Lifetime Physical Activity and Breast Cancer: a Case-Control Study in Kelantan, Malaysia

  • Yen, Siew Hwa (School of Distance Education, Universiti Sains Malaysia) ;
  • Knight, A (Advanced Medical and Dental Institute, Universiti Sains Malaysia) ;
  • Krishna, MBV (Department of Oncology, Hospital Universiti Sains Malaysia) ;
  • Muda, WMW (School of Health Sciences, Universiti Sains Malaysia, Health Campus) ;
  • Rufai, AA (School of Health Sciences, Universiti Sains Malaysia, Health Campus)
  • Published : 2016.08.01


Background: Physical inactivity has been identified as the fourth leading risk factor for global mortality and is associated with increased breast cancer diagnosis and recurrence. Purpose: To examine the association between adult lifetime physical activity and breast cancer risk in a case-control analysis. Materials and Methods: This study involved 122 cases of breast cancer and 121 controls in the state of Kelantan in Malaysia. A comprehensive measure of lifetime physical activity was used to assess occupational, household, and recreational/sports activity. For every type of activity, a metabolic equivalent (MET) score was assigned using the compendium of physical activities. MET-hours/week per year for all types of activities at different levels of intensities for different age groups were calculated. Logistic regression analysis was used to estimate odds ratios between various measures of physical activity and breast cancer risk. Conclusions: The mean MET-hours/week per year for all activities were 120.0 and 132.9 of MET-hours/week per year for cases and controls respectively. Household activities accounted for about 70% of the total lifetime physical activities. Only about 2.5% of the total lifetime physical activities were in the form of recreational/sports. This study found no association between lifetime occupational and recreational/sports physical activities with breast cancer risk among Kelantanese women. However, higher intensity lifetime household activities seemed to significantly reduce risk of breast cancer.


Supported by : Universiti Sains Malaysia


  1. Abdullah NA, Wan Mahiyuddin WR, Muhammad NA, et al (2013). Survival rate of breast cancer patients in Malaysia: a population-based study. Asian Pac J Cancer Prev, 14, 4591-4.
  2. Ainsworth BE, Haskell WL, Whitt MC, et al (2000). Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc, 32, 498-504.
  3. American Cancer Society (2015). Breast Cancer Facts & Figures 2015. Published by American Cancer Society, Atlanta, Georgia. editorial/documents/document/acspc-044552.pdf
  4. Brinton LA, Sherman ME, Carreon JD, et al (2008). Recent trends in breast cancer among younger women in the United States. J Natl Cancer Inst, 100, 1643-8.
  5. Brown WJ, Bauman AE, Owen N (2009). Stand up, sit down,keep moving: turning circles in physical activity research? Br J Sports Med, 43, 86-8.
  6. Chu KC, Anderson WF (2002). Rates for breast cancer characteristics by estrogen and progesterone receptor status in the major racial/ethnic groups. Breast Cancer Res Treat, 74, 199-211.
  7. Colditz G, Rosner B (2000). Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses' Health Study. Am J Epidemiol, 152, 950-64.
  8. Dallal CM, Sullivan-Halley J, Ross RK, et al (2007) Long-term recreational physical activity and risk of invasive and in situ breast cancer: the California teachers study. Arch Intern Med, 167, 408-15.
  9. Dorn J, Vena J, Brasure J, et al (2003). Lifetime physical activity and breast cancer risk in pre- and postmenopausal women. Med Sci Sports Exerc, 35, 278-85.
  10. Fair AM, Montgomery K (2009). Energy Balance, Physical Activity and Cancer Risk. Methods Mol Biol, 472, 57-88.
  11. Friedenreich CM (2011). Physical activity and breast cancer. review of the epidemiologic evidence and biologic mechanisms. Clin Cancer Prev, 186, 13-42.
  12. Friedenriech CM, Cust AE (2008). Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroups effects. Br J Sports Med, 42, 636-47.
  13. Friedenreich CM, Bryant HE, Courneya KS (2001). Case-control study of lifetime physical activity and breast cancer risk. Am J Epidemiol, 154, 336-47.
  14. Friedenreich CM, Coumeya KS, Bryant HE (1998). The lifetime total physical activity questionnaire: development and reliability. Med Sci Sports Exerc, 30, 266-74.
  15. Key TJ, Verkasalo PK, Banks E (2001). Epidemiology of breast cancer. Lancet Oncol, 2, 133-40.
  16. Jatoi I, Anderson WF, Rosenberg PS (2008). Qualitative ageinteractions in breast cancer: a tale of two diseases? Am J Clin Oncol, 31, 504-6.
  17. Lahmann PH, Friedenreich CM, Schuit AJ, et al (2007). Physical activity and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiol Biomarkers Prev, 16, 36-42.
  18. Lynch BM, Courneya KS, Friedenriech CM (2013). A casecontrol study of lifetime occupational sitting and likelihood of breast cancer. Cancer Causes Control, 24, 1257-62.
  19. McCullough LE, Eng SM, Bradshaw PT, et al (2012). Fat or fit: The joint effects of physical activity, weight gain, and body size on breast cancer risk. Cancer, 118, 4860-8.
  20. Monninkhof EM, Elias SG, Vlems FA, et al (2007). Physical activity and breast cancer: a systematic review. Epidemiol, 18, 137-57.
  21. Nasui B, Ciuciuc N (2013). Epidemiological study on breast cancer risk and physical activity level among Transylvanian females. Palestrica of the Third Millennium Civilizat Sport, 14, 96-9.
  22. Ng S, Popkin B (2012). Time use and physical activity: a shift away from movement across the globe. Obes Rev, 13, 659-80.
  23. Pronk A, Ji BT, Shu XO, et al (2011). Physical activity and breast cancer risk in Chinese women. Bri J Cancer, 105, 1443-50.
  24. Rosenberg L, Zhang Y, Coogan PF, et al (2009). A case-control study of oral contraceptive use and incident breast cancer. Am J Epidemiol, 169, 473-9.
  25. Slattery ML, Edwards S, Murtaugh MA, et al (2007). Physical activity and breast cancer risk among women in the southwestern United States. Epidemiol, 17, 342-53.