Sustained Weight Loss and Risk of Breast Cancer in Women 50 Years and Older: A Pooled Analysis of Prospective Data.
Age Factors
Aged
Aged, 80 and over
Breast Neoplasms
/ epidemiology
Cohort Studies
Female
Humans
Middle Aged
Obesity
/ complications
Overweight
/ complications
Postmenopause
/ physiology
Prospective Studies
Risk Factors
Risk Reduction Behavior
United States
/ epidemiology
Weight Gain
/ physiology
Weight Loss
/ physiology
Journal
Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089
Informations de publication
Date de publication:
01 09 2020
01 09 2020
Historique:
received:
09
11
2018
revised:
23
10
2019
accepted:
03
12
2019
pubmed:
18
12
2019
medline:
29
4
2021
entrez:
18
12
2019
Statut:
ppublish
Résumé
Excess body weight is an established cause of postmenopausal breast cancer, but it is unknown if weight loss reduces risk. Associations between weight change and risk of breast cancer were examined among women aged 50 years and older in the Pooling Project of Prospective Studies of Diet and Cancer. In 10 cohorts, weight assessed on three surveys was used to examine weight change patterns over approximately 10 years (interval 1 median = 5.2 years; interval 2 median = 4.0 years). Sustained weight loss was defined as no less than 2 kg lost in interval 1 that was not regained in interval 2. Among 180 885 women, 6930 invasive breast cancers were identified during follow-up. Compared with women with stable weight (±2 kg), women with sustained weight loss had a lower risk of breast cancer. This risk reduction was linear and specific to women not using postmenopausal hormones (>2-4.5 kg lost: hazard ratio [HR] = 0.82, 95% confidence interval [CI] = 0.70 to 0.96; >4.5-<9 kg lost: HR = 0.75, 95% CI = 0.63 to 0.90; ≥9 kg lost: HR = 0.68, 95% CI = 0.50 to 0.93). Women who lost at least 9 kg and gained back some (but not all) of it were also at a lower risk of breast cancer. Other patterns of weight loss and gain over the two intervals had a similar risk of breast cancer to women with stable weight. These results suggest that sustained weight loss, even modest amounts, is associated with lower breast cancer risk for women aged 50 years and older. Breast cancer prevention may be a strong weight-loss motivator for the two-thirds of American women who are overweight or obese.
Sections du résumé
BACKGROUND
Excess body weight is an established cause of postmenopausal breast cancer, but it is unknown if weight loss reduces risk.
METHODS
Associations between weight change and risk of breast cancer were examined among women aged 50 years and older in the Pooling Project of Prospective Studies of Diet and Cancer. In 10 cohorts, weight assessed on three surveys was used to examine weight change patterns over approximately 10 years (interval 1 median = 5.2 years; interval 2 median = 4.0 years). Sustained weight loss was defined as no less than 2 kg lost in interval 1 that was not regained in interval 2. Among 180 885 women, 6930 invasive breast cancers were identified during follow-up.
RESULTS
Compared with women with stable weight (±2 kg), women with sustained weight loss had a lower risk of breast cancer. This risk reduction was linear and specific to women not using postmenopausal hormones (>2-4.5 kg lost: hazard ratio [HR] = 0.82, 95% confidence interval [CI] = 0.70 to 0.96; >4.5-<9 kg lost: HR = 0.75, 95% CI = 0.63 to 0.90; ≥9 kg lost: HR = 0.68, 95% CI = 0.50 to 0.93). Women who lost at least 9 kg and gained back some (but not all) of it were also at a lower risk of breast cancer. Other patterns of weight loss and gain over the two intervals had a similar risk of breast cancer to women with stable weight.
CONCLUSIONS
These results suggest that sustained weight loss, even modest amounts, is associated with lower breast cancer risk for women aged 50 years and older. Breast cancer prevention may be a strong weight-loss motivator for the two-thirds of American women who are overweight or obese.
