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Cancer Epidemiology, Biomarkers & Prevention

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Research Articles

Physical Activity and Postmenopausal Breast Cancer Risk in the NIH-AARP Diet and Health Study

Tricia M. Peters, Arthur Schatzkin, Gretchen L. Gierach, Steven C. Moore, James V. Lacey Jr., Nicholas J. Wareham, Ulf Ekelund, Albert R. Hollenbeck and Michael F. Leitzmann
Tricia M. Peters
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Arthur Schatzkin
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Gretchen L. Gierach
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Steven C. Moore
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James V. Lacey
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Nicholas J. Wareham
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Ulf Ekelund
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Albert R. Hollenbeck
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Michael F. Leitzmann
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DOI: 10.1158/1055-9965.EPI-08-0768 Published January 2009
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Tables

  • Table 1.

    Characteristics of the study population by level of physical activity at baseline, 182,862 postmenopausal women, NIH-American Association of Retired Persons Diet and Health Study (1995-1996)

    CharacteristicsTotalPhysical activity (times per week)
    Inactive<11-23-4≥5
    Participants, n (%)182,86241,580 (22.7)26,311 (14.4)38,713 (21.2)46,251 (25.3)30,007 (16.4)
    Age at baseline (y)62.162.461.361.862.462.5
    BMI (kg/m2)26.928.627.626.926.025.3
    Race/ethnicity (%)
        White89.988.590.290.690.090.8
        Black5.56.65.65.05.34.9
        Hispanic1.92.31.81.81.91.5
        Asian/Pacific Islander/Native American1.51.41.31.51.71.6
    College education (%)29.621.628.531.033.134.2
    Family history of breast cancer* (%)12.412.012.612.512.512.4
    Current smoker (%)14.419.717.614.810.69.6
    Current MHT use (%)44.937.845.346.048.947.0
    Age at menarche (y)12.5112.4612.4812.5012.5312.55
    Age at first birth in parous women (y)22.8822.6822.7822.9423.0222.97
    Parity (no. children)2.012.022.012.002.021.99
    Age at menopause (y)46.8846.4646.7646.9147.1147.21
    Alcohol intake (g/d)6.05.86.15.86.16.3
    Total energy intake† (kcal/d)1,597.41,623.51,557.31,583.21,576.11,647.4
    • NOTE: All values, except age, are adjusted for age.

    • ↵* Family history of breast cancer in a first-degree female relative.

    • ↵† Adjusted for total energy intake.

  • Table 2.

    RR (95% CI) for the association between physical activity and postmenopausal breast cancer incidence among 182,862 postmenopausal women

    Physical activity (times per week)Person-yearsNo. casesAge-adjusted RR (95% CI)Multivariate RR* (95% CI)Multivariate RR† (95% CI)
    Inactive285,3491,4851.0 (Reference)1.0 (Reference)1.0 (Reference)
    <1184,6829811.04 (0.96-1.13)0.99 (0.91-1.07)1.00 (0.92-1.08)
    1-2271,4971,3910.99 (0.92-1.07)0.94 (0.87-1.01)0.96 (0.89-1.03)
    3-4325,7011,7111.01 (0.94-1.08)0.93 (0.87-1.00)0.97 (0.90-1.04)
    ≥5211,5571,0410.94 (0.87-1.02)0.87 (0.81-0.95)0.92 (0.85-1.00)
    Ptrend0.13<0.0010.04
    • ↵* Multivariate models used age as the underlying time metric and were adjusted for race/ethnicity (White, Black, Hispanic, Asian/Pacific Islander/American Indian), education level (<12 years or high school equivalent, 12 years or high school equivalent, post-high school vocational or technical training, some college, college graduate, postgraduate), smoking status (nonsmoker, former, current), family history of breast cancer (no, yes), menopausal hormone use (never, current, past), age at first birth (nulliparous, <20, 20-24, 25-29, ≥30 years), age at menarche (<13, 13-14, ≥15 years), age at menopause (<40, 40-44, 45-49, 50-54, ≥55 years), parity (number of children: 0, 1-2, ≥3), and alcohol intake (g/d; quintiles adjusted for total energy intake).

    • ↵† Additionally adjusted for BMI (<25.0, 25.0-29.9, 30.0-34.9, ≥35.0 kg/m2).

  • Table 3.

