Sustained Weight Loss and Risk of Breast Cancer in Women 50 Years and Older: A Pooled Analysis of Prospective Data

被引：59

作者：

Teras, Lauren R. ^{[1
]}

Patel, Alpa, V ^{[1
]}

Wang, Molin ^{[2
,3
,5
]}

Yaun, Shiaw-Shyuan ^{[4
]}

Anderson, Kristin ^{[6
]}

Brathwaite, Roderick ^{[4
]}

Caan, Bette J. ^{[7
]}

Chen, Yu ^{[8
]}

Connor, Avonne E. ^{[10
]}

Eliassen, A. Heather ^{[2
,5
]}

Gapstur, Susan M. ^{[1
]}

Gaudet, Mia M. ^{[1
]}

Genkinger, Jeanine M. ^{[11
,12
]}

Giles, Graham G. ^{[13
,14
]}

Lee, I-Min ^{[2
,15
]}

Milne, Roger L. ^{[13
,14
]}

Robien, Kim ^{[16
]}

Sawada, Norie ^{[17
]}

Sesso, Howard D. ^{[2
,15
]}

Stampfer, Meir J. ^{[2
,4
,5
]}

Tamimi, Rulla M. ^{[2
,5
]}

Thomson, Cynthia A. ^{[18
]}

Tsugane, Shoichiro ^{[17
]}

Visvanathan, Kala ^{[10
]}

Willett, Walter C. ^{[2
,4
,5
]}

Zeleniuch-Jacquotte, Anne ^{[9
]}

Smith-Warner, Stephanie A. ^{[2
,4
]}

机构：

[1] Amer Canc Soc, Epidemiol Res Program, 250 Williams St NW, Atlanta, GA 30303 USA

[2] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[3] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA

[4] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA

[5] Harvard Med Sch, Dept Med, Channing Div Network Med, Boston, MA 02115 USA

[6] Univ Minnesota, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[7] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA

[8] NYU, Sch Med, Dept Populat Hlth & Environm Med, New York, NY USA

[9] NYU, Sch Med, Inst Canc, New York, NY USA

[10] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[11] Columbia Univ, Dept Epidemiol, Med Sch Publ Hlth, New York, NY USA

[12] Columbia Univ, Med Ctr, Herbert Irving Comprehens Canc Ctr, New York, NY USA

[13] Canc Council Victoria, Canc Epidemiol & Intelligence Div, Melbourne, Vic, Australia

[14] Univ Melbourne, Ctr Epidemiol & Biostat, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia

[15] Harvard Med Sch, Div Prevent Med, Brigham & Womens Hosp, Boston, MA 02115 USA

[16] George Washington Univ, Dept Exercise & Nutr Sci, Milken Inst Sch Publ Hlth, Washington, DC USA

[17] Natl Canc Ctr, Ctr Publ Hlth Sci, Epidemiol & Prevent Grp, Tokyo, Japan

[18] Univ Arizona, Dept Hlth Promot Sci, Mel & Enid Zuckerman Coll Publ Hlth, Tucson, AZ USA

来源：

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2020年 / 112卷 / 09期

基金：

美国国家卫生研究院; 英国医学研究理事会;

关键词：

BODY-MASS INDEX; BARIATRIC SURGERY; REGRESSION-MODELS; HEALTH; MORTALITY; DESIGN; METAANALYSIS; ESTROGEN; OBESITY;

D O I：

10.1093/jnci/djz226

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：929 / 937

页数：9

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