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Beverly Rockhill, PhD; Walter C. Willett, MD, DrPH; David J. Hunter, MD, ScD; JoAnn E. Manson, MD, DrPH; Susan E. Hankinson, ScD; Graham A. Colditz, MD, DrPH

Arch Intern Med. 1999;159:2290-2296.

Background  Increased physical activity has been hypothesized to prevent breast cancer, largely by reducing cumulative lifetime exposure to circulating ovarian hormones. However, epidemiologic findings are inconsistent, and there is no consensus on the best way to quantify physical activity. We thus examined this issue in a large cohort of women, using several different measures of adult physical activity.

Methods  We analyzed data from the Nurses' Health Study, a prospective study of women aged 30 to 55 years in 1976. In 1980 and on subsequent surveys, women were asked about the average number of hours per week spent in various moderate and vigorous recreational physical activity during the past year. We computed a "baseline-only" (1980) measure of hours per week of physical activity, as well as a cumulative average measure that used updated reports on physical activity. During 16 years of follow-up, we identified 3137 cases of invasive breast cancer (1036 premenopausal and 2101 postmenopausal women). Data were analyzed by use of multivariate pooled logistic regression to produce relative risks of breast cancer, and the associated confidence intervals.

Results  Women who were more physically active in adulthood had a lower risk of breast cancer than those who were less physically active. Comparing those who reported engaging in moderate or vigorous physical activity for 7 or more hours per week with those who engaged in such physical activity for less than 1 hour per week, the relative risk was 0.82 (95% confidence interval, 0.70-0.97), using the cumulative average updating. The dose-response trend was statistically significant (P=.004). Using the baseline-only measure of physical activity produced slightly weaker relative risks.

Conclusion  These results contribute to the body of evidence suggesting that higher levels of adult physical activity afford modest protection against breast cancer.

From the Channing Laboratory (Drs Rockhill, Willett, Hunter, Manson, Hankinson, and Colditz) and the Division of Preventive Medicine (Dr Manson), Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, and the Departments of Epidemiology (Drs Willett, Hunter, Manson, Hankinson, and Colditz) and Nutrition (Dr Willett), Harvard School of Public Health, Boston, Mass.

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