    Multivariate RR (95% CI) for the association between physical activity and breast cancer incidence among postmenopausal women according to selected tumor characteristics

    Tumor characteristics*No. casesPhysical activity (times per week)
    PtrendPheterogeneity
    Inactive<11-23-4≥5
    Hormone receptor status
        ER+2,0831.0 (Reference)1.03 (0.89-1.19)0.95 (0.83-1.08)0.98 (0.86-1.11)0.97 (0.84-1.12)0.640.07
        ER−4111.0 (Reference)1.10 (0.81-1.49)0.85 (0.63-1.14)0.85 (0.64-1.12)0.75 (0.54-1.04)0.03
        ER+/PR+1,6491.0 (Reference)1.00 (0.84-1.18)0.97 (0.84-1.13)0.96 (0.83-1.11)0.96 (0.82-1.13)0.53
        ER+/PR−3381.0 (Reference)1.29 (0.90-1.84)0.93 (0.65-1.32)1.17 (0.85-1.60)1.05 (0.73-1.51)0.85
        ER−/PR+481.0 (Reference)1.10 (0.41-2.95)1.15 (0.47-2.78)1.29 (0.56-2.95)0.62 (0.21-1.86)0.560.37
        ER−/PR−3591.0 (Reference)1.10 (0.80-1.53)0.84 (0.61-1.15)0.81 (0.60-1.10)0.78 (0.55-1.10)0.05
        Unknown ER or PR3,0391.0 (Reference)0.90 (0.80-1.02)0.95 (0.85-1.06)0.92 (0.83-1.01)0.81 (0.72-0.91)0.002
    Tumor stage
        In situ1,1761.0 (Reference)1.10 (0.91-1.33)0.90 (0.75-1.08)0.93 (0.78-1.10)0.93 (0.77-1.13)0.200.85
        Invasive5,4331.0 (Reference)0.97 (0.88-1.06)0.95 (0.87-1.03)0.94 (0.87-1.01)0.86 (0.79-0.94)0.001
            Localized3,1581.0 (Reference)0.97 (0.86-1.09)0.95 (0.86-1.06)1.00 (0.90-1.10)0.85 (0.76-0.96)0.040.17
            Regional/distant1,2981.0 (Reference)0.99 (0.83-1.17)0.83 (0.71-0.98)0.74 (0.63-0.86)0.85 (0.71-1.01)0.0030.36†
    Tumor histology
        Ductal3,5681.0 (Reference)0.98 (0.88-1.10)0.96 (0.87-1.06)0.93 (0.84-1.02)0.89 (0.80-0.99)0.02
        Lobular5501.0 (Reference)1.24 (0.95-1.63)0.92 (0.71-1.19)0.89 (0.69-1.14)0.87 (0.65-1.15)0.050.41
        Ductal-lobular4361.0 (Reference)0.80 (0.58-1.12)0.80 (0.60-1.08)0.95 (0.73-1.24)0.89 (0.66-1.20)0.96
    • NOTE: Multivariate models used age as the underlying time metric and were adjusted for race/ethnicity (White, Black, Hispanic, Asian/Pacific Islander/American Indian), education level (<12 years or high school equivalent, 12 years or high school equivalent, post-high school vocational or technical training, some college, college graduate, postgraduate), smoking status (nonsmoker, former, current), family history of breast cancer (no, yes), menopausal hormone use (never, current, past), age at first birth (nulliparous, <20, 20-24, 25-29, ≥30 years), age at menarche (<13, 13-14, ≥15 years), age at menopause (<40, 40-44, 45-49, 50-54, ≥55 years), parity (number of children: 0, 1-2, ≥3), and alcohol intake (g/d; quintiles adjusted for total energy intake).

    • ↵* Hormone receptor status and tumor histology limited to invasive cancers.

    • ↵† P value for comparison of in situ, localized, and regional/distant.

  • Table 4.

    Multivariate RR (95% CI) for the association between physical activity and breast cancer incidence among postmenopausal women according to BMI, MHT use, and family history of breast cancer

