13–19 y) and adulthood (last 10 y), as was lifetime occupational activity. Logistic regression was used to estimate odds ratios (OR) and 95% confidence limits (OR (95% CL)) while controlling for confounders. Risk was reduced for exercise only in adolescence (OR = 0.84 (0.70–1.00)); exercise only in adulthood (OR = 0.68 (0.53–0.88)), and was further reduced for exercise in both adolescence and adulthood (OR = 0.47 (0.36–0.62)). Graded reductions in risk were noted with increasing years of exercise participation (OR 1–5 yrs= 0.81 (0.67–0.94); OR 6–10 yrs= 0.74 (0.59–0.93); OR 11–15 yrs= 0.55 (0.38–0.79); OR 16 + yrs= 0.40 (0.27–0.60);Ptrend,< 0.01). Lifetime occupational activity also was inversely related to risk (Ptrend< 0.01). These findings demonstrate that consistently high activity levels throughout life reduce breast cancer risk. Furthermore, they suggest that women may reduce their risk by increasing their activity levels in adulthood. © 2001 Cancer Research Campaignhttp://www.bjcancer.com

Keywords: exercise, epidemiology, breast cancer, prevention

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Selected References

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  1. Ainsworth B. E., Haskell W. L., Whitt M. C., Irwin M. L., Swartz A. M., Strath S. J., O'Brien W. L., Bassett D. R., Jr, Schmitz K. H., Emplaincourt P. O. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498–S504. doi: 10.1097/00005768-200009001-00009. [DOI] [PubMed] [Google Scholar]
  2. Ballard-Barbash R. Anthropometry and breast cancer. Body size--a moving target. Cancer. 1994 Aug 1;74(3 Suppl):1090–1100. doi: 10.1002/1097-0142(19940801)74:3+<1090::aid-cncr2820741518>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  3. Bernstein L., Henderson B. E., Hanisch R., Sullivan-Halley J., Ross R. K. Physical exercise and reduced risk of breast cancer in young women. J Natl Cancer Inst. 1994 Sep 21;86(18):1403–1408. doi: 10.1093/jnci/86.18.1403. [DOI] [PubMed] [Google Scholar]
  4. Bernstein L., Ross R. K. Endogenous hormones and breast cancer risk. Epidemiol Rev. 1993;15(1):48–65. doi: 10.1093/oxfordjournals.epirev.a036116. [DOI] [PubMed] [Google Scholar]
  5. Bernstein L., Ross R. K., Lobo R. A., Hanisch R., Krailo M. D., Henderson B. E. The effects of moderate physical activity on menstrual cycle patterns in adolescence: implications for breast cancer prevention. Br J Cancer. 1987 Jun;55(6):681–685. doi: 10.1038/bjc.1987.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Blair S. N., Dowda M., Pate R. R., Kronenfeld J., Howe H. G., Jr, Parker G., Blair A., Fridinger F. Reliability of long-term recall of participation in physical activity by middle-aged men and women. Am J Epidemiol. 1991 Feb 1;133(3):266–275. doi: 10.1093/oxfordjournals.aje.a115871. [DOI] [PubMed] [Google Scholar]
  7. Carpenter C. L., Ross R. K., Paganini-Hill A., Bernstein L. Lifetime exercise activity and breast cancer risk among post-menopausal women. Br J Cancer. 1999 Aug;80(11):1852–1858. doi: 10.1038/sj.bjc.6690610. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cauley J. A., Gutai J. P., Kuller L. H., LeDonne D., Powell J. G. The epidemiology of serum sex hormones in postmenopausal women. Am J Epidemiol. 1989 Jun;129(6):1120–1131. doi: 10.1093/oxfordjournals.aje.a115234. [DOI] [PubMed] [Google Scholar]
  9. De Souza M. J., Miller B. E., Loucks A. B., Luciano A. A., Pescatello L. S., Campbell C. G., Lasley B. L. High frequency of luteal phase deficiency and anovulation in recreational women runners: blunted elevation in follicle-stimulating hormone observed during luteal-follicular transition. J Clin Endocrinol Metab. 1998 Dec;83(12):4220–4232. doi: 10.1210/jcem.83.12.5334. [DOI] [PubMed] [Google Scholar]
  10. Friedenreich C. M., Courneya K. S., Bryant H. E. The lifetime total physical activity questionnaire: development and reliability. Med Sci Sports Exerc. 1998 Feb;30(2):266–274. doi: 10.1097/00005768-199802000-00015. [DOI] [PubMed] [Google Scholar]
  11. Friedenreich C. M., Thune I., Brinton L. A., Albanes D. Epidemiologic issues related to the association between physical activity and breast cancer. Cancer. 1998 Aug 1;83(3 Suppl):600–610. doi: 10.1002/(sici)1097-0142(19980801)83:3+<600::aid-cncr2>3.3.co;2-0. [DOI] [PubMed] [Google Scholar]
