E Manouchehri1, A Taghipour2, V Ghavami3, A Ebadi4,5, F Homaei6, R Latifnejad Roudsari7,8. 1. Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. 2. Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. 3. Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. 4. Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran. 5. Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran. 6. Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. 7. Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. latifnejadr@mums.ac.ir. 8. Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. latifnejadr@mums.ac.ir.
Abstract
BACKGROUND: The International Agency for Research on Cancer (IARC) has classified shift work as a possible human carcinogen. The results of systematic on this topic is contradictory. This systematic review and meta-analysis, therefore, aimed to update the current evidence regarding the relationship between night-shift work duration and breast cancer risk. METHODS: PubMed, Web of Science, and Scopus as well as reference list of included studies were searched until December 19, 2020. Observational case-control or cohort studies investigating the relationship between the duration of night-shift work and breast cancer in women were included, which all quantified night-shift work exposure. All statistical analyses were done by Stata version 11.2. RESULTS: Our literature search was resulted in retrieval of 4854 publications from which 26 eligible studies with 1,313,348 participants were included in the meta-analyses. The pooled relative risk (RR) and 95% confidence intervals (CIs) of breast cancer for short-term night-shift workers (< 10 years) was 1.13 (95% CI 1.03-1.24, p = 0.008, I2 = 71.3%), and for long-term night-shift workers (≥ 10 years) was 1.08 (95% CI 0.99-1.17, p = 0.09, I2 = 42.2%), with moderate to substantial statistical heterogeneity observed in both analyses. The results of subgroup analysis showed that flight attendants with long overnight flights were at an elevated risk of breast cancer, but unmeasured confounders limited these results. The risk of breast cancer in case control studies, adjusted for reproductive factors and family history of breast cancer as well as studies with high quality was increased in both short term and long term night-shift workers. CONCLUSIONS: This systematic review found a positive statistical relationship between night work and breast cancer risk in short-term night-shift workers but no increase was observed in the long-term night-shift workers.
BACKGROUND: The International Agency for Research on Cancer (IARC) has classified shift work as a possible human carcinogen. The results of systematic on this topic is contradictory. This systematic review and meta-analysis, therefore, aimed to update the current evidence regarding the relationship between night-shift work duration and breast cancer risk. METHODS: PubMed, Web of Science, and Scopus as well as reference list of included studies were searched until December 19, 2020. Observational case-control or cohort studies investigating the relationship between the duration of night-shift work and breast cancer in women were included, which all quantified night-shift work exposure. All statistical analyses were done by Stata version 11.2. RESULTS: Our literature search was resulted in retrieval of 4854 publications from which 26 eligible studies with 1,313,348 participants were included in the meta-analyses. The pooled relative risk (RR) and 95% confidence intervals (CIs) of breast cancer for short-term night-shift workers (< 10 years) was 1.13 (95% CI 1.03-1.24, p = 0.008, I2 = 71.3%), and for long-term night-shift workers (≥ 10 years) was 1.08 (95% CI 0.99-1.17, p = 0.09, I2 = 42.2%), with moderate to substantial statistical heterogeneity observed in both analyses. The results of subgroup analysis showed that flight attendants with long overnight flights were at an elevated risk of breast cancer, but unmeasured confounders limited these results. The risk of breast cancer in case control studies, adjusted for reproductive factors and family history of breast cancer as well as studies with high quality was increased in both short term and long term night-shift workers. CONCLUSIONS: This systematic review found a positive statistical relationship between night work and breast cancer risk in short-term night-shift workers but no increase was observed in the long-term night-shift workers.
Entities:
Keywords:
Breast cancer; Meta-analysis; Night-shift work; Shift-work; Systematic review
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