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Postdiagnosis body fatness, recreational physical activity, dietary factors and breast cancer prognosis: Global Cancer Update Programme (CUP Global) summary of evidence grading

Title: Postdiagnosis body fatness, recreational physical activity, dietary factors and breast cancer prognosis: Global Cancer Update Programme (CUP Global) summary of evidence grading
Authors: Tsilidis, KK
Cariolou, M
Becerra-Tomas, N
Balducci, K
Vieira, R
Abar, L
Aune, D
Markozannes, G
Nanu, N
Greenwood, DC
Giovannucci, EL
Gunter, MJ
Jackson, AA
Kampman, E
Lund, V
Allen, K
Brockton, NT
Croker, H
Katsikioti, D
McGinley-Gieser, D
Mitrou, P
Wiseman, M
Cross, AJ
Riboli, E
Clinton, SK
McTiernan, A
Norat, T
Chan, DSM
Item Type: Journal Article
Abstract: Based on the Global Cancer Update Programme, formally known as the World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project, we performed systematic reviews and meta-analyses to investigate the association of postdiagnosis body fatness, physical activity and dietary factors with breast cancer prognosis. We searched PubMed and Embase for randomised controlled trials and longitudinal observational studies from inception to 31 October 2021. We calculated summary relative risks (RRs) and 95% confidence intervals (CIs) using random-effects meta-analyses. An independent Expert Panel graded the quality of evidence according to predefined criteria. The evidence on postdiagnosis body fatness and higher all-cause mortality (RR per 5 kg/m2 in body mass index: 1.07, 95% CI: 1.05-1.10), breast cancer-specific mortality (RR: 1.10, 95% CI: 1.06-1.14) and second primary breast cancer (RR: 1.14, 95% CI: 1.04-1.26) was graded as strong (likelihood of causality: probable). The evidence for body fatness and breast cancer recurrence and other nonbreast cancer-related mortality was graded as limited (likelihood of causality: limited-suggestive). The evidence on recreational physical activity and lower risk of all-cause (RR per 10 metabolic equivalent of task-hour/week: 0.85, 95% CI: 0.78-0.92) and breast cancer-specific mortality (RR: 0.86, 95% CI: 0.77-0.96) was judged as limited-suggestive. Data on dietary factors was limited, and no conclusions could be reached except for healthy dietary patterns, isoflavone and dietary fibre intake and serum 25(OH)D concentrations that were graded with limited-suggestive evidence for lower risk of the examined outcomes. Our results encourage the development of lifestyle recommendations for breast cancer patients to avoid obesity and be physically active.
Issue Date: 15-Feb-2023
Date of Acceptance: 23-Sep-2022
URI: http://hdl.handle.net/10044/1/100665
DOI: 10.1002/ijc.34320
ISSN: 0020-7136
Publisher: Wiley
Start Page: 635
End Page: 644
Journal / Book Title: International Journal of Cancer
Volume: 152
Issue: 4
Copyright Statement: © 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Publication Status: Published
Online Publication Date: 2022-10-24
Appears in Collections:Faculty of Medicine
School of Public Health

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