Schernhammer Eva S, Kroenke Candyce H, Laden Francine, Hankinson Susan E
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Epidemiology. 2006 Jan;17(1):108-11. doi: 10.1097/01.ede.0000190539.03500.c1.
Melatonin shows potential oncostatic activity and is acutely suppressed by light exposure. Some evidence suggests an association between night work and breast cancer risk, possibly through the melatonin pathway.
In a cohort of premenopausal nurses, we prospectively studied the relation between rotating night shift work and breast cancer risk. Total number of months during which the nurses worked rotating night shifts was first assessed at baseline in 1989 and periodically updated thereafter. We used Cox proportional hazards models to calculate relative risks (RRs) and 95% confidence intervals (CIs).
Among 115,022 women without cancer at baseline, 1,352 developed invasive breast cancer during 12 years of follow up. Women who reported more than 20 years of rotating night shift work experienced an elevated relative risk of breast cancer compared with women who did not report any rotating night shift work (multivariate RR = 1.79; 95% CI = 1.06-3.01). There was no increase in risk associated with fewer years of rotating night work.
Our results suggest a modestly elevated risk of breast cancer after longer periods of rotating night work. Additional studies are warranted to rule out small sample size or uncontrolled sources for confounding as alternative explanations.
褪黑素具有潜在的抑癌活性,且会因光照而急性抑制。一些证据表明夜班工作与乳腺癌风险之间存在关联,可能是通过褪黑素途径。
在一组绝经前护士中,我们前瞻性地研究了轮班夜班工作与乳腺癌风险之间的关系。护士轮班夜班工作的总月数在1989年基线时首次评估,此后定期更新。我们使用Cox比例风险模型来计算相对风险(RRs)和95%置信区间(CIs)。
在基线时无癌症的115,022名女性中,1,352名在12年随访期间患浸润性乳腺癌。与未报告任何轮班夜班工作的女性相比,报告轮班夜班工作超过20年的女性患乳腺癌的相对风险升高(多变量RR = 1.79;95% CI = 1.06 - 3.01)。轮班夜班工作年限较少与风险增加无关。
我们的结果表明,长期轮班夜班工作后患乳腺癌的风险略有升高。需要进行更多研究以排除小样本量或未控制的混杂因素来源作为替代解释。