A case-control study was conducted in Ibaraki, Japan. Cases were 148 women aged 26-69 diagnosed with breast cancer at Tsukuba University Hospital or Tsukuba Medical Center Hospital between January 1990 and March 1997. Two controls were individually matched to cases by age (within 1 year) and residence (municipalities). A self-administered questionnaire was used to obtain information on physical activity and the effects of potential confounding factors. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95 percent confidence intervals (95% CIs). After adjustment for potential confounding factors (height, body mass index (BMI), family history of breast cancer, education, age at menarche, age at first birth, parity, menopausal status), recreational physical activity was associated with a reduced risk of breast cancer (p for trend = 0.005). OR for breast cancer among women who played regular sport or exercise more than 15.3 METs per week was 0.35 (95% Cl = 0.17, 0.73), as compared to women with no sport or exercise. The risk of breast cancer was also reduced in women with higher occupational physical activity levels, but it was not significant (p for trend = 0.223). The adjusted OR among the highest quartile level was 0.55 (95% CI = 0.27, 1.12) with the lowest quartile level as reference. Our findings support a protective effect of recreational physical activity on breast cancer in Japanese women.J Epidemiol, 1998 ; 8 : 116-122. physical exercise, breast neoplasms, primary prevention, case-controlIn recent years, mounting epidemiologic evidence has indicated that physical activity is associated with decreased incidence of specific types of cancers 1-7). The cancer site most frequently studied in relation to physical activity is the colon 2.3. 4,6) Physical activity is known to delay age at menarche, influence menstrual cycle patterns and ovulatory frequency, and may also be related to breast cancer 8-12). These effects of physical activity may reduce cumulative exposure to ovarian hormones, therefore inhibiting carcinogenesis in the breast. Several epidemiologic studies have examined the association between physical activity and breast cancer risk 13-27). In the most recently published cohort study, Thune et al. 27) concluded that physical activity during leisure time and at work is associated with a reduced risk of breast cancer. In addition, several animal experimental studies have shown that mammary tumor incidence is decreased by exercise 28-31) However, the amount of scientific evidence in support of the relation is still quite limited, and the relation is not clarified in Japanese women. We conducted a matched case-control study of breast cancer among Japanese women. The purpose of this study was to clarify the relationship between recreational and occupational physical activity and the risk of breast cancer in Japanese women.Received October 8, 1997 ; accepted December 17, 1997. 1 Graduate School of Medicine, University of Tsukuba, Japan.M. Ueji, et al.
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