Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
Am J Prev Med. 2014 Mar;46(3 Suppl 1):S34-41. doi: 10.1016/j.amepre.2013.10.032.
The International Agency for Research on Cancer determination that shift work is a "probable" human carcinogen was based primarily on studies of breast cancer but it was also noted that additional aspects of circadian disruption and other cancer sites deserved further research.
To examine possible associations of three measures of circadian disruption: nontypical work schedules, nightly sleep duration, and monthly frequency of insomnia with risk of fatal ovarian cancer in a sample of American women.
Several measures of circadian disruption and other information were assessed in 1982 from 161,004 employed women in the American Cancer Society's Cancer Prevention Study-II, a cohort that has been followed for mortality through 2010. In 2013, Cox proportional hazards regression was used to model the relative risks (RRs) and 95% CIs of death from ovarian cancer for categories of each indicator of circadian disruption.
Over 28 years of follow-up, 1289 deaths from ovarian cancer occurred in the at-risk cohort. Compared to fixed daytime work, a rotating schedule was associated with an elevated risk of fatal ovarian cancer (RR=1.27, 95% CI=1.03, 1.56). No significant associations were observed for sleep duration (p trend=0.24) or insomnia (p trend=0.44).
In this large prospective study, there was a higher risk of fatal ovarian cancer in women who reported a rotating work schedule. These findings and the high prevalence of rotating shift schedules underscore the need for further research examining the role of work schedule and risk of ovarian cancer.
国际癌症研究机构（IARC）将轮班工作确定为“可能”的人类致癌物，主要依据的是乳腺癌研究，但也指出昼夜节律紊乱的其他方面和其他癌症部位值得进一步研究。
在美国女性样本中，研究三种昼夜节律紊乱指标（非典型工作时间表、夜间睡眠时间和每月失眠频率）与致命性卵巢癌风险之间的可能关联。
1982 年，美国癌症协会癌症预防研究 II 中的 161004 名在职女性评估了几种昼夜节律紊乱指标和其他信息，该队列一直随访至 2010 年的死亡率。2013 年，使用 Cox 比例风险回归模型对每个昼夜节律紊乱指标类别的卵巢癌死亡相对风险（RR）和 95%置信区间（CI）进行建模。
在 28 年的随访期间，高危队列中有 1289 例卵巢癌死亡。与固定日间工作相比，轮班工作与致命性卵巢癌风险升高相关（RR=1.27，95%CI=1.03，1.56）。睡眠时间（p 趋势=0.24）或失眠（p 趋势=0.44）与风险无显著关联。
在这项大型前瞻性研究中，报告轮班工作的女性致命性卵巢癌风险较高。这些发现以及轮班工作时间表的高流行率突显了进一步研究工作时间表和卵巢癌风险的必要性。