Identifiants
pubmed: 31845728
pii: 5675519
doi: 10.1093/jnci/djz226
pmc: PMC7492760
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
929-937Subventions
Organisme : NCI NIH HHS
ID : U01 CA182913
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA182934
Pays : United States
Organisme : NCI NIH HHS
ID : UM1 CA182934
Pays : United States
Organisme : NCI NIH HHS
ID : UM1 CA186107
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA016087
Pays : United States
Organisme : NIEHS NIH HHS
ID : P30 ES000260
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600018C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600001C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600002C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600003C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600004C
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
Int J Epidemiol. 1994 Oct;23(5):991-9
pubmed: 7860180
Obstet Gynecol. 2012 Sep;120(3):595-603
pubmed: 22914469
Ann Surg. 2019 Apr 13;:
pubmed: 30998538
Diabetes Obes Metab. 2011 Dec;13(12):1063-72
pubmed: 21733057
Cancer. 2002 May 1;94(9):2490-501
pubmed: 12015775
Lancet. 2016 Aug 20;388(10046):776-86
pubmed: 27423262
Nat Rev Cancer. 2005 May;5(5):388-96
pubmed: 15864280
Steroids. 2015 Jul;99(Pt A):49-55
pubmed: 25304359
J Natl Cancer Inst. 1995 Sep 6;87(17):1297-302
pubmed: 7658481
CA Cancer J Clin. 2015 Mar;65(2):87-108
pubmed: 25651787
Am J Obstet Gynecol. 1992 Aug;167(2):459-60
pubmed: 1497051
Am J Epidemiol. 1994 May 15;139(10):990-1000
pubmed: 8178787
Cancer. 2019 Jan 15;125(2):205-212
pubmed: 30294816
Psychiatr Clin North Am. 2011 Dec;34(4):717-32
pubmed: 22098799
Control Clin Trials. 1986 Sep;7(3):177-88
pubmed: 3802833
Res Q Exerc Sport. 2000 Jun;71 Suppl 2:1-14
pubmed: 25680007
Stat Med. 2002 Jun 15;21(11):1539-58
pubmed: 12111919
JAMA. 2006 Jul 12;296(2):193-201
pubmed: 16835425
J Lab Clin Med. 1979 Jun;93(6):1004-8
pubmed: 571447
Surg Obes Relat Dis. 2008 Nov-Dec;4(6):691-5
pubmed: 19026373
Jpn J Clin Oncol. 2014 Sep;44(9):777-82
pubmed: 25104790
J Natl Cancer Inst. 1998 Apr 1;90(7):512-8
pubmed: 9539246
Control Clin Trials. 1998 Feb;19(1):61-109
pubmed: 9492970
Lancet Oncol. 2009 Jul;10(7):653-62
pubmed: 19556163
Am J Epidemiol. 2009 Jul 15;170(2):244-56
pubmed: 19494242
JAMA Oncol. 2015 Aug;1(5):611-21
pubmed: 26182172
Am J Epidemiol. 2006 Jun 1;163(11):1053-64
pubmed: 16624970
N Engl J Med. 2016 Aug 25;375(8):794-8
pubmed: 27557308
J Natl Cancer Inst. 1995 Feb 1;87(3):190-7
pubmed: 7707406
Public Health Nutr. 2019 Apr;22(6):1019-1028
pubmed: 30449294
Cancer Causes Control. 2011 Apr;22(4):573-9
pubmed: 21327461
Age Ageing. 2002 May;31(3):169-74
pubmed: 12006304
Peptides. 2016 Mar;77:28-37
pubmed: 26344355
Med Sci Sports Exerc. 2019 Jan;51(1):41-48
pubmed: 30095743
Obesity (Silver Spring). 2009 Apr;17(4):796-802
pubmed: 19148123
Breast Cancer Res. 2015 Sep 02;17:120
pubmed: 26330303
Cancer Epidemiol. 2017 Jun;48:140-146
pubmed: 28549339
Maturitas. 1982 Aug;4(2):155-62
pubmed: 7121295