Leisure-time physical activity is associated with reduced risks of breast cancer and triple negative breast cancer in Nigerian women |
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| Institution: | 1. Department of Epidemiology and Public Health, Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, United States;2. University of Abuja Teaching Hospital, Gwagwalada, Nigeria;3. National Hospital Abuja, Abuja, Nigeria;4. African Collaborative Center for Microbiome and Genomics Research(ACCME) Biorepository and Research Laboratory, Institute of Human Virology, Nigeria;5. University of Nigeria Teaching Hospital, Enugu, Nigeria;6. Asokoro District Hospital, Abuja, Nigeria;7. Garki Hospital, Abuja, Nigeria;8. Wuse General Hospital, Abuja, Nigeria;9. Federal Staff Hospital, Abuja, Nigeria;1. Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Germany;2. School of Public Health, Department of Epidemiology, Boston University, Boston, USA;3. Cancer Registry of North Rhine-Westphalia, Bochum, Germany;4. Saarland Cancer Registry, Saarbrücken, Germany;5. CaritasKlinikum Saarbrücken St. Theresia, Saarbrücken, Germany;1. Faculty of Medicine, University of Iceland, Reykjavik, Iceland;2. Department of Pathology, Landspitali University Hospital of Iceland, Reykjavik, Iceland;3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Landspitali University Hospital of Iceland, Reykjavik, Iceland;1. Department of Preventive and Population Medicine, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore;2. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore;3. Research & Surveillance Division, Health Promotion Board, Singapore;4. Department of Haematology, Tan Tock Seng Hospital, Singapore;1. Department of Cancer Strategy, Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka City, Osaka Prefecture 541-8567, Japan;2. Inequalities in Cancer Outcome Network, Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom;1. Maccabi Institute for Research and Innovation (Maccabitech), Maccabi Healthcare Services, HaMered 27, Tel Aviv, 68125, Israel;2. MSD Israel, Merck Sharp & Dohme (Israel-1996) Company Ltd. 34 Hacharash St. P.O.B 7340, Hod Hasharon 45240, Israel;3. Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel;4. Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel;5. Sackler Faculty of Medicine, Tel Aviv University, Israel;1. School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia;2. Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia;3. Department of Anatomical Pathology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia;4. Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, MD, USA;5. Walter Reed National Military Medical Center (WRNMM) Uniformed Services University (USU) Department of Surgery, Bethesda, MD, USA;6. The Walter & Eliza Hall Institute of Medical Research, University of Melbourne,1 G Royal Parade, Parkville, Victoria 3052, Australia;7. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Massachusetts, USA;8. Department of Medical Oncology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia |
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| Abstract: | BackgroundLeisure-time physical activity(LTPA) is associated with a reduced risk of breast cancer, but this has less been investigated by cancer subtypes in Africans living in Sub-Saharan Africa(SSA). We examined the associations between LTPA and breast cancer including its subtypes in Nigerian women and explored the effect modification of body size on such associations.MethodsThe sample included 508 newly diagnosed primary invasive breast cancer cases and 892 controls from the Nigerian Integrative Epidemiology of Breast Cancer(NIBBLE) Study. Immunohistochemical(IHC) analysis was available for 294 cases. Total metabolic equivalents(METs) per hour/week of LTPA were calculated and divided by quartiles(Q1 <3.75, Q2:3.75–6.69, Q3:6.70–14.74, Q4:14.75 ≤). We applied logistic regressions to estimate the adjusted Odds Ratios(ORs) between LTPA and breast cancer and by its molecular subtypes and whether age-adjusted associations are modified by BMI.ResultsThe mean age(Mean±SD) of cases vs. controls(45.5 ± 11.1vs.40.1 ± 9.0) was higher, and the mean total METs hour/week was higher in controls vs. cases(11.9 ± 14.9vs.8.3 ± 11.1,p-value<0.001). Overall, 43.2%(N = 127/294) were classified as HRP, and 41.8%(N = 123/294) as TNBC. Women in the higher LTPA quartiles(Q3-Q4) vs. Q1 had lower odds of having breast cancer(ORQ4vs.Q1=0.51,95%CI:0.35–0.74) and TNBC(ORQ4vs.Q1=0.51, 95%CI:0.27–0.96), but not HRP(ORQ4vs.Q1=0.61,95%CI:0.34–1.09) after adjusting for age, age at first menarche, body size, breastfeeding, menopausal, parity, contraceptives, demographics, alcohol, smoking, and physical activity at home and work. Lastly, LTPA and its age-adjusted association with breast cancer was more pronounced in women with BMI< 30 vs. BMI 30 + .ConclusionsLTPA may reduce the risk of breast cancer, especially TNBC, which is the more aggressive and prevalent molecular subtype of breast cancer in SSA. |
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| Keywords: | Breast cancer Triple-negative Leisure-time physical activity Nigeria Sub-Saharan Africa |
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