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Mangini C, Zarantonello L, Formentin C, Giusti G, Domenie ED, Ruggerini D, Costa R, Skene DJ, Basso D, Battagliarin L, Di Bella A, Angeli P, Montagnese S. Managing Circadian Disruption due to Hospitalization: A Pilot Randomized Controlled Trial of the CircadianCare Inpatient Management System. J Biol Rhythms 2024; 39:183-199. [PMID: 38153134 DOI: 10.1177/07487304231213916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
The objective of the present study was to test the effects of an inpatient management system (CircadianCare) aimed at limiting the negative impact of hospitalization on sleep by enhancing circadian rhythmicity. Fifty inpatients were randomized to either CircadianCare (n = 25; 18 males, 62.4 ± 1.9 years) or standard of care (n = 25; 14 males, 64.5 ± 2.3 years). On admission, all underwent a full sleep-wake evaluation; they then completed daily sleep diaries and wore an actigraph for the whole length of hospitalization. On days 1 (T0), 7 (T1), and 14 (T2, if still hospitalized), salivary melatonin for dim light melatonin onset (DLMO) and 24-h skin temperature were recorded. In addition, environmental noise, temperature, and illuminance were monitored. Patients in the CircadianCare arm followed 1 of 3 schedules for light/dark, meal, and physical activity timings, based on their diurnal preference/habits. They wore short-wavelength-enriched light-emitting glasses for 45 min after awakening and short-wavelength light filter shades from 18:00 h until sleep onset. While the first, primary registered outcome (reduced sleep-onset latency on actigraphy or diary) was not met, based on sleep diaries, there was a trend (0.05 < p < 0.1) toward an advance in bedtime for CircadianCare compared to standard of care patients between T0 and T1. Similarly, DLMO time significantly advanced in the small group of patients for whom it could be computed on both occasions, with untreated ones starting from earlier baseline values. Patients sleeping near the window had significantly higher sleep efficiency, regardless of treatment arm. As noise fluctuation increased, so did the number of night awakenings, regardless of treatment arm. In conclusion, the CircadianCare management system showed positive results in terms of advancing sleep timing and the circadian rhythm of melatonin. Furthermore, our study identified a combination of environmental noise and lighting indices, which could be easily modulated to prevent hospitalization-related insomnia.
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Affiliation(s)
- Chiara Mangini
- Department of Medicine, University of Padova, Padova, Italy
| | | | | | - Gianluca Giusti
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | | | | | - Rodolfo Costa
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- Institute of Neuroscience, National Research Council, Padova, Italy
| | - Debra J Skene
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Daniela Basso
- Department of Medicine, University of Padova, Padova, Italy
| | - Lisa Battagliarin
- Department of Industrial Engineering, University of Padova, Padova, Italy
- Iuav University of Venice, Venice, Italy
| | - Antonino Di Bella
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Paolo Angeli
- Department of Medicine, University of Padova, Padova, Italy
| | - Sara Montagnese
- Department of Medicine, University of Padova, Padova, Italy
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Frias-Gomez J, Alemany L, Benavente Y, Clarke MA, de Francisco J, De Vivo I, Du M, Goodman MT, Lacey J, Liao LM, Lipworth L, Lu L, Merritt MA, Michels KA, O'Connell K, Paytubi S, Pelegrina B, Peremiquel-Trillas P, Petruzella S, Ponce J, Risch H, Setiawan VW, Schouten LJ, Shu XO, Trabert B, Van den Brandt PA, Wentzensen N, Wilkens LR, Yu H, Costas L. Night shift work, sleep duration and endometrial cancer risk: A pooled analysis from the Epidemiology of Endometrial Cancer Consortium (E2C2). Sleep Med Rev 2023; 72:101848. [PMID: 37716022 PMCID: PMC10840870 DOI: 10.1016/j.smrv.2023.101848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023]
Abstract
Data on the role of circadian related factors in the etiology of endometrial cancer are scarce. We collected individual data on night shift work or daily sleep duration from 7,207 cases and 22,027 controls participating in 11 studies from the Epidemiology of Endometrial Cancer Consortium (E2C2). Main analyses were performed among postmenopausal women: 6,335 endometrial cancer cases and 18,453 controls. Using individual data, study-specific odd ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated with logistic regression and pooled analyses were conducted using random-effects meta-analyses. A non-significant inverse association was observed between endometrial cancer and night shift work (OR=0.89, 95%CI=0.72-1.09; I2=0.0%, Pheterogeneity=0.676). Associations did not vary by shift type (permanent or rotating), or duration of night work. Categorizations of short (<7h) or long (≥9h) sleep duration were not associated with endometrial cancer risk (ORshort=1.02, 95%CI=0.95-1.10; I2=55.3%, Pheterogeneity=0.022; ORlong=0.93, 95%CI=0.81-1.06; I2=11.5%, Pheterogeneity=0.339). No associations were observed per 1-h increment of sleep (OR=0.98, 95%CI=0.95-1.01; I2=46.1%, Pheterogeneity=0.063), but an inverse association was identified among obese women (OR=0.93, 95%CI=0.89-0.98 per 1-h increment; I2=12.7%, Pheterogeneity=0.329). Overall, these pooled analyses provide evidence that night shift work and sleep duration are not strong risk factors for endometrial cancer in postmenopausal women.
