Moon Jinyoung, Ikeda-Araki Atsuko, Mun Yongseok
Interdisciplinary Program in Bioinformatics, College of Natural Sciences, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea.
Department of Occupational and Environmental Medicine, Inha University Hospital, 27, Inhang-ro, Jung-gu, Incheon, 22332, South Korea.
BMC Public Health. 2024 Jul 31;24(1):2065. doi: 10.1186/s12889-024-19518-2.
The hypothesis of this study is night shift work exposure can increase the risk of female breast cancer. To validate this hypothesis, the authors conducted a two-stage dose-response meta-analysis with improved quality on this topic.
The medical librarian searched PubMed, EMBASE, and the Cochrane Library on December 30th, 2022. The eight inclusion criteria were determined and strictly applied to the selection process. A reliable dose-response meta-analysis methodology was applied.
Reliable 10 cohort (total cases: 15,953, and total person-years: 6,812,138) and 11 case-control reports (total cases: 9196, and total controls:12,210) were included in the final analysis. The pooled risk ratio (RR) of female breast cancer (from cohort studies) for 1, 10, 20, and 30 years of night shift work exposure was 1.0042 (95% CI 1.0014-1.0070), 1.0425 (95% CI 1.0138-1.0719), 1.0867 (95% CI 1.0278-1.1490), and 1.1328 (95% CI 1.0419-1.2317), respectively. The pooled odds ratio (OR) of female breast cancer (from case-control studies) for 1, 10, 20, and 30 years of night shift work exposure was 1.0213 (95% CI 1.0108-1.0319), 1.2346 (95% CI 1.1129-1.3695), 1.5242 (95% CI 1.2386-1.8756), and 1.8817 (95% CI 1.3784-2.5687), respectively.
This study has several strengths from the perspective of a dose-response meta-analysis: Strictly applied eight inclusion criteria, separately synthesized RRs from cohort studies and ORs from case-control studies, clearly defined exposure dose, years of night shift work for each risk estimate, a reliable dose-response meta-analysis methodology, and careful considering of selection, exposure, and outcome biases and confounder adjustment for each study. This careful consideration of potential biases and confounding led to the exclusion of unreliable two cohort and five case-control studies.
本研究的假设是夜班工作暴露会增加女性患乳腺癌的风险。为验证这一假设，作者针对该主题进行了一项质量有所提升的两阶段剂量反应荟萃分析。
医学图书馆员于2022年12月30日检索了PubMed、EMBASE和Cochrane图书馆。确定了八项纳入标准并严格应用于筛选过程。应用了可靠的剂量反应荟萃分析方法。
最终分析纳入了可靠的10项队列研究（总病例数：15953例，总人年数：6812138人年）和11项病例对照研究（总病例数：9196例，总对照数：12210例）。夜班工作暴露1年、10年、20年和30年的女性乳腺癌（来自队列研究）合并风险比（RR）分别为1.0042（95%CI 1.0014 - 1.0070）、1.0425（95%CI 1.0138 - 1.0719）、1.0867（95%CI 1.0278 - 1.1490）和1.1328（95%CI 1.0419 - 1.2317）。夜班工作暴露1年、10年、20年和30年的女性乳腺癌（来自病例对照研究）合并比值比（OR）分别为1.0213（95%CI 1.0108 - 1.0319）、1.2346（95%CI 1.1129 - 1.3695）、1.5242（95%CI 1.2386 - 1.8756）和1.8817（95%CI 1.3784 - 2.5687）。
从剂量反应荟萃分析的角度来看，本研究有几个优点：严格应用八项纳入标准，分别汇总队列研究的RR和病例对照研究的OR，明确界定暴露剂量，每项风险估计对应的夜班工作年限，可靠的剂量反应荟萃分析方法，以及仔细考虑每项研究的选择、暴露和结果偏倚及混杂因素调整。对潜在偏倚和混杂因素的这种仔细考虑导致排除了不可靠的两项队列研究和五项病例对照研究。
