Abstract
Objectives Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics. Methods We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105-377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (n snps =5) or sedentary time (n snps =6), or accelerometer-measured (n snps =1) or self-reported (n snps =5) vigorous physical activity. Results Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;∼8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (∼7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger). Conclusion Our study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women.
Original language | English |
---|---|
Pages (from-to) | 1157-1170 |
Number of pages | 14 |
Journal | British Journal of Sports Medicine |
Volume | 56 |
Issue number | 20 |
DOIs | |
Publication status | Published - 6 Sep 2022 |
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Physical activity, sedentary time and breast cancer risk : a Mendelian randomisation study. / Breast Cancer Association Consortium (BCAC); Dixon-Suen, Suzanne C.; Lewis, Sarah J. et al.
In: British Journal of Sports Medicine, Vol. 56, No. 20, 06.09.2022, p. 1157-1170.Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Physical activity, sedentary time and breast cancer risk
T2 - a Mendelian randomisation study
AU - Breast Cancer Association Consortium (BCAC)
AU - Dixon-Suen, Suzanne C.
AU - Lewis, Sarah J.
AU - Martin, Richard M.
AU - English, Dallas R.
AU - Boyle, Terry
AU - Giles, Graham G.
AU - Michailidou, Kyriaki
AU - Bolla, Manjeet K.
AU - Wang, Qin
AU - Dennis, Joe
AU - Lush, Michael
AU - Investigators, Abctb
AU - Ahearn, Thomas U.
AU - Ambrosone, Christine B.
AU - Andrulis, Irene L.
AU - Anton-Culver, Hoda
AU - Arndt, Volker
AU - Aronson, Kristan J.
AU - Augustinsson, Annelie
AU - Auvinen, Päivi
AU - Freeman, Laura E.Beane
AU - Becher, Heiko
AU - Beckmann, Matthias W.
AU - Behrens, Sabine
AU - Bermisheva, Marina
AU - Blomqvist, Carl
AU - Bogdanova, Natalia V.
AU - Bojesen, Stig E.
AU - Bonanni, Bernardo
AU - Brenner, Hermann
AU - Brüning, Thomas
AU - Buys, Saundra S.
AU - Camp, Nicola J.
AU - Campa, Daniele
AU - Canzian, Federico
AU - Castelao, Jose E.
AU - Cessna, Melissa H.
AU - Chang-Claude, Jenny
AU - Chanock, Stephen J.
AU - Clarke, Christine L.
AU - Conroy, Don M.
AU - Couch, Fergus J.
AU - Cox, Angela
AU - Cross, Simon S.
AU - Czene, Kamila
AU - Daly, Mary B.
AU - Devilee, Peter
AU - Dörk, Thilo
AU - Dwek, Miriam
AU - Eccles, Diana M.
AU - Eliassen, A. Heather
AU - Engel, Christoph
AU - Eriksson, Mikael
AU - Evans, D. Gareth
AU - Fasching, Peter A.
AU - Fletcher, Olivia
AU - Flyger, Henrik
AU - Fritschi, Lin
AU - Gabrielson, Marike
AU - Gago-Dominguez, Manuela
AU - García-Closas, Montserrat
AU - García-Sáenz, José A.
AU - Goldberg, Mark S.
AU - Guénel, Pascal
AU - Gündert, Melanie
AU - Hahnen, Eric
AU - Haiman, Christopher A.
AU - Häberle, Lothar
AU - Håkansson, Niclas
AU - Hall, Per
AU - Hamann, Ute
AU - Hart, Steven N.
AU - Harvie, Michelle
AU - Hillemanns, Peter
AU - Hollestelle, Antoinette
AU - Hooning, Maartje J.
AU - Hoppe, Reiner
AU - Hopper, John
AU - Howell, Anthony
AU - Hunter, David J.
AU - Jakubowska, Anna
AU - Janni, Wolfgang
AU - John, Esther M.
AU - Jung, Audrey
AU - Kaaks, Rudolf
AU - Keeman, Renske
AU - Kitahara, Cari M.
AU - Koutros, Stella
AU - Kraft, Peter
AU - Kristensen, Vessela N.
AU - Kubelka-Sabit, Katerina
AU - Kurian, Allison W.
AU - Lacey, James V.
AU - Lambrechts, Diether
AU - Le Marchand, Loic
AU - Lindblom, Annika
AU - Loibl, Sibylle
AU - Lubiński, Jan
AU - Mannermaa, Arto
AU - Manoochehri, Mehdi
AU - Margolin, Sara
AU - Martinez, Maria Elena
AU - Mavroudis, Dimitrios
AU - Menon, Usha
AU - Mulligan, Anna Marie
AU - Murphy, Rachel A.
AU - Collaborators, Nbcs
AU - Nevanlinna, Heli
AU - Nevelsteen, Ines
AU - Newman, William G.
AU - Offit, Kenneth
AU - Olshan, Andrew F.
AU - Olsson, Håkan
AU - Orr, Nick
AU - Patel, Alpa
AU - Peto, Julian
AU - Plaseska-Karanfilska, Dijana
AU - Presneau, Nadege
AU - Rack, Brigitte
AU - Radice, Paolo
AU - Rees-Punia, Erika
AU - Rennert, Gad
AU - Rennert, Hedy S.
AU - Romero, Atocha
AU - Saloustros, Emmanouil
AU - Sandler, Dale P.
AU - Schmidt, Marjanka K.
AU - Schmutzler, Rita K.