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Affiliation(s)
- Jon Frias-Gomez
- Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain; University of Barcelona (UB), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Megan A Clarke
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Rockville, MD, USA
| | - Javier de Francisco
- Department of Anesthesiology. Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Barcelona, Spain
| | - Immaculata De Vivo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Mengmeng Du
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marc T Goodman
- Cedars-Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James Lacey
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute of the City of Hope National Medical Center, Duarte, CA, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Loren Lipworth
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lingeng Lu
- Chronic Disease Epidemiology Department, Yale School of Public Health, Yale University, New Haven, CT 06510, USA
| | - Melissa A Merritt
- The Daffodil Centre, The University of Sydney, Joint Venture with Cancer Council NSW, Sydney, NSW, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kara A Michels
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kelli O'Connell
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sonia Paytubi
- Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Pelegrina
- Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain; University of Barcelona (UB), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Stacey Petruzella
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jordi Ponce
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Barcelona, Spain
| | - Harvey Risch
- Chronic Disease Epidemiology Department, Yale School of Public Health, Yale University, New Haven, CT 06510, USA
| | - Veronica Wendy Setiawan
- Department of Preventive Medicine and Norris Comprehensive Cancer Center, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Leo J Schouten
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, the Netherlands
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Britton Trabert
- Department of Obstetrics and Gynecology, University of Utah, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | - Piet A Van den Brandt
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, the Netherlands
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Rockville, MD, USA
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Herbert Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Laura Costas
- Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Barber LE, VoPham T, White LF, Roy HK, Palmer JR, Bertrand KA. Circadian Disruption and Colorectal Cancer Incidence in Black Women. Cancer Epidemiol Biomarkers Prev 2023; 32:927-935. [PMID: 36409509 PMCID: PMC10199956 DOI: 10.1158/1055-9965.epi-22-0808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/11/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Animal and experimental studies suggest circadian disruption increases colorectal cancer risk, but evidence in humans is limited. We examined night shift work, chronotype, and residential position within a time zone, proxies for circadian disruption, in relation to colorectal cancer risk. METHODS Participants in the Black Women's Health Study, a prospective cohort of 59,000 Black American women established in 1995, reported history of night shift work and chronotype on follow-up questionnaires. Residential position within a time zone was estimated using participant addresses at each questionnaire cycle. Number of colorectal cancer cases and follow-up duration varied by analysis depending on timing of exposure assessment, ranging from 204 over the 2005 to 2018 night shift work study period to 452 over the 1995 to 2018 residential position study period. Cox proportional hazards regression was used to estimate multivariable-adjusted HRs and 95% confidence intervals (CI). RESULTS Compared with never having worked a night shift, working a night shift for ≥10 years was associated with increased colorectal cancer risk (HR = 1.64; 95% CI, 1.01-2.66). However, shorter duration was not. The HR for evening versus morning chronotype was 0.96 (95% CI, 0.73-1.27). Westward position of residence within a time zone was not associated with colorectal cancer risk (HR per 5-degree longitude increase: 0.92; 95% CI, 0.82-1.03). CONCLUSIONS Our findings suggest a possible increased risk of colorectal cancer associated with long duration night shift work; however, results require confirmation in larger studies. IMPACT Circadian disruption from long-term night shift work may contribute to colorectal cancer development in Black women.
