Unit:
Postgraduate Programme Biostatistics & Health Science DataLibrary of the School of Health Sciences
Supervisors info:
Μπενέτου Βασιλική, Αν. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Μπάμια Χριστίνα, Αν. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Σαμόλη Ευαγγελία, Επ. Καθηγήτρια, ΕΚΠΑ
Original Title:
Dietary patterns and physical activity in breast cancer survivors: a systematic review and meta-analysis
Translated title:
Dietary patterns and physical activity in breast cancer survivors: a systematic review and meta-analysis
Summary:
Objective There is evidence that physical activity and diet may contribute to a better survival among women with a history of breast cancer. Nevertheless, findings are still inconclusive. We have conducted a systematic review and meta-analysis in order to clarify the association of physical activity and dietary patterns after diagnosis of breast cancer with overall mortality, breast cancer mortality and/or recurrence.
Methods We searched PubMed database up to November 2017 for observational studies investigating physical activity and dietary patterns independently with total and breast cancer mortality and/or remission/recurrence in adult women. Pooled Hazard Ratios (HRs) alongside the 95% Confidence Interval (CIs) were estimated by the use of a random-effects model. Subgroup analysis by Estrogens Status (ER) was also performed. Assessment quality was carried out through the Newcastle-Ottawa scale. Analyses were performed using STATA 13.1.
Results Ten studies related to physical activity were included in the meta-analysis. During an average follow-up period ranging from 3.5 years to 12.7 years there were 23041 participants, 1955 deaths from all causes, 739 deaths from breast cancer and 1398 recurrences/remissions. The average Newcastle-Ottawa score was 6.8 stars. Compared to women who reported low recreational physical activity (lowest quintile/quartile), women with high physical activity levels (highest quintile/quartile) had a significantly lower risk of all-cause mortality (HR= 0.55, 95% CI 0.45-0.68, HR stratified by ES = 0.51, 95% CI 0.36-0.72), death from breast cancer (HR=0.62, 95% CI 0.42-0.93) and an indicative lower risk of recurrence (HR=0.81, 95% CI 0.56-1.16). However, there was evidence of heterogeneity across studies (Τ² = 0.0438; Ι² = 52.4%). No meta-analysis could be performed for dietary patterns due to the differences observed among the patterns. Nevertheless, post-diagnosis dietary patterns characterized as “healthy” (i.e. prudent) were associated with a decreased risk of death from all causes or causes other than breast cancer.
Conclusion Post-diagnosis recreational physical activity was associated with lower overall and breast cancer mortality among breast cancer survivors. It seems that physical activity is beneficial for breast cancer survivors. More studies (such as Randomized Controlled Trials) are needed to investigate the role of post-diagnosis dietary patterns and physical activity, respectively, on all-cause mortality and breast cancer outcomes.
Main subject category:
Health Sciences
Keywords:
Meta-analysis, Systematic review, Physical activity, Dietary patterns, Breast cancer
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Spei Maria-Eleni Master.pdf
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