PO.PR01.04 · 预防研究
体力活动、吸烟与乳腺癌风险：英国生物银行的前瞻性队列研究
Physical activity, smoking and breast cancer risk: A prospective cohort study in the UK biobank
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：体力活动和吸烟是可改变的乳腺癌危险因素，它们通过部分共享的生物学通路（如激素调节和炎症）发挥作用。然而，它们潜在的相互作用，尤其是在不同绝经组之间，仍在很大程度上未被探索。本研究旨在评估吸烟状态是否会改变体力活动与乳腺癌风险之间的关联。
方法：英国生物银行（UK Biobank，2007-2010）中≥40岁、既往无癌症的女性提供了自我报告的生活方式因素。体力活动采用每周代谢当量小时数（MET-hrs/周）分类：高（≥50）、中（10-50）和低（<10）。新发癌症的确定截至2022年5月。采用带乘积项的Cox比例风险模型评估体力活动与吸烟状态（从不、既往、当前）之间的相互作用。多变量模型对人体测量、生殖、生活方式、社会经济和筛查因素进行了校正。
结果：在242,721名参与者中，平均随访12.53年（SD：2.55），发生了773例绝经前和7989例绝经后乳腺癌病例。高体力活动与较低的绝经前（HR=0.78，95%CI：0.62-0.97）和绝经后（HR=0.88，95%CI：0.83-0.94）乳腺癌风险相关。吸烟状态与绝经前乳腺癌风险无关（既往吸烟者：HR=0.95，95%CI：0.79-1.13；当前：HR=0.89，95%CI：0.70-1.15），但与较高的绝经后乳腺癌风险相关（既往吸烟者：HR=1.05，95%CI：1.00-1.11；当前：HR=1.13，95%CI：1.03-1.23）。在评估体力活动与吸烟的联合关联时，当前吸烟似乎减弱了体力活动对绝经前（HR=1.61，95%CI：0.74-3.51）和绝经后（HR=1.29，95%CI：1.02至1.62）乳腺癌风险的保护性关联，尽管乘法交互项无统计学显著性。
结论：吸烟状态与绝经前乳腺癌风险无独立关联，但与较高的绝经后乳腺癌风险相关。然而，当前吸烟者从体力活动中获得的保护性益处似乎少于从不吸烟者。这些发现凸显了在乳腺癌预防中评估生活方式联合效应而非单一暴露的重要性。
查看英文原文 English abstract
Background: Physical activity and smoking are modifiable breast cancer risk factors that operate through partially shared biological pathways, such as hormone regulation and inflammation. However, their potential interactions, especially across menopausal groups, remain largely unexplored. This study aimed to assess whether smoking status modifies the association between physical activity and breast cancer risk.
Methods: Females ≥40 years without prior cancer in the UK Biobank (2007-2010) provided self-reported lifestyle factors. Physical activity was categorized using metabolic equivalent hours per week (MET-hrs/week): high (≥50), moderate (10-50), and low (<10). Incident cancers were ascertained through May 2022. Interaction between physical activity and smoking status (never, past, current) was evaluated using Cox proportional hazards models with product terms. Multivariable models were adjusted for anthropometrics, reproductive, lifestyle, socioeconomic and screening factors.
Results: Among 242 721 participants followed for a mean of 12.53 years (SD: 2.55), 773 premenopausal and 7989 postmenopausal breast cancer cases occurred. High physical activity was associated with lower risk of both premenopausal (HR=0.78, 95%CI: 0.62-0.97) and postmenopausal (HR=0.88, 95%CI: 0.83-0.94) breast cancer. Smoking status was not associated with premenopausal breast cancer risk (past smoker: HR=0.95, 95%CI:0.79-1.13; current: HR=0.89, 95%CI: 0.70-1.15) but was associated with a higher postmenopausal breast cancer risk (past smoker: HR=1.05, 95%CI:1.00-1.11; current: HR=1.13, 95%CI: 1.03-1.23). When evaluating the joint association between physical activity and smoking, current smoking appeard to attenuate the protective association of physical activity with both premenopausal (HR=1.61, 95%CI: 0.74-3.51) and postmenopausal (HR=1.29, 95%CI:1.02 to 1.62) breast cancer risk, although multiplicative interaction terms were not statistically significant.
Conclusions: Smoking status was not independently associated with premenopausal but associated with higher postmenopausal breast cancer risk. Nevertheless, current smokers appeared to derive less protective benefits from physical activity than never smokers. These findings highlight the importance of evaluating joint lifestyle effects rather than single exposure alone in breast cancer prevention.
利益披露 Disclosure
H. Harsanyi, None..
A. Harper, None..
S. Lupichuk, None..
L. Yang, None.