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Affiliation(s)
- Lauren E. Barber
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
- Slone Epidemiology Center at Boston University, Boston, MA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Laura F. White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Hemant K. Roy
- Department of Medicine, Baylor College of Medicine, Houston, TX
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Miro C, Docimo A, Barrea L, Verde L, Cernea S, Sojat AS, Marina LV, Docimo G, Colao A, Dentice M, Muscogiuri G. "Time" for obesity-related cancer: The role of the circadian rhythm in cancer pathogenesis and treatment. Semin Cancer Biol 2023; 91:99-109. [PMID: 36893964 DOI: 10.1016/j.semcancer.2023.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023]
Abstract
The circadian rhythm is regulated by an intrinsic time-tracking system, composed both of a central and a peripheral clock, which influences the cycles of activities and sleep of an individual over 24 h. At the molecular level, the circadian rhythm begins when two basic helix-loop-helix/Per-ARNT-SIM (bHLH-PAS) proteins, BMAL-1 and CLOCK, interact with each other to produce BMAL-1/CLOCK heterodimers in the cytoplasm. The BMAL-1/CLOCK target genes encode for the repressor components of the clock, cryptochrome (Cry1 and Cry2) and the Period proteins (Per1, Per2 and Per3). It has been recently demonstrated that the disruption of circadian rhythm is associated with an increased risk of developing obesity and obesity-related diseases. In addition, it has been demonstrated that the disruption of the circadian rhythm plays a key role in tumorigenesis. Further, an association between the circadian rhythm disruptions and an increased incidence and progression of several types of cancer (e.g., breast, prostate, colorectal and thyroid cancer) has been found. As the perturbation of circadian rhythm has adverse metabolic consequences (e.g., obesity) and at the same time tumor promoter functions, this manuscript has the aim to report how the aberrant circadian rhythms affect the development and prognosis of different types of obesity-related cancers (breast, prostate, colon rectal and thyroid cancer) focusing on both human studies and on molecular aspects.
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Affiliation(s)
- Caterina Miro
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy
| | - Annamaria Docimo
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia ed Andrologia, Università Federico II, Naples, Italy
| | - Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, 80143 Naples, Italy
| | - Ludovica Verde
- Department of Public Health, University of Federico II, 80131 Naples, Italy
| | - Simona Cernea
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures/Internal Medicine I, Târgu Mureş, Romania; Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, Târgu Mureş, Romania
| | - Antoan Stefan Sojat
- National Centre for Infertility and Endocrinology of Gender, Clinic for Endocrinology Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Serbia
| | - Ljiljana V Marina
- National Centre for Infertility and Endocrinology of Gender, Clinic for Endocrinology Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Serbia
| | - Giovanni Docimo
- Department of Medical and Advanced Surgical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia ed Andrologia, Università Federico II, Naples, Italy; UNESCO Chair "Education for Health and Sustainable Development", University of Naples "Federico II", Naples, Italy
| | - Monica Dentice
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia ed Andrologia, Università Federico II, Naples, Italy; UNESCO Chair "Education for Health and Sustainable Development", University of Naples "Federico II", Naples, Italy.
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5
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Niedhammer I, Coutrot T, Geoffroy-Perez B, Chastang JF. Shift and Night Work and All-Cause and Cause-Specific Mortality: Prospective Results From the STRESSJEM Study. J Biol Rhythms 2022; 37:249-259. [PMID: 35502698 PMCID: PMC9149517 DOI: 10.1177/07487304221092103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The literature remains sparse and inconclusive about the impact of shift and
night work on mortality, and still more on specific causes of death. The
objectives were to explore the prospective associations between exposure to
shift and night work and all-cause and cause-specific mortality. The study was
based on a large national representative French prospective cohort of 1,511,456
employees followed up from 1976 to 2002. Exposure to shift and night work relied
on a job-exposure matrix, and 3 time-varying measures (current, cumulative, and
recency-weighted cumulative exposure) were constructed. Mortality and causes of
death were provided by the national registry, and all-cause, cardiovascular,
cancer and preventable mortality, and suicide were studied. Cox proportional
hazards models were performed to study the associations between shift and night
work and mortality. During follow-up, 22,105 deaths occurred for all-cause
mortality. In the study of mortality until the end of last job during follow-up,
shift and/or night work were associated with all-cause, cardiovascular, cancer
and preventable mortality, and suicide (except night without shift work with
cancer mortality and suicide) among men. Shift work (especially shift without
night work) was associated with all-cause, cancer and preventable mortality
among women. The results were similar for current, cumulative, and
recency-weighted cumulative exposure. Associations were found for more detailed
causes of death: cerebrovascular diseases for both genders, ischemic heart
diseases, respiratory cancers, smoking-related mortality, and external causes of
death among men, and breast cancer among women. In the study of mortality until
the end of follow-up, some additional associations were found among women
between night work and all-cause and preventable mortality, and suicide,
suggesting long-term or delayed exposure effects. The study may, however, be
underpowered to detect all the exposure-outcome associations, especially among
women. More research and prevention are needed to reduce mortality among shift
and night workers.
