This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (80)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Exercise  • Women's Health, Other  • Oncology  • Breast Cancer  • Alert me on articles by topic

The Women's Health Initiative Cohort Study

Anne McTiernan, MD, PhD; Charles Kooperberg, PhD; Emily White, PhD; Sara Wilcox, PhD; Ralph Coates, PhD; Lucile L. Adams-Campbell, PhD; Nancy Woods, PhD; Judith Ockene, PhD

JAMA. 2003;290:1331-1336.

Context  Women who are physically active have a decreased risk for breast cancer, but the types, amounts, and timing of activity needed are unknown.

Objective  To prospectively examine the association between current and past recreational physical activity and incidence of breast cancer in postmenopausal women.

Design, Setting, and Patients  Prospective cohort study in 74 171 women aged 50 to 79 years who were recruited by 40 US clinical centers from 1993 through 1998.

Main Outcome Measure  Incident invasive and in situ breast cancer.

Results  We documented 1780 newly diagnosed cases of breast cancer over a mean follow-up of 4.7 years. Compared with less active women, women who engaged in regular strenuous physical activity at age 35 years had a 14% decreased risk of breast cancer (relative risk [RR], 0.86; 95% confidence interval [CI], 0.78-0.95). Similar but attenuated findings were observed for strenuous physical activity at ages 18 years and 50 years. An increasing total current physical activity score was associated with a reduced risk for breast cancer (P = .03 for trend). Women who engaged in the equivalent of 1.25 to 2.5 hours per week of brisk walking had an 18% decreased risk of breast cancer (RR, 0.82; 95% CI, 0.68-0.97) compared with inactive women. Slightly greater reduction in risk was observed for women who engaged in the equivalent of 10 hours or more per week of brisk walking. The effect of exercise was most pronounced in women in the lowest tertile of body mass index (BMI) (<24.1), but also was observed for women in the middle tertile of BMI (24.1-28.4).

Conclusions  These data suggest that increased physical activity is associated with reduced risk for breast cancer in postmenopausal women, longer duration provides most benefit, and that such activity need not be strenuous.

Author Affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Wash (Drs McTiernan, Kooperberg, and White); Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia (Dr Wilcox); Division of Cancer Prevention and Control, NCCDPHP, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Coates); Howard University Cancer Center, Washington, DC (Dr Adams-Campbell); School of Nursing, University of Washington, Seattle (Dr Woods); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester (Dr Ockene).

RELATED ARTICLES

Effect of Exercise Duration and Intensity on Weight Loss in Overweight, Sedentary Women: A Randomized Trial
John M. Jakicic, Bess H. Marcus, Kara I. Gallagher, Melissa Napolitano, and Wei Lang
JAMA. 2003;290(10):1323-1330.
ABSTRACT | FULL TEXT  

Physical Activity in Women: How Much Is Good Enough?
I-Min Lee
JAMA. 2003;290(10):1377-1379.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Impact of a Mixed Strength and Endurance Exercise Intervention on Insulin Levels in Breast Cancer Survivors
Ligibel et al.
JCO 2008;26:907-912.
ABSTRACT | FULL TEXT  

Increased risk of breast cancer among survivors of allogeneic hematopoietic cell transplantation: a report from the FHCRC and the EBMT-Late Effect Working Party
Friedman et al.
Blood 2008;111:939-944.
ABSTRACT | FULL TEXT  

Recreational Physical Activity and Mammographic Breast Density Characteristics
Reeves et al.
Cancer Epidemiol. Biomarkers Prev. 2007;16:934-942.
ABSTRACT | FULL TEXT  

Long-term Recreational Physical Activity and Risk of Invasive and In Situ Breast Cancer: The California Teachers Study
Dallal et al.
Arch Intern Med 2007;167:408-415.
ABSTRACT | FULL TEXT  

Physical Activity and Breast Cancer Risk: The European Prospective Investigation into Cancer and Nutrition
Lahmann et al.
Cancer Epidemiol. Biomarkers Prev. 2007;16:36-42.
ABSTRACT | FULL TEXT  