    No. casesPhysical activity (times per week)
    PtrendPheterogeneity
    Inactive<11-23-4≥5
    BMI (kg/m2)
        ≥25.03,7871.0 (Reference)0.98 (0.89-1.08)0.98 (0.90-1.08)0.92 (0.84-1.01)0.86 (0.77-0.96)0.0030.07
        <25.02,8221.0 (Reference)1.01 (0.92-1.11)0.97 (0.89-1.05)0.99 (0.92-1.08)0.95 (0.87-1.05)0.64
    MHT use
        Ever use4,0731.0 (Reference)1.03 (0.93-1.15)1.00 (0.90-1.10)1.00 (0.92-1.10)0.97 (0.88-1.08)0.340.002
        Never use2,5281.0 (Reference)0.95 (0.84-1.08)0.88 (0.79-0.99)0.86 (0.77-0.96)0.76 (0.67-0.86)<0.001
    Family history
        Family history1,1931.0 (Reference)0.99 (0.83-1.19)0.92 (0.78-1.08)0.75 (0.64-0.89)0.75 (0.62-0.91)<0.0010.003
        No family history5,1241.0 (Reference)0.99 (0.90-1.09)0.95 (0.87-1.03)0.98 (0.90-1.06)0.88 (0.81-0.97)0.03
    • NOTE: Multivariate models used age as the underlying time metric and were adjusted for race/ethnicity (White, Black, Hispanic, Asian/Pacific Islander/American Indian), education level (<12 years or high school equivalent, 12 years or high school equivalent, post-high school vocational or technical training, some college, college graduate, postgraduate), smoking status (nonsmoker, former, current), family history of breast cancer (no, yes), menopausal hormone use (never, current, past), age at first birth (nulliparous, <20, 20-24, 25-29, ≥30 years), age at menarche (<13, 13-14, ≥15 years), age at menopause (<40, 40-44, 45-49, 50-54, ≥55 years), parity (number of children: 0, 1-2, ≥3), and alcohol intake (g/d; quintiles adjusted for total energy intake).

  • Table 5.

    Multivariate RR (95% CI) for the association between physical activity and breast cancer incidence among postmenopausal women according to joint effect of physical activity and BMI, joint effect of physical activity and MHT use, and joint effect of physical activity and family history of breast cancer

    No. casesPhysical activity (times per week)
    Inactive<11-23-4≥5
    BMI (kg/m2)
        ≥25.03,7871.0 (Reference)0.98 (0.89-1.08)0.98 (0.90-1.08)0.92 (0.84-1.01)0.86 (0.77-0.96)
        <25.02,8220.84 (0.75-0.94)0.85 (0.75-0.96)0.76 (0.68-0.84)0.84 (0.77-0.92)0.80 (0.72-0.88)
    MHT use
        Ever use4,0731.0 (Reference)1.03 (0.93-1.15)1.00 (0.90-1.10)1.01 (0.92-1.10)0.97 (0.88-1.08)
        Never use2,5280.79 (0.72-0.88)0.76 (0.67-0.85)0.70 (0.63-0.78)0.68 (0.61-0.76)0.60 (0.53-0.68)
    Family history
        Family history1,1931.0 (Reference)0.99 (0.83-1.19)0.92 (0.78-1.08)0.75 (0.64-0.89)0.75 (0.62-0.91)
        No family history5,1240.57 (0.50-0.65)0.57 (0.50-0.65)0.54 (0.48-0.62)0.56 (0.49-0.64)0.51 (0.44-0.58)
    • NOTE: Multivariate models used age as the underlying time metric and were adjusted for race/ethnicity (White, Black, Hispanic, Asian/Pacific Islander/American Indian), education level (<12 years or high school equivalent, 12 years or high school equivalent, post-high school vocational or technical training, some college, college graduate, postgraduate), smoking status (nonsmoker, former, current), family history of breast cancer (no, yes), menopausal hormone use (never, current, past), age at first birth (nulliparous, <20, 20-24, 25-29, ≥30 years), age at menarche (<13, 13-14, ≥15 years), age at menopause (<40, 40-44, 45-49, 50-54, ≥55 years), parity (number of children: 0, 1-2, ≥3), and alcohol intake (g/d; quintiles adjusted for total energy intake).

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Cancer Epidemiology Biomarkers & Prevention: 18 (1)
January 2009
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Physical Activity and Postmenopausal Breast Cancer Risk in the NIH-AARP Diet and Health Study
Tricia M. Peters, Arthur Schatzkin, Gretchen L. Gierach, Steven C. Moore, James V. Lacey Jr., Nicholas J. Wareham, Ulf Ekelund, Albert R. Hollenbeck and Michael F. Leitzmann
Cancer Epidemiol Biomarkers Prev January 1 2009 (18) (1) 289-296; DOI: 10.1158/1055-9965.EPI-08-0768

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Physical Activity and Postmenopausal Breast Cancer Risk in the NIH-AARP Diet and Health Study
Tricia M. Peters, Arthur Schatzkin, Gretchen L. Gierach, Steven C. Moore, James V. Lacey Jr., Nicholas J. Wareham, Ulf Ekelund, Albert R. Hollenbeck and Michael F. Leitzmann
Cancer Epidemiol Biomarkers Prev January 1 2009 (18) (1) 289-296; DOI: 10.1158/1055-9965.EPI-08-0768
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