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Affiliation(s)
- Isabelle Niedhammer
- INSERM, Univ Angers, Univ Rennes, EHESP, Institut de Recherche en Santé, Environnement et Travail (IRSET) - UMR_S 1085, Epidemiology in Occupational Health and Ergonomics Team (ESTER), Angers, France
| | - Thomas Coutrot
- Direction de l'Animation de la Recherche, des Etudes et des Statistiques (DARES), Ministère du Travail, Paris, France
| | | | - Jean-François Chastang
- INSERM, Univ Angers, Univ Rennes, EHESP, Institut de Recherche en Santé, Environnement et Travail (IRSET) - UMR_S 1085, Epidemiology in Occupational Health and Ergonomics Team (ESTER), Angers, France
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6
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Clocking cancer: the circadian clock as a target in cancer therapy. Oncogene 2021; 40:3187-3200. [PMID: 33846572 PMCID: PMC8549632 DOI: 10.1038/s41388-021-01778-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 02/08/2023]
Abstract
Disruption of the cellular pathway modulating endogenous 24-h rhythms, referred to as "the circadian clock", has been recently proven to be associated with cancer risk, development, and progression. This pathway operates through a complex network of transcription-translation feedback loops generated by a set of interplaying proteins. The expression of core circadian clock genes is frequently dysregulated in human tumors; however, the specific effects and underlying mechanisms seem to vary depending on the cancer types and are not fully understood. In addition, specific oncogenes may differentially induce the dysregulation of the circadian clock in tumors. Pharmacological modulation of clock components has been shown to result in specific lethality in certain types of cancer cells, and thus holds great promise as a novel anti-cancer therapeutic approach. Here we present an overview of the rationale and current evidence for targeting the clock in cancer treatment.
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7
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Pariollaud M, Lamia KA. Cancer in the Fourth Dimension: What Is the Impact of Circadian Disruption? Cancer Discov 2020; 10:1455-1464. [PMID: 32934020 PMCID: PMC7541588 DOI: 10.1158/2159-8290.cd-20-0413] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/08/2020] [Accepted: 07/01/2020] [Indexed: 11/16/2022]
Abstract
Circadian rhythms integrate many physiological pathways, helping organisms to align the timing of various internal processes to daily cycles in the external environment. Disrupted circadian rhythmicity is a prominent feature of modern society, and has been designated as a probable carcinogen. Here, we review multiple studies, in humans and animal models, that suggest a causal effect between circadian disruption and increased risk of cancer. We also discuss the complexity of this connection, which may depend on the cellular context. SIGNIFICANCE: Accumulating evidence points to an adverse effect of circadian disruption on cancer incidence and progression, indicating that time of day could influence the effectiveness of interventions targeting cancer prevention and management.
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Affiliation(s)
- Marie Pariollaud
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, California
| | - Katja A Lamia
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, California.
