Night work and breast cancer – results from the German GENICA study
Open accessAbstract
OBJECTIVES: Some epidemiological and animal data indicate that night work might increase the risk for breast cancer. We have investigated the risk in a German population-based case-control study known as GENICA (gene environment interaction and breast cancer). METHODS: The GENICA study involved interviews to assess shift work information in 857 breast cancer cases and 892 controls. We estimated risks of employment status and night shift characteristics using conditional logistic regression models, adjusting for potential confounders. Resampling and bootstrapping were applied to adjust the risk estimates for a potential selection bias. RESULTS: Among 1749 women, 56 cases and 57 controls worked in night shifts for > or =1 year, usually in the healthcare sector (63.0% of controls). Female night workers were more frequently nulliparous and low-educated than day workers (28.6% versus 17.8% and 12.3% versus 9.2%, respectively). Fewer women in night work had ever used post-menopausal hormone therapy (35.7% versus 51.9%). An elevated breast cancer risk was not associated with having ever done shift or night work when compared to women employed in day work only [odds ratio (OR) 0.96, 95% confidence interval (95% CI) 0.67-1.38 and OR 0.91, 95% CI 0.55-1.49, respectively). Women who reported >807 night shifts, the third quartile of the distribution among controls, experienced a breast cancer risk of 1.73 (95% CI 0.71-4.22). Night work for > or =20 years was associated with an OR of 2.48 (95% CI 0.62-9.99) based on 12 cases and 5 controls. CONCLUSIONS: Long-term night work was associated with a modestly, but not significantly, increased breast cancer risk, while having ever done night work was not. The precision of the results was limited by a low prevalence of night work in this study population.
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Further evidence for the association between shift work and breast cancer point toward exposure to light at night as causal factor.
“Further evidence for the association between shift work and breast cancer 101, 102, 103, 104, 105 point toward exposure to light at night as causal factor, but see 106.”
From The inner clock-Blue light sets the human rhythm (2019) · cites this paper as [101]
The Abstract and Discussion describe light at night as a possible pathway linking night work to breast cancer, and report a modest, statistically non-significant increase in risk with long-term night work. The study did not establish exposure to light at night as the causal factor; the Discussion says further research is needed to establish the mechanism. (LLM, conf=0.85)
Experimental — accuracy not yet measuredA number of studies found no association between cancer and shift work.
“However, a number of studies have found no association between cancer and shift work [64,65,66,67].”
From Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being (2017) · cites this paper as [64]
Observational studies consistently suggest positive associations of night shift work with cardiovascular disease and cancer risk.
“Observational studies consistently suggest positive associations of night shift work and cardiovascular disease (CVD)2 and cancer risk.3-18”
From Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts (2015) · cites this paper as [10]
The current study provides further support for a link between night shift work, especially of longer durations, and increased IHD events.
“Together with previous evidence,8,10 the current study provides further support for a link between night shift work, especially of longer durations, and increased IHD events.”
From Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts (2015) · cites this paper as [10]
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Night Shift Work and Risk of Breast Cancer in Women
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- Authors
- Pesch, B., Harth, V., Rabstein, S., Baisch, C., Schiffermann, M., Pallapies, D., Bonberg, N., Heinze, E., Spickenheuer, A., Justenhoven, C., Brauch, H., Hamann, U., Ko, Y., Straif, K., & Brüning, T.
- Affiliations
- Institute for Prevention and Occupational Medicine (DE)
- Ruhr University Bochum (DE)
- Johanniter-Krankenhaus Bonn (DE)
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology (DE)
- German Cancer Research Center (DE)
- ORCID
- Venue
- Scandinavian Journal of Work, Environment & Health
- Published
- 2009-12-29
- Volume
- 36
- Issue
- 2
- Pages
- 134-141
- ISSN
- 0355-3140 (ISSN-L)
- 1795-990X
- OpenAlex
- W2016787405
- Cited by
- 132
- References
- 35
- Citations by year
- 2024: 3 · 2023: 4 · 2022: 2 · 2021: 6 · 2020: 7 · 2019: 4 · 2018: 7 · 2017: 8 · 2016: 5 · 2015: 12 · 2014: 12 · 2013: 22 · 2012: 18
- FWCI
- 16.93
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Scandinavian Journal of Work Environment & Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Deutsches Krebsforschungszentrum (01KW9976/8, 01KW9977/0, 01KW0114, 01KW9975/5)
- Robert Bosch Stiftung (01KW9976/8, 01KW0114, 01KW9977/0, 01KW9975/5)
- Bundesministerium für Bildung und Forschung (01KW9977/0, 01KW9975/5, 01KW9976/8, 01KW0114)
- Deutsche Gesetzliche Unfallversicherung
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- night work, shift work, breast cancer risk, healthcare workers, nulliparity, educational attainment, hormone replacement therapy, selection bias
- MeSH terms
- Adult, Aged, Aged, 80 and over, Breast Neoplasms, Female, Germany, Humans, Interviews as Topic, Middle Aged, Regression Analysis, Risk Factors, Work Schedule Tolerance, Odds Ratio, Risk Assessment, Young Adult
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