Zhong Charlie, Franklin Meredith, Wiemels Joseph, McKean-Cowdin Roberta, Chung Nadia T, Benbow Jennifer, Wang Sophia S, Lacey James V, Longcore Travis
Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, United States; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Cancer Epidemiol. 2020 Dec;69:101811. doi: 10.1016/j.canep.2020.101811. Epub 2020 Sep 28.
Outdoor artificial light at night (ALAN) has been implicated in a growing number of adverse health outcomes. ALAN is believed to disrupt circadian rhythms and has been associated with increased inflammation, one of the hallmarks of cancer. We examined the association between outdoor ALAN and a cancer strongly associated with autoimmune and inflammatory conditions, non-Hodgkin lymphoma (NHL), in the prospective California Teachers Study cohort.
Outdoor ALAN was assigned to participant addresses at study baseline (1995-96) through use of the New World Atlas of Artificial Night Sky Brightness. Among 105,937 women followed from 1995 to 2015, linkage to the California Cancer Registry identified 873 incident cases of NHL. Age-stratified Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % confidence intervals (95 %CI) for overall NHL and the most common NHL subtypes; diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Multivariate analyses adjusted for previously reported subtype specific covariates (e.g. body mass index (BMI) for DLBCL).
Compared to the lowest quintile, participants residing in the highest quintile of outdoor ALAN at baseline were more likely to develop NHL (HR = 1.32, 95 %CI = 1.07-1.63), and, in particular, DLBCL (HR = 1.87, 95 %CI = 1.16-3.02). The elevated risk for DLBCL remained statistically significant after adjusting for age, race/ethnicity, BMI, and socioeconomic status (DLBCL:HR = 1.87, 95 %CI = 1.16-3.02, NHL:HR = 1.32, 95 %CI = 1.07-1.63). There was no association between ALAN and FL or CLL/SLL.
DLBCL risk was elevated among women residing in neighborhoods with greater outdoor ALAN. Future research in circadian disruption and DLBCL may clarify potential biological processes implicated in this association.
夜间户外人造光（ALAN）与越来越多的不良健康后果有关。人们认为ALAN会扰乱昼夜节律，并与炎症增加有关，而炎症是癌症的标志之一。我们在加利福尼亚教师前瞻性队列研究中，研究了户外ALAN与一种与自身免疫和炎症性疾病密切相关的癌症——非霍奇金淋巴瘤（NHL）之间的关联。
在研究基线（1995 - 1996年），通过使用《新世界人造夜空亮度地图集》将户外ALAN分配到参与者的住址。在1995年至2015年随访的105937名女性中，与加利福尼亚癌症登记处的数据关联后确定了873例NHL新发病例。采用年龄分层的Cox比例风险模型计算总体NHL以及最常见的NHL亚型（弥漫性大B细胞淋巴瘤（DLBCL）、滤泡性淋巴瘤（FL）和慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL））的风险比（HR）和95%置信区间（95%CI）。多变量分析对先前报道的亚型特异性协变量进行了调整（例如DLBCL的体重指数（BMI））。
与最低五分位数相比，基线时居住在户外ALAN最高五分位数的参与者患NHL的可能性更高（HR = 1.32，95%CI = 1.07 - 1.63），尤其是DLBCL（HR = 1.87，95%CI = 1.16 - 3.02）。在调整年龄、种族/族裔、BMI和社会经济地位后，DLBCL升高的风险仍具有统计学意义（DLBCL：HR = 1.87，95%CI = 1.16 - 3.02；NHL：HR = 1.32，95%CI = 1.07 - 1.63）。ALAN与FL或CLL/SLL之间没有关联。
居住在户外ALAN较强社区的女性患DLBCL的风险升高。未来关于昼夜节律紊乱与DLBCL的研究可能会阐明这种关联中潜在的生物学过程。