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9
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Risk factors including night shift work of colorectal polyp. Ann Occup Environ Med 2020; 32:e26. [PMID: 32802342 PMCID: PMC7406667 DOI: 10.35371/aoem.2020.32.e26] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/26/2020] [Indexed: 12/15/2022] Open
Abstract
Background The destruction of circadian rhythms by night shift work affects major circadian genes, which are known to play a role in advancing or killing the cell cycle through tumor suppressor genes. To find out whether night shift work affects the incidence of colorectal cancer, which was found to be associated with long-term night shift work in previous studies, we surveyed effect of night shift work on colorectal polyps that have a higher incidence than colorectal cancer and can progress to colorectal cancer. Methods To examine the correlation between rotating night shifts and colorectal polyps, a survey was conducted with 299 men aged 40–60 years from two university hospitals. We examined lifestyle, work history, work patterns, and colonoscopy results. The differences in prevalence among the groups was compared, and prevalence ratio (PR) was calculated via generalized linear modeling. Results The prevalence of colorectal polyps in night shift and non-shift workers were 53.0% and 33.5%, respectively. After adjusting for age, smoking status, dietary habits, family history of colorectal cancer, obesity, job type, night shift work (PR: 1.13, 95% CI: 1.02–1.25) was a risk factor of colorectal polyps. Conclusions The risk of colorectal polyps was greater in night shift workers than non-shift workers. Also risk of colorectal polyp was higher in older group. Our study investigated colorectal polyp instead of colorectal cancer and lacks information about types and gene mutations of colorectal polyps. Further study is needed to clarify effect of night shift work on development of colorectal cancer.
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10
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Wichert K, Rabstein S, Stang A, Erbel R, Eisele L, Arendt M, Keimer A, Dragano N, Hoffmann W, Lerch MM, Roskoden FC, Schmidt CO, Völzke H, Jöckel KH, Brüning T, Behrens T. Associations between shift work and risk of colorectal cancer in two German cohort studies. Chronobiol Int 2020; 37:1235-1243. [PMID: 32654542 DOI: 10.1080/07420528.2020.1782930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The association between shift work and the risk of colorectal cancer (CRC) is still unclear. Therefore, we studied the associations between exposure to shift or night work and incident CRC in two German population-based cohort studies, the Heinz Nixdorf Recall Study (HNR) and the Study of Health in Pomerania (SHIP). Including up to 6,903 participants, we analyzed the cohorts pooled and individually. We estimated incidence rate ratios (IRRs) with adjusted log-linear Poisson regression models with the natural logarithm of person-years as offset and performed subgroup analyses by sex and tumor localization in HNR. The pooled analysis revealed no increased risks for men working in night shifts (IRR: 1.03, 95% CI: 0.62; 1.71). In male HNR participants, we found an increased risk estimate for cancer of the distal colon in shift workers (IRR: 1.60, 95% CI: 0.53; 4.87) and in shift workers who did not perform night work (IRR: 3.93, 95% CI: 0.98; 15.70), but not in night workers. In SHIP, we observed elevated CRC risk estimates for rotating shift work including night work (IRR: 1.45, 95% CI: 0.72; 2.92) and for long-term exposure (IRR: 1.79, 95% CI: 0.81; 3.92) for men. In conclusion, night-shift work was not associated with CRC, although an increased risk was suggested for rotating shift work including nights in SHIP. The heterogeneity of shift-work jobs and schedules and associated lifestyle factors should be taken into account to disentangle a possible relationship between shift work and the risk for CRC in future investigations.
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Affiliation(s)
- Katharina Wichert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University Bochum , Germany
| | - Sylvia Rabstein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University Bochum , Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen , Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen , Essen, Germany
| | - Lewin Eisele
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen , Essen, Germany
| | - Marina Arendt
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen , Essen, Germany.,Department of Computer Science, University of Applied Sciences and Arts Dortmund , Dortmund, Germany
| | - Andrea Keimer
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen , Essen, Germany
| | - Nico Dragano
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen , Essen, Germany.,Medical Faculty, Institute for Medical Sociology, University of Düsseldorf , Düsseldorf, Germany
| | - Wolfgang Hoffmann
- SHIP/KEF, Institute for Community Medicine, University Medicine Greifswald , Greifswald, Germany
| | - Markus M Lerch
- Department of Medicine A, University Medicine Greifswald , Greifswald, Germany
| | | | - Carsten Oliver Schmidt
- SHIP/KEF, Institute for Community Medicine, University Medicine Greifswald , Greifswald, Germany
| | - Henry Völzke
- SHIP/KEF, Institute for Community Medicine, University Medicine Greifswald , Greifswald, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen , Essen, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University Bochum , Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University Bochum , Germany
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11
