Physical activity and risk of recurrence and mortality in breast cancer survivors: findings from the LACE study.
Physical activity and risk of recurrence and mortality in breast cancer survivors: findings from the LACE study.
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DOI：
10.1158/1055-9965.epi-08-0595
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Caan BJ
中科院分区：
文献类型：
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作者：
Sternfeld B;Weltzien E;Quesenberry CP Jr;Castillo AL;Kwan M;Slattery ML;Caan BJ
确定降低复发风险和提高乳腺癌幸存者生存率的可改变因素是一个紧迫的问题。本研究的目的是检查诊断和治疗后的体力活动与乳腺癌复发风险和死亡率以及早期乳腺癌女性的全因死亡率之间的关系。该样本包括来自癌症后生活流行病学研究的1，970名女性，这是一项对行为风险因素和健康结果的前瞻性调查。评估了入组前6个月内自我报告的工作相关、家庭和娱乐、娱乐和交通相关活动的频率和持续时间。结果从电子或纸质病历中确定。风险比和95%置信区间由延迟进入考克斯比例风险模型估计。虽然年龄调整的结果表明，较高水平的体力活动与降低复发风险和乳腺癌死亡率有关，（对于每周中等体力活动的最高小时数与最低小时数，趋势P值分别为0.05和0.07），在校正预后因素和其他混杂变量后，这些相关性减弱（趋势P = 0.36和0.26）。相反，在多变量分析中，体力活动和全因死亡率之间存在统计学显著的保护性关联（风险比，0.66; 95%置信区间，0.42-1.03;趋势P = 0.04）。这些研究结果并不支持体力活动对乳腺癌复发或死亡率的保护作用，但确实表明定期体力活动对乳腺癌幸存者的总死亡率有益。
Identifying modifiable factors that reduce the risk of recurrence and improve survival in breast cancer survivors is a pressing concern. The purpose of this study was to examine the association of physical activity following diagnosis and treatment with the risk of breast cancer recurrence and mortality and all-cause mortality in women with early-stage breast cancer. The sample consisted of 1,970 women from the Life After Cancer Epidemiology study, a prospective investigation of behavioral risk factors and health outcomes. Self-reported frequency and duration of work-related, household and caregiving, recreational, and transportation-related activities during the six months prior to enrollment were assessed. Outcomes were ascertained from electronic or paper medical charts. Hazard ratios and 95% confidence intervals were estimated from delayed entry Cox proportional hazards models. Although age-adjusted results suggested that higher levels of physical activity were associated with reduced risk of recurrence and breast cancer mortality (P for trend = 0.05 and 0.07, respectively for highest versus lowest level of hours per week of moderate physical activity), these associations were attenuated after adjustment for prognostic factors and other confounding variables (P for trend = 0.36 and 0.26). In contrast, a statistically significant protective association between physical activity and all-cause mortality remained in multivariable analyses (hazard ratio, 0.66; 95% confidence interval, 0.42–1.03; P for trend = 0.04). These findings do not support a protective effect of physical activity on breast cancer recurrence or mortality but do suggest that regular physical activity is beneficial for breast cancer survivors in terms of total mortality.