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长期夜班工作者的乳腺钼靶高密度影:西班牙DDM研究/可变DDM研究

High Mammographic Density in Long-Term Night-Shift Workers: DDM-Spain/Var-DDM.

作者信息

Pedraza-Flechas Ana María, Lope Virginia, Sánchez-Contador Carmen, Santamariña Carmen, Pedraz-Pingarrón Carmen, Moreo Pilar, Ederra María, Miranda-García Josefa, Vidal Carmen, Llobet Rafael, Aragonés Nuria, Salas-Trejo Dolores, Pollán Marina, Pérez-Gómez Beatriz

机构信息

Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.

PhD student. Complutense University, Madrid, Spain.

出版信息

Cancer Epidemiol Biomarkers Prev. 2017 Jun;26(6):905-913. doi: 10.1158/1055-9965.EPI-16-0507. Epub 2017 Mar 23.

Abstract

Night-shift work (NSW) has been suggested as a possible cause of breast cancer, and its association with mammographic density (MD), one of the strongest risk factors for breast cancer, has been scarcely addressed. This study examined NSW and MD in Spanish women. The study covered 2,752 women aged 45-68 years recruited in 2007-2008 in 7 population-based public breast cancer screening centers, which included 243 women who had performed NSW for at least one year. Occupational data and information on potential confounders were collected by personal interview. Two trained radiologist estimated the percentage of MD assisted by a validated semiautomatic computer tool (DM-scan). Multivariable mixed linear regression models with random screening center-specific intercepts were fitted using log-transformed percentage of MD as the dependent variable and adjusting by known confounding variables. Having ever worked in NSW was not associated with MD [Formula: see text]:0.96; 95% confidence interval (CI), 0.86-1.06]. However, the adjusted geometric mean of the percentage of MD in women with NSW for more than 15 years was 25% higher than that of those without NSW history (MD:20.7% vs. MD:16.5%;[Formula: see text]:1.25; 95% CI,1.01-1.54). This association was mainly observed in postmenopausal participants ([Formula: see text]:1.28; 95% CI, 1.00-1.64). Among NSW-exposed women, those with ≤2 night-shifts per week had higher MD than those with 5 to 7 nightshifts per week ([Formula: see text]:1.42; 95% CI, 1.10-1.84). Performing NSW was associated with higher MD only in women with more than 15 years of cumulated exposure. These findings warrant replication in futures studies. Our findings suggest that MD could play a role in the pathway between long-term NSW and breast cancer. .

摘要

夜班工作(NSW)被认为可能是乳腺癌的一个病因,而其与乳腺X线密度(MD)(乳腺癌最强的风险因素之一)之间的关联几乎未得到探讨。本研究对西班牙女性的夜班工作情况和乳腺X线密度进行了调查。该研究涵盖了2007年至2008年期间在7个基于人群的公共乳腺癌筛查中心招募的2752名年龄在45至68岁之间的女性,其中包括243名从事过至少一年夜班工作的女性。通过个人访谈收集职业数据和潜在混杂因素的信息。两名经过培训的放射科医生使用经过验证的半自动计算机工具(DM - scan)辅助估计乳腺X线密度的百分比。以对数转换后的乳腺X线密度百分比为因变量,并通过已知的混杂变量进行调整,拟合了具有随机筛查中心特定截距的多变量混合线性回归模型。曾经从事过夜班工作与乳腺X线密度无关[公式:见正文]:0.96;95%置信区间(CI),0.86 - 1.06]。然而,从事超过15年夜班工作的女性,其乳腺X线密度百分比的调整几何平均值比没有夜班工作史的女性高25%(乳腺X线密度:20.7%对乳腺X线密度:16.5%;[公式:见正文]:1.25;95% CI,1.01 - 1.54)。这种关联主要在绝经后参与者中观察到([公式:见正文]:1.28;95% CI,1.00 - 1.64)。在从事过夜班工作的女性中,每周值夜班≤2次的女性比每周值夜班5至7次的女性具有更高的乳腺X线密度([公式:见正文]:1.42;95% CI,1.10 - 1.84)。仅在累积暴露超过15年的女性中,从事夜班工作与更高的乳腺X线密度相关。这些发现有待在未来研究中重复验证。我们的研究结果表明,乳腺X线密度可能在长期夜班工作与乳腺癌之间的关联途径中起作用。

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