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Dun A, Zhao X, Jin X, Wei T, Gao X, Wang Y, Hou H. Association Between Night-Shift Work and Cancer Risk: Updated Systematic Review and Meta-Analysis. Front Oncol 2020; 10:1006. [PMID: 32656086 PMCID: PMC7324664 DOI: 10.3389/fonc.2020.01006] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/21/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Nightshift work introduces light at night and causes circadian rhythm among night workers, who are considered to be at increased risk of cancer. However, in the last 2 years, nine population-based studies reported insignificant associations between night-shift work and cancer risks. We aimed to conduct an updated systematic review and meta-analysis to ascertain the effect of night-shift work on the incidence of cancers. Methods: Our protocol was registered in PROSPERO and complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Embase, PubMed, and Web of Science databases were used to comprehensively search studies published up to May 31, 2019. The random-effect model (Der Simonian-Laird method) was carried out to combine the risk estimates of night-shift work for cancers. The dose-response meta-analysis was performed to verify whether the association was in a dose-dependent manner. Results: Our literature searching retrieved 1,660 publications. Included in the meta-analyses were 57 eligible studies with 8,477,849 participants (mean age 55 years; 2,560,886 men, 4,220,154 women, and 1,696,809 not mentioned). The pooled results showed that night-shift work was not associated with the risk of breast cancer (OR = 1.009, 95% CI = 0.984-1.033), prostate cancer (OR = 1.027, 95% CI = 0.982-1.071), ovarian cancer (OR = 1.027, 95% CI = 0.942-1.113), pancreatic cancer (OR = 1.007, 95% CI = 0.910-1.104), colorectal cancer (OR = 1.016, 95% CI = 0.964-1.068), non-Hodgkin's lymph (OR = 1.046, 95% CI = 0.994-1.098), and stomach cancer (OR = 1.064, 95% CI = 0.971-1.157), while night-shift work was associated with a reduction of lung cancer (OR = 0.949, 95% CI = 0.903-0.996), and skin cancer (OR = 0.916, 95% CI = 0.879-0.953). The dose-response meta-analysis found that cancer risk was not significantly elevated with the increased light exposure of night- shift work. Conclusion: This systematic review of 57 observational studies did not find an overall association between ever-exposure to night-shift work and the risk of breast, prostate ovarian, pancreatic, colorectal, non-Hodgkin's lymph, and stomach cancers.
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Affiliation(s)
- Aishe Dun
- School of Basic Medical Science, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Xuan Zhao
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Xu Jin
- School of Basic Medical Science, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Tao Wei
- School of Basic Medical Science, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Xiang Gao
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
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12
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Formentin C, Carraro S, Turco M, Zarantonello L, Angeli P, Montagnese S. Effect of Morning Light Glasses and Night Short-Wavelength Filter Glasses on Sleep-Wake Rhythmicity in Medical Inpatients. Front Physiol 2020; 11:5. [PMID: 32047444 PMCID: PMC6997239 DOI: 10.3389/fphys.2020.00005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/08/2020] [Indexed: 11/24/2022] Open
Abstract
Sleep and circadian rhythm disorders are common amongst medical inpatients. They are caused by a mixture of factors, including noise, loss of habitual daily routines, and abnormal exposure to light, which tends to be insufficient in the day and too high at night. The aim of the present study was to test the efficacy of morning light therapy plus night short-wavelength filter glasses on sleep quality/timing, and sleepiness/mood over the daytime hours, in a group of well-characterized medical inpatients. Thirty-three inpatients were enrolled and randomized (2:1) to either treatment (n = 22; 13 males, 48.3 ± 13.3 years) or standard of care (n = 11; 8 males, 56.9 ± 12.9 years). On admission, all underwent a baseline assessment of sleep quality/timing and diurnal preference. During hospitalization they underwent monitoring of sleep quality/timing (sleep diaries and actigraphy), plus hourly assessment of sleepiness/mood during the daytime hours on one, standard day of hospitalization. Patients in the treatment arm were administered bright light through glasses immediately after awakening, and wore short-wavelength filter glasses in the evening hours. Treated and untreated patients were comparable in terms of demographics, disease severity/comorbidity, diurnal preference and pre-admission sleep quality/timing. During hospitalization, sleep diaries documented a trend for a lower number of night awakenings in treated compared to untreated patients (1.6 ± 0.8 vs. 2.4 ± 1.3, p = 0.057). Actigraphy documented significantly earlier day mode in treated compared to untreated patients (06:39 ± 00:35 vs. 07:44 ± 00:40, p = 0.008). Sleepiness during a standard day of hospitalization, recorded between 09:30 and 21:30, showed physiological variation in treated compared to untreated patients, who exhibited a more blunted profile. The level of sleepiness reported by treated patients was lower over the 09:30-14:30 interval, i.e., soon after light administration (interaction effect: F = 2.661; p = 0.026). Mood levels were generally higher in treated patients, with statistically significant differences over the 09:30-14:30 time interval, i.e., soon after light administration (treatment: F = 5.692, p = 0.026). In conclusion, treatment with morning bright light and short-wavelength filter glasses in the evening, which was well tolerated, showed positive results in terms of sleepiness/mood over the morning hours and a trend for decreased night awakenings.
