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Physical activity, sedentary time and breast cancer risk: a Mendelian randomisation study

Physical activity, sedentary time and breast cancer risk: a Mendelian randomisation study
Physical activity, sedentary time and breast cancer risk: a Mendelian randomisation study

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.

Breast, Genetics, Physical activity, Sedentary Behaviour
0306-3674
1157-1170
Dixon-Suen, Suzanne C.
d3336826-4358-463e-bd10-618350707873
Lewis, Sarah J
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Martin, Richard M.
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English, Dallas
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Boyle, Terry
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Giles, Graham
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Eccles, Diana
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Tapper, William
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Milne, Roger
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Lynch, Brigid
b97c14b9-0e9e-4e21-86e7-2ec891e58cf4
et al.
ABCTB Investigators
Dixon-Suen, Suzanne C.
d3336826-4358-463e-bd10-618350707873
Lewis, Sarah J
ffd0c4a5-d8a0-46d8-a2b6-b5f611abee59
Martin, Richard M.
ce5c4184-4432-4435-bd1e-221f665d42d8
English, Dallas
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Boyle, Terry
f5627ba5-c85e-47bd-b6f2-d2d5bf49f9a4
Giles, Graham
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Eccles, Diana
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Tapper, William
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Milne, Roger
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Lynch, Brigid
b97c14b9-0e9e-4e21-86e7-2ec891e58cf4

Dixon-Suen, Suzanne C., Lewis, Sarah J, Martin, Richard M., English, Dallas, Boyle, Terry, Giles, Graham, Milne, Roger and Lynch, Brigid , et al. and ABCTB Investigators (2022) Physical activity, sedentary time and breast cancer risk: a Mendelian randomisation study. British Journal of Sports Medicine, 56 (20), 1157-1170, [597]. (doi:10.1136/bjsports-2021-105132).

Record type: Article

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.

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More information

Accepted/In Press date: 29 June 2022
e-pub ahead of print date: 6 September 2022
Published date: 29 September 2022
Additional Information: 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: ©
Keywords: Breast, Genetics, Physical activity, Sedentary Behaviour

Identifiers

Local EPrints ID: 468336
URI: http://eprints.soton.ac.uk/id/eprint/468336
ISSN: 0306-3674
PURE UUID: d6238532-461a-4929-bb68-34b9d3756681
ORCID for Diana Eccles: ORCID iD orcid.org/0000-0002-9935-3169
ORCID for William Tapper: ORCID iD orcid.org/0000-0002-5896-1889

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Date deposited: 10 Aug 2022 18:12
Last modified: 17 Mar 2024 02:49

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Contributors

Author: Suzanne C. Dixon-Suen
Author: Sarah J Lewis
Author: Richard M. Martin
Author: Dallas English
Author: Terry Boyle
Author: Graham Giles
Author: Diana Eccles ORCID iD
Author: William Tapper ORCID iD
Author: Roger Milne
Author: Brigid Lynch
Corporate Author: et al.
Corporate Author: ABCTB Investigators

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