  12. Frisch R. E., Wyshak G., Albright N. L., Albright T. E., Schiff I., Jones K. P., Witschi J., Shiang E., Koff E., Marguglio M. Lower prevalence of breast cancer and cancers of the reproductive system among former college athletes compared to non-athletes. Br J Cancer. 1985 Dec;52(6):885–891. doi: 10.1038/bjc.1985.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kaaks R. Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control. 1996 Nov;7(6):605–625. doi: 10.1007/BF00051703. [DOI] [PubMed] [Google Scholar]
  14. Kohrt W. M., Malley M. T., Dalsky G. P., Holloszy J. O. Body composition of healthy sedentary and trained, young and older men and women. Med Sci Sports Exerc. 1992 Jul;24(7):832–837. [PubMed] [Google Scholar]
  15. Kohrt W. M., Obert K. A., Holloszy J. O. Exercise training improves fat distribution patterns in 60- to 70-year-old men and women. J Gerontol. 1992 Jul;47(4):M99–105. doi: 10.1093/geronj/47.4.m99. [DOI] [PubMed] [Google Scholar]
  16. Loucks A. B., Mortola J. F., Girton L., Yen S. S. Alterations in the hypothalamic-pituitary-ovarian and the hypothalamic-pituitary-adrenal axes in athletic women. J Clin Endocrinol Metab. 1989 Feb;68(2):402–411. doi: 10.1210/jcem-68-2-402. [DOI] [PubMed] [Google Scholar]
  17. Mayer-Davis E. J., D'Agostino R., Jr, Karter A. J., Haffner S. M., Rewers M. J., Saad M., Bergman R. N. Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. JAMA. 1998 Mar 4;279(9):669–674. doi: 10.1001/jama.279.9.669. [DOI] [PubMed] [Google Scholar]
  18. Merzenich H., Boeing H., Wahrendorf J. Dietary fat and sports activity as determinants for age at menarche. Am J Epidemiol. 1993 Aug 15;138(4):217–224. doi: 10.1093/oxfordjournals.aje.a116850. [DOI] [PubMed] [Google Scholar]
  19. Pike M. C., Spicer D. V., Dahmoush L., Press M. F. Estrogens, progestogens, normal breast cell proliferation, and breast cancer risk. Epidemiol Rev. 1993;15(1):17–35. doi: 10.1093/oxfordjournals.epirev.a036102. [DOI] [PubMed] [Google Scholar]
  20. Rockhill B., Willett W. C., Hunter D. J., Manson J. E., Hankinson S. E., Colditz G. A. A prospective study of recreational physical activity and breast cancer risk. Arch Intern Med. 1999 Oct 25;159(19):2290–2296. doi: 10.1001/archinte.159.19.2290. [DOI] [PubMed] [Google Scholar]
  21. Sellers T. A. Genetic factors in the pathogenesis of breast cancer: their role and relative importance. J Nutr. 1997 May;127(5 Suppl):929S–932S. doi: 10.1093/jn/127.5.929S. [DOI] [PubMed] [Google Scholar]
  22. Slattery M. L., Jacobs D. R., Jr Assessment of ability to recall physical activity of several years ago. Ann Epidemiol. 1995 Jul;5(4):292–296. doi: 10.1016/1047-2797(94)00095-b. [DOI] [PubMed] [Google Scholar]
  23. Stoll B. A. Western nutrition and the insulin resistance syndrome: a link to breast cancer. Eur J Clin Nutr. 1999 Feb;53(2):83–87. doi: 10.1038/sj.ejcn.1600700. [DOI] [PubMed] [Google Scholar]
  24. Thune I., Brenn T., Lund E., Gaard M. Physical activity and the risk of breast cancer. N Engl J Med. 1997 May 1;336(18):1269–1275. doi: 10.1056/NEJM199705013361801. [DOI] [PubMed] [Google Scholar]
  25. Toniolo P. G., Levitz M., Zeleniuch-Jacquotte A., Banerjee S., Koenig K. L., Shore R. E., Strax P., Pasternack B. S. A prospective study of endogenous estrogens and breast cancer in postmenopausal women. J Natl Cancer Inst. 1995 Feb 1;87(3):190–197. doi: 10.1093/jnci/87.3.190. [DOI] [PubMed] [Google Scholar]
  26. Verloop J., Rookus M. A., van der Kooy K., van Leeuwen F. E. Physical activity and breast cancer risk in women aged 20-54 years. J Natl Cancer Inst. 2000 Jan 19;92(2):128–135. doi: 10.1093/jnci/92.2.128. [DOI] [PubMed] [Google Scholar]
  27. Walker R. A., Lees E., Webb M. B., Dearing S. J. Breast carcinomas occurring in young women (< 35 years) are different. Br J Cancer. 1996 Dec;74(11):1796–1800. doi: 10.1038/bjc.1996.632. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Wyshak G., Frisch R. E. Breast cancer among former college athletes compared to non-athletes: a 15-year follow-up. Br J Cancer. 2000 Feb;82(3):726–730. doi: 10.1054/bjoc.1999.0987. [DOI] [PMC free article] [PubMed] [Google Scholar]

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