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13
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Effects of exposure to night shift work on cancer risk in workers. Hippokratia 2019. [DOI: 10.1002/14651858.cd013466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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14
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Sauvé JF, Friesen MC. Using Decision Rules to Assess Occupational Exposure in Population-Based Studies. Curr Environ Health Rep 2019; 6:148-159. [PMID: 31297745 PMCID: PMC6698417 DOI: 10.1007/s40572-019-00240-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Population-based studies increasingly link task-based occupational questionnaire responses collected from subjects to exposure estimates via transparent, programmable decision rules. We reviewed recent applications and methodological developments of rule-based approaches. RECENT FINDINGS Agent-specific decision rules require interviews incorporating work-task-based questions. Some studies have developed rules before the interviews took place, while others developed rules after the interviews were completed. Agreement between rule-based estimates and exposures assigned using job-by-job expert review were generally moderate to good (Kappa = 0.4-0.8). Rules providing quantitative intensity levels using measurement data or that integrate multiple independent exposure sources for the same job represent further advances to improve the characterization of occupational exposures in population studies. Decision rules have provided transparent and reproducible assessments, reduce job-by-job review, and facilitate sensitivity analyses in epidemiologic studies. Future studies should consider the development of decision rules concurrent with the questionnaire design to facilitate occupational exposure assessment efforts.
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Affiliation(s)
- Jean-François Sauvé
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
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Abstract
PURPOSE OF REVIEW Many hospitals, particularly large academic centers, have begun to provide 24-h in-house intensive care attending coverage. Proposed advantages for this model include improved patient care, greater provider, nursing and patient satisfaction, better communication, and greater cost-effectiveness. This review will evaluate current evidence with respect to 24/7 coverage, including patient outcomes, cost-effectiveness, and impact on training/education. RECENT FINDINGS Evidence surrounding 24-h intensivist staffing has been mixed. Although a subset of studies suggest a possible benefit to 24-h intensivist coverage, recent prospective studies have shown no difference in major patient outcomes, including mortality and ICU length of stay between patients in ICUs with and those without 24-h intensivist coverage. SUMMARY Although some studies cite increased caregiver and patient satisfaction, outcome studies find no consistent effect on patient-centered outcomes such as mortality or length of stay. Downsides to in-house nighttime attending staffing include physician burnout, adverse effects on physician health, decreased trainee autonomy, and effects on trainee specialty choices because of undesirable lifestyle considerations. Tele-ICU and other novel approaches may allow for attending supervision without physical presence.
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16
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Sex Differences in the Association between Night Shift Work and the Risk of Cancers: A Meta-Analysis of 57 Articles. DISEASE MARKERS 2018; 2018:7925219. [PMID: 30598709 PMCID: PMC6287141 DOI: 10.1155/2018/7925219] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/25/2018] [Indexed: 01/20/2023]
Abstract
Objectives To identify the association between night shift work and the risk of various cancers with a comprehensive perspective and to explore sex differences in this association. Methods We searched PubMed, Embase, and Web of Science for studies on the effect of night shift work on cancer, including case-control, cohort, and nested case-control studies. We computed risk estimates with 95% confidence intervals (CIs) in a random or fixed effects model and quantified heterogeneity using the I 2 statistic. Subgroup, metaregression, and sensitivity analyses were performed to explore potential sources of heterogeneity. Contour-enhanced funnel plots and the trim and fill method were used together to analyze bias. Linear dose-response analysis was used to quantitatively estimate the accumulative effect of night shift work on the risk of cancer. Results Fifty-eight studies were eligible for our meta-analysis, including 5,143,838 participants. In the random effects model, the pooled odds ratio (OR) of cancers was 1.15 (95% CI = 1.08-1.22, P < 0.001; I 2 = 76.2%). Night shift work increased the cancer risk in both men (OR = 1.14, 95% CI = 1.05-1.25, P = 0.003) and women (OR = 1.12, 95% CI = 1.04-1.20, P = 0.002). Subgroup analyses showed that night shift work positively increased the risk of breast (OR = 1.22, 95% CI = 1.08-1.38), prostate (OR = 1.26, 95% CI = 1.05-1.52), and digestive system (OR = 1.15, 95% CI = 1.01-1.32) cancers. For every 5 years of night shift work, the cancer risk increased by 3.2% (OR = 1.032, 95% CI = 1.013-1.051). Conclusion This is the first meta-analysis identifying the positive association between night shift work and the risk of cancer and verifying that there is no sex difference in the effect of night shift work on cancer risk. Cancer risk increases with cumulative years of night shift work.
