Sedentary behavior and risk of breast cancer: a dose–response meta-analysis from prospective studies

Background Emerging studies examined the association between sedentary behavior and risk of breast cancer, however, the dose–response relationship remained unclear. We aim to explore dose–response relationship of sedentary behavior and breast cancer risk based on relevant cohort studies. Methods Online database (PubMed, Web of Science, EMBASE and Cochrane Library) were searched up to March 29, 2019. Overall relative risk (RR) with 95% confidence interval (CI) were pooled, and generalized least squares (GLS) method and restricted cubic splines were applied to evaluate the linear or nonlinear relation. Attributable risk proportion (ARP) was used to assess the health hazards of sedentary behavior in different countries. Results Eight prospective studies were included in the meta-analysis, containing 17 048 breast cancer cases and 426 506 participants. The borderline statistical association was detected between prolonged sedentary behavior and risk of breast cancer (RR 1.08, 95% CI 0.99–1.19). Linear association between sedentary and breast cancer was observed ( P nonlinearity = 0.262), and for 1 h/d increment of sedentary behavior, there was 1% increase of breast cancer risk (RR 1.01, 95% CI1.00–1.02). Similar results were also found between TV viewing and risk of breast cancer ( P nonlinearity = 0.551), with 1 h/day increment of TV viewing daily attributing to 2% increase of breast cancer risk (RR 1.02, 95% CI 1.00–1.04). Moreover, sedentary behavior may statistically increase the risk of breast cancer by 21.6% for Asian countries, 8.26% for North America. Conclusions Sedentary behavior was validated as a risk factor of breast cancer through dose–response analysis, especially TV viewing.