AU - Schwentner, Lukas
AU - Scott, Christopher
AU - Shah, Mitul
AU - Shu, Xiao Ou
AU - Simard, Jacques
AU - Southey, Melissa C.
AU - Stone, Jennifer
AU - Surowy, Harald
AU - Swerdlow, Anthony J.
AU - Tamimi, Rulla M.
AU - Tapper, William J.
AU - Taylor, Jack A.
AU - Terry, Mary Beth
AU - Tollenaar, Rob A.E.M.
AU - Troester, Melissa A.
AU - Truong, Thérèse
AU - Untch, Michael
AU - Vachon, Celine M.
AU - Joseph, Vijai
AU - Wappenschmidt, Barbara
AU - Weinberg, Clarice R.
AU - Wolk, Alicja
AU - Yannoukakos, Drakoulis
AU - Zheng, Wei
AU - Ziogas, Argyrios
AU - Dunning, Alison M.
AU - Pharoah, Paul D.P.
AU - Easton, Douglas F.
AU - Milne, Roger L.
AU - Lynch, Brigid M.
N1 - Funding Information: MWB conducts research funded by Amgen, Novartis and Pfizer. PAF conducts research funded by Amgen, Novartis and Pfizer. He received honoraria from Roche, Novartis and Pfizer. AWK declares research funding to her institution from Myriad Genetics for an unrelated project (funding dates 2017-2019). SL declares grants and honoraria paid to her institution from Amgen, Novartis, Pfizer, Roche, and, outside the submitted work, grants and/or honoraria paid to her institution from AbbVie, Celgene, Seattle Genetics, PrIME/Medscape, Daiichi-Sankyo, Lilly, Samsung, BMS, Puma, Immunomedics, AstraZeneca, Pierre Fabre, Merck, GlaxoSmithKlein, EirGenix, and Bayer, and personal fees from Chugai; SL also has a patent EP14153692.0 pending. UM declares stock ownership in Abcodia Ltd. RAM has been a consultant for Pharmavite. No other authors have conflicts to declare. Funding Information: This work was supported by the following agencies. Funders had no role in study design, data collection, analysis, interpretation, writing of the report, or the decision to submit the paper for publication. BCAC is funded by the European Union's Horizon 2020 Research and Innovation Programme (grant numbers 634935 and 633784 for BRIDGES and B-CAST respectively), and the PERSPECTIVE IandI project, funded by the Government of Canada through Genome Canada and the Canadian Institutes of Health Research, the Ministere de l'Economie et de l'Innovation du Quebec through Genome Québec, the Quebec Breast Cancer Foundation. The EU Horizon 2020 Research and Innovation Programme funding source had no role in study design, data collection, data analysis, data interpretation or writing of the report. Additional funding for BCAC is provided via the Confluence project which is funded with intramural funds from the National Cancer Institute Intramural Research Program, National Institutes of Health. Genotyping of the OncoArray was funded by the NIH Grant U19 CA148065, and Cancer Research UK Grant C1287/A16563 and the PERSPECTIVE project supported by the Government of Canada through Genome Canada and the Canadian Institutes of Health Research (grant GPH-129344) and, the Ministere de l'Economie, Science et Innovation du Quebec through Genome Quebec and the PSRSIIRI-701 grant, and the Quebec Breast Cancer Foundation. Funding for iCOGS came from: the European Community's Seventh Framework Programme under grant agreement no 223175 (HEALTH-F2- 2009-223175) (COGS), Cancer Research UK (C1287/A10118, C1287/A10710, C12292/A11174, C1281/A12014, C5047/A8384, C5047/A15007, C5047/A10692, C8197/A16565), the National Institutes of Health (CA128978) and Post-Cancer GWAS initiative (1U19 CA148537, 1U19 CA148065 and 1U19 CA148112 - the GAME-ON initiative), the Department of Defence (W81XWH-10-1-0341), the Canadian Institutes of Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer, and Komen Foundation for the Cure, the Breast Cancer Research Foundation, and the Ovarian Cancer Research Fund. The BRIDGES panel sequencing was supported by the European Union Horizon 2020 research and innovation program BRIDGES (grant number, 634935) and the Wellcome Trust (v203477/Z/16/Z). The Australian Breast Cancer Family Study (ABCFS) was supported by grant UM1 CA164920 from the National Cancer Institute (USA) Publisher Copyright: ©
PY - 2022/9/6
Y1 - 2022/9/6
N2 - Objectives Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics. Methods We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105-377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (n snps =5) or sedentary time (n snps =6), or accelerometer-measured (n snps =1) or self-reported (n snps =5) vigorous physical activity. Results Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;∼8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (∼7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger). Conclusion Our study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women.
AB - Objectives Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics. Methods We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105-377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (n snps =5) or sedentary time (n snps =6), or accelerometer-measured (n snps =1) or self-reported (n snps =5) vigorous physical activity. Results Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;∼8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (∼7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger). Conclusion Our study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women.
KW - Breast
KW - Genetics
KW - Physical activity
KW - Sedentary Behaviour
UR - http://www.scopus.com/inward/record.url?scp=85137660444&partnerID=8YFLogxK
U2 - 10.1136/bjsports-2021-105132
DO - 10.1136/bjsports-2021-105132
M3 - Article
C2 - 36328784
AN - SCOPUS:85137660444
VL - 56
SP - 1157
EP - 1170
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
SN - 0306-3674
IS - 20
ER -