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Papantoniou K, Devore EE, Massa J, Strohmaier S, Vetter C, Yang L, Shi Y, Giovannucci E, Speizer F, Schernhammer ES. Rotating night shift work and colorectal cancer risk in the nurses' health studies. Int J Cancer 2018; 143:2709-2717. [PMID: 29978466 PMCID: PMC6235706 DOI: 10.1002/ijc.31655] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/21/2018] [Accepted: 06/01/2018] [Indexed: 12/19/2022]
Abstract
Animal and human data have suggested that shift work involving circadian disruption may be carcinogenic for humans, but epidemiological evidence for colorectal cancer remains limited. We investigated the association of rotating night shift work and colorectal cancer risk in two prospective female cohorts, the Nurses' Health Study (NHS) and NHS2, with 24 years of follow‐up. In total, 190,810 women (NHS = 77,439; NHS2 = 113,371) were included in this analysis, and 1,965 incident colorectal cancer cases (NHS = 1,527; NHS2 = 438) were reported during followup (NHS: 1988–2012, NHS2: 1989–2013). We used Cox proportional hazards models adjusted for a wide range of potential confounders. We did not observe an association between rotating night work duration and colorectal cancer risk in these cohorts (NHS: 1–14 years: Hazard Ratio (HR) 1.04, 95% CI: 0.94, 1.16; 15+ years: HR 1.15, 95% CI: 0.95, 1.39; Ptrend = 0.14 and NHS2: 1–14 years: HR 0.81, 95% CI: 0.66, 0.99; 15+ years: HR 0.96, 95% CI: 0.56, 1.64 and Ptrend = 0.88). In subsite analysis in NHS, rectal cancer risk increased after long‐term (15+ years) rotating night shift work (proximal colon cancer: HR 1.00, 95% CI: 0.75, 1.34, Ptrend = 0.90; distal colon cancer: HR 1.27, 95% CI: 0.87, 1.85, Ptrend = 0.32; rectal cancer: HR 1.60, 95% CI: 1.09, 2.34, Ptrend = 0.02). We found no overall evidence of an association between rotating night shift work and colorectal cancer risk in these two large cohorts of nurses. Risk for rectal cancer significantly increased with shift work duration, suggesting that long‐term circadian disruption may play a role in rectal cancer development. What's new? Night shift work is associated with circadian rhythm disruption, sleep deprivation, and lifestyle changes. Circadian disruption in particular can lead to the deregulation of basic cellular functions, including DNA damage repair, and thus is potentially carcinogenic in humans. In the present study, involving two large prospective cohorts of nurses, no overall evidence of an association was detected between rotating night shift work and colorectal cancer risk. Risk for rectal cancer increased significantly, however, with long‐term rotating night shift work, lasting 15 or more years, suggesting that long‐term circadian disruption may play a role in rectal cancer development.
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Affiliation(s)
- Kyriaki Papantoniou
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Elizabeth E Devore
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jennifer Massa
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Susanne Strohmaier
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Céline Vetter
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Integrative Physiology, University of Colorado, Boulder, CO
| | - Lin Yang
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Yan Shi
- Department of Medical Oncology, Chinese PLA General Hospital, Beijing, China
| | - Edward Giovannucci
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Frank Speizer
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Eva S Schernhammer
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, Austria.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
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