Healthy Lifestyle Index and Breast Cancer Risk among Postmenopausal Women: The Multiethnic Cohort Study.

IF 3.4 3区医学 Q2 ONCOLOGY Cancer Epidemiology Biomarkers & Prevention Pub Date : 2025-06-03 DOI:10.1158/1055-9965.EPI-24-1181

Bethany T Ogbenna, Xin He, Anna H Wu, Loïc Le Marchand, Lynne R Wilkens, James Butler, Typhanye Dyer, Iona Cheng, Cher M Dallal

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Abstract

Background: Consistent evidence supports a reduction in breast cancer risk with a high healthy lifestyle index (HLI) score; however, this relationship has not been well studied in multiethnic populations.

Methods: Within the multiethnic cohort study, we followed 65,561 African American, Japanese American, Latina, Native Hawaiian, and White postmenopausal women for incident invasive breast cancer (n = 4,555, mean 19.2 years). The HLI summed seven components with higher scores assigned to healthier behaviors: diet quality, physical activity, sedentary behavior, smoking status, alcohol consumption, body mass index, and sleep duration. Multivariable Cox proportional hazards models estimated adjusted HRs (aHR) and 95% confidence intervals (CI) for associations between the HLI score [continuous and tertiles (T)] and breast cancer risk overall, stratified by race and ethnicity and hormone receptor status. Multiplicative interaction by race and ethnicity (P-int) and heterogeneity of effect by hormone receptor status (P-het) were assessed by the Wald test.

Results: Higher HLI scores were associated with reduced postmenopausal breast cancer risk [aHRcont: 0.95 (95% CI, 0.94-0.97), P < 0.0001; aHRT2vsT1: 0.92 (95% CI, 0.85-0.99), aHRT3vsT1: 0.81 (95% CI, 0.75-0.87), P-trend < 0.01] with similar risk reductions observed across racial and ethnic groups (P-trend ≤ 0.05; P-int = 0.96). Similar findings were observed with hormone receptor-positive breast cancer (overall: P-trend < 0.01; P-int = 0.90); no significant associations were observed with hormone receptor-negative breast cancer (P-trend > 0.05; P-int = 0.64; P-het = 0.79).

Conclusions: Higher HLI scores are associated with breast cancer risk reductions overall by race and ethnicity and hormone receptor status.

Impact: Engaging in healthy lifestyle behaviors may reduce breast cancer risk among a multiethnic population of postmenopausal women. See related In the Spotlight, p. 833.

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绝经后妇女健康生活方式指数与乳腺癌风险：多民族队列研究

背景：一致的证据支持高健康生活方式指数（HLI）评分可以降低乳腺癌风险；然而，这种关系尚未在多民族人群中得到很好的研究。方法：在多种族队列研究中，我们随访了65,561名非裔美国人、日裔美国人、拉丁裔、夏威夷原住民和白人绝经后妇女的侵袭性乳腺癌事件（n=4,555，平均19.2岁）。HLI总结了七个得分较高的健康行为组成部分：饮食质量、身体活动、久坐行为、吸烟状况、饮酒、体重指数和睡眠时间。多变量Cox比例风险模型估计了HLI评分（连续，分位数(T)）与总体乳腺癌风险之间的校正风险比（aHR）和95%置信区间（CI），并按种族、民族和激素受体状态分层。种族和民族的乘法相互作用（P-int）和激素受体状态（p - et）影响的异质性通过Wald检验评估。结果：高HLI评分与绝经后乳腺癌风险降低相关(aHRcont:0.95 [95% CI:0.94-0.97], P0.05；P-int = 0.64;P-het = 0.79)。结论：HLI分数越高，总体上乳腺癌风险越低，与种族、民族和激素受体状态有关。影响：参与健康的生活方式行为可以降低多种族绝经后妇女患乳腺癌的风险。

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来源期刊

Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

2.60%

发文量

538

审稿时长

1.6 months

期刊介绍： Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.