Recreational Physical Activity and Risk of Postmenopausal Breast Cancer Based on Hormone Receptor Status
Bardia et al.
Arch Intern Med 2006;166:2478-2483.
ABSTRACT | FULL TEXT  

Alleviating the Burden of Cancer: A Perspective on Advances, Challenges, and Future Directions.
Schottenfeld and Beebe-Dimmer
Cancer Epidemiol. Biomarkers Prev. 2006;15:2049-2055.
ABSTRACT | FULL TEXT  

Group Cohesion and Social Support in Exercise Classes: Results From a Danish Intervention Study
Christensen et al.
Health Educ Behav 2006;33:677-689.
ABSTRACT  

Association of physical activity with hormone receptor status: the shanghai breast cancer study.
Adams et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:1170-1178.
ABSTRACT | FULL TEXT  

Effect of Physical Activity on Women at Increased Risk of Breast Cancer: Results from the E3N Cohort Study
Tehard et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:57-64.
ABSTRACT | FULL TEXT  

World-wide rises in obesity: minimal hopes of control
Walker and Wadee
The Journal of the Royal Society for the Promotion of Health 2006;126:16-17.
 

Lifetime Recreational Exercise Activity and Breast Cancer Risk Among Black Women and White Women
Bernstein et al.
JNCI J Natl Cancer Inst 2005;97:1671-1679.
ABSTRACT | FULL TEXT  

Estrogen-Plus-Progestin Use and Mammographic Density in Postmenopausal Women: Women's Health Initiative Randomized Trial
McTiernan et al.
JNCI J Natl Cancer Inst 2005;97:1366-1376.
ABSTRACT | FULL TEXT  

Second World Congress on the Insulin Resistance Syndrome: Mediators, pediatric insulin resistance, the polycystic ovary syndrome, and malignancy
Bloomgarden
Diabetes Care 2005;28:1821-1830.
FULL TEXT  

Energy Balance and Breast Cancer Risk
Malin et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:1496-1501.
ABSTRACT | FULL TEXT  

Obesity and Early-Stage Breast Cancer
Chlebowski
JCO 2005;23:1345-1347.
FULL TEXT  

Hormone Therapy: Making Decisions in the Face of Uncertainty
Peterson et al.
Arch Intern Med 2004;164:2308-2312.
FULL TEXT  

Insulin, Physical Activity, and Caloric Intake in Postmenopausal Women: Breast Cancer Implications
Chlebowski et al.
JCO 2004;22:4507-4513.
ABSTRACT | FULL TEXT  

Effect of Exercise on Serum Androgens in Postmenopausal Women: A 12-Month Randomized Clinical Trial
McTiernan et al.
Cancer Epidemiol. Biomarkers Prev. 2004;13:1099-1105.
ABSTRACT | FULL TEXT  

Effects of a Moderate Intensity Exercise Intervention on Estrogen Metabolism in Postmenopausal Women
Atkinson et al.
Cancer Epidemiol. Biomarkers Prev. 2004;13:868-874.
ABSTRACT | FULL TEXT  

Effect of Exercise on Serum Estrogens in Postmenopausal Women: A 12-Month Randomized Clinical Trial
McTiernan et al.
Cancer Res. 2004;64:2923-2928.
ABSTRACT | FULL TEXT  

Definitions of the Insulin Resistance Syndrome: The 1st World Congress on the Insulin Resistance Syndrome
Bloomgarden
Diabetes Care 2004;27:824-830.
FULL TEXT  

Exercise and Risk of Breast Cancer
Burke
JAMA 2003;290:3193-3193.
FULL TEXT  

Brisk Walking Reduces Breast Cancer Risk in Postmenopausal Women
JWatch Women's Health 2003;2003:2-2.
FULL TEXT  

Exercise can cut risk of breast cancer
Gottlieb
BMJ 2003;327:640.
FULL TEXT  

Physical Activity in Women: How Much Is Good Enough?
Lee
JAMA 2003;290:1377-1379.
FULL TEXT