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- A., Johnsson, et al.
(författare)
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Physical inactivity increases the risk of endometrial cancer and premenopausal breast cancer
- 2015
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Ingår i: Cancer Research. - 0008-5472. ; 75:15 Suppl
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Konferensbidrag (refereegranskat)abstract
- Background. Epidemiological studies indicate that physical activity reduces the risk of cancer. Physical inactivity or sedentary behavior, has recently been suggested as a risk factor independent of physical activity level. Breast and endometrial cancer incidence have both been associated with physical activity, and endometrial cancer incidence with physical inactivity/sedentary behavior. The purpose of the present study was to investigate physical inactivity as a risk factor for breast cancer, divided into pre- and postmenopausal subtypes, and for endometrial cancer, and to explore possible dose-response relations regarding the level of physical inactivity. Methods. In a population-based prospective cohort study, 29 520 women in the southern part of Sweden, in ages between 25 and 64 years, participated. A questionnaire-based survey was performed 1990-92. Their reported professions were classified as sedentary or not which together with reported participation in competitive sports constituted the basis for classification into three activity-levels; (1) physical inactivity, defined as having sedentary occupation and no participation in competitive sports, (2) partly inactive, defined as either having a sedentary occupation or non- participation in competitive sports, (3) Physical active, defined as not having a sedentary occupation and participation in competitive sports. The association between physical inactivity and pre and postmenopausal breast and endometrial cancer incidence were analyzed by Cox regression, adjusted for hormonal factors, family history of cancer, body mass index (BMI) and age. Results. Physical inactive women had a significantly increased risk of endometrial cancer (HR = 2.41, 95% CI 1.14-5.11) and premenopausal breast cancer (HR = 2.40, 95% CI 1.14-5.02), compared with women who were less physical inactive. No such association was found for postmenopausal breast cancer. Analysis of linear trend showed a significant dose-response relationship with increased risk of both premenopausal breast cancer (ptrend 0.02) and endometrial cancer (ptrend
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| 2. |
- H., Olsson, et al.
(författare)
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Tamoxifen treated patients have a better survival than patients treated with aromatase inhibitors - A population based registry study in Sweden
- 2015
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Ingår i: Cancer Research. - 0008-5472. ; 75:9 Suppl
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Konferensbidrag (refereegranskat)abstract
- Background. Randomised trials suggest that therapy with aromatase inhibitors improves survival in breast cancer compared with tamoxifen therapy in postmenopausal cases with hormone receptor positive breast cancer. Whether these results from randomized studies transform into the general population is unknown. We have therefore compared survival for all breast cancer cases in Sweden diagnosed 2000-2008 (n=54406) who received adjuvant antihormonal therapy. Material and methods. The study includes all women with BC diagnosed in Sweden between 2000 through 2008 (n=54406). The women had no previous cancer diagnosis during the period of 1958-1999. Dates of birth, BC diagnosis and TNM-stage where directly extracted from the cancer registry. The women's antihormonal therapy was gathered from the Swedish Prescription Registry (22213 women were on antihormonal therapy). Information regarding the cause of death and date of death was obtained from the Cause of Death Registry and tbe Swedish Population Register up until the 31st of December 2012 and 31st of December 2013 respectively. The breast cancer death and overall death have been calculated and the survival was compared between tamoxifen and aromatase inhibitor treated breast cancer patients. Analyses were adjusted for TNM-stage and age at diagnosis and restricted to women aged 50 and above. Results. Patients being treated with tamoxifen had a better breast cancer prognosis compared with aromatase inhibitor treated patients (HR 0.54, 95%CI 0.48-0.61). Restricting the analysis to stage 1 disease confirmed a better prognosis for tamoxifen treated women (HR 0.48, 95%CI 0.34-0.66). A better prognosis could be seen in all age strata studies, 50-60.61-70.71-90. The findings for overall survival gave similar results. Conclusion .This population based observational study show that women treated with aromatase inhibitors have a worse overall and breast cancer specific survival compared with tamoxifen treated women regardless of age and tumor stage.
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| 3. |
- H., Olsson, et al.
(författare)
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Worse breast cancer prognosis in insulin treated diabetic patients - A population based registry study in Sweden
- 2015
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Ingår i: Cancer Research. - 0008-5472. ; 75:9 Suppl
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Konferensbidrag (refereegranskat)abstract
- Background. Diabetes may be linked to incidence of different tumor diseases and prognosis through various mechanisms such as the disease itself, hyperglycemia, obesity and anti-diabetes therapy. Material and methods. The study includes all women with BC diagnosed in Sweden between 2000 through 2008 (n=54406). The women had no previous cancer diagnosis during the period of 1958-1999. Dates of birth, BC diagnosis and TNM-stage where directly extracted from the cancer registry. The women's anti-diabetes therapy was gathered from the Swedish Prescribed Drug Registry. Information regarding the cause of death and date of death was obtained from the Cause of Death Registry and tbe Swedish Population Register up until the 31st of December 2012 and 31st of December 2013 respectively. Analyses have been restricted to patients receiving insulin therapy (n=2463) and their breast cancer prognosis has been calculated in comparison with breast cancer patients without diabetes. All analyses were adjusted for TNM-stage and age at diagnosis. Results. Patients with insulin treated diabetes had a worse prognosis compared with other women with breast cancer (HR 1.7, 95%CI 1.5-2.0). The worse prognosis could be seen both for patients with ER+ and ER- tumors. The worst prognosis was seen for patients treated with NPH insulins (HR 2.8, 95% CI 2.4-3.3) while patients treated with long-acting insulin analogs had an intermediate prognosis (HR 1.6, 95% CI 1.2-2.2). Those women treated with NPH insulins and metformin had a slightly worse prognosis (HR 1.4, 95% CI 1.0-1.8). The results for breast cancer specific survival and total survival were similar. Conclusion. Our results imply that insulin treated breast cancer patients have a worse survival compared with other women with breast cancer regardless of tumor stage. Metformin therapy may partially counteract the association.
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