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Ogunlusi O, Sarkar M, Chakrabarti A, Boland DJ, Nguyen T, Sampson J, Nguyen C, Fails D, Jones-Hall Y, Fu L, Mallick B, Keene A, Jones J, Sarkar TR. Disruption of Circadian Clock Induces Abnormal Mammary Morphology and Aggressive Basal Tumorigenesis by Enhancing LILRB4 Signaling. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.19.585534. [PMID: 38562905 PMCID: PMC10983926 DOI: 10.1101/2024.03.19.585534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Epidemiological studies have shown that circadian rhythm disruption (CRD) is associated with the risk of breast cancer. However, the role of CRD in mammary gland morphology and aggressive basal mammary tumorigenesis and the molecular mechanisms underlying CRD and cancer risk remain unknown. To investigate the effect of CRD on aggressive tumorigenesis, a genetically engineered mouse model that recapitulates the human basal type of breast cancer was used for this study. The effect of CRD on mammary gland morphology was investigated using wild-type mice model. The impact of CRD on the tumor microenvironment was investigated using the tumors from LD12:12 and CRD mice via scRNA seq. ScRNA seq was substantiated by multiplexing immunostaining, flow cytometry, and realtime PCR. The effect of LILRB4 immunotherapy on CRD-induced tumorigenesis was also investigated. Here we identified the impact of CRD on basal tumorigenesis and mammary gland morphology and identified the role of LILRB4 on CRD-induced lung metastasis. We found that chronic CRD disrupted mouse mammary gland morphology and increased tumor burden, and lung metastasis and induced an immunosuppressive tumor microenvironment by enhancing LILRB4a expression. Moreover, CRD increased the M2-macrophage and regulatory T-cell populations but decreased the M1-macrophage, and dendritic cell populations. Furthermore, targeted immunotherapy against LILRB4 reduced CRD-induced immunosuppressive microenvironment and lung metastasis. These findings identify and implicate LILRB4a as a link between CRD and aggressive mammary tumorigenesis. This study also establishes the potential role of the targeted LILRB4a immunotherapy as an inhibitor of CRD-induced lung metastasis.
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Moon J, Ikeda-Araki A, Mun Y. Night shift work and female breast cancer: a two-stage dose-response meta-analysis for the correct risk definition. BMC Public Health 2024; 24:2065. [PMID: 39085800 PMCID: PMC11293116 DOI: 10.1186/s12889-024-19518-2] [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] [Received: 10/30/2023] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
INTRODUCTION 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. METHODS 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. RESULTS 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. DISCUSSION 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.
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Affiliation(s)
- Jinyoung Moon
- 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
| | - Atsuko Ikeda-Araki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yongseok Mun
- Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, 1, Singil-ro, Yeongdeungpo-gu, Seoul, 07441, South Korea.
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Munteanu C, Turti S, Achim L, Muresan R, Souca M, Prifti E, Mârza SM, Papuc I. The Relationship between Circadian Rhythm and Cancer Disease. Int J Mol Sci 2024; 25:5846. [PMID: 38892035 PMCID: PMC11172077 DOI: 10.3390/ijms25115846] [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: 04/06/2024] [Revised: 05/25/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
The circadian clock regulates biological cycles across species and is crucial for physiological activities and biochemical reactions, including cancer onset and development. The interplay between the circadian rhythm and cancer involves regulating cell division, DNA repair, immune function, hormonal balance, and the potential for chronotherapy. This highlights the importance of maintaining a healthy circadian rhythm for cancer prevention and treatment. This article investigates the complex relationship between the circadian rhythm and cancer, exploring how disruptions to the internal clock may contribute to tumorigenesis and influence cancer progression. Numerous databases are utilized to conduct searches for articles, such as NCBI, MEDLINE, and Scopus. The keywords used throughout the academic archives are "circadian rhythm", "cancer", and "circadian clock". Maintaining a healthy circadian cycle involves prioritizing healthy sleep habits and minimizing disruptions, such as consistent sleep schedules, reduced artificial light exposure, and meal timing adjustments. Dysregulation of the circadian clock gene and cell cycle can cause tumor growth, leading to the need to regulate the circadian cycle for better treatment outcomes. The circadian clock components significantly impact cellular responses to DNA damage, influencing cancer development. Understanding the circadian rhythm's role in tumor diseases and their therapeutic targets is essential for treating and preventing cancer. Disruptions to the circadian rhythm can promote abnormal cell development and tumor metastasis, potentially due to immune system imbalances and hormonal fluctuations.
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Affiliation(s)
- Camelia Munteanu
- Department of Plant Culture, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania; (C.M.); (S.T.); (L.A.); (R.M.); (M.S.); (E.P.)
| | - Sabina Turti
- Department of Plant Culture, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania; (C.M.); (S.T.); (L.A.); (R.M.); (M.S.); (E.P.)
| | - Larisa Achim
- Department of Plant Culture, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania; (C.M.); (S.T.); (L.A.); (R.M.); (M.S.); (E.P.)
| | - Raluca Muresan
- Department of Plant Culture, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania; (C.M.); (S.T.); (L.A.); (R.M.); (M.S.); (E.P.)
| | - Marius Souca
- Department of Plant Culture, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania; (C.M.); (S.T.); (L.A.); (R.M.); (M.S.); (E.P.)
| | - Eftimia Prifti
- Department of Plant Culture, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania; (C.M.); (S.T.); (L.A.); (R.M.); (M.S.); (E.P.)
| | - Sorin Marian Mârza
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania;
| | - Ionel Papuc
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania;
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Mortazavi SAR, Tahmasebi S, Lech JC, Welsh JS, Taleie A, Rezaianzadeh A, Zamani A, Mega K, Nematollahi S, Zamani A, Mortazavi SMJ, Sihver L. Digital Screen Time and the Risk of Female Breast Cancer: A Retrospective Matched Case-Control Study. J Biomed Phys Eng 2024; 14:169-182. [PMID: 38628888 PMCID: PMC11016821 DOI: 10.31661/jbpe.v0i0.2310-1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 11/02/2023] [Indexed: 04/19/2024]
Abstract
Background As the use of electronic devices such as mobile phones, tablets, and computers continues to rise globally, concerns have been raised about their potential impact on human health. Exposure to high energy visible (HEV) blue light, emitted from digital screens, particularly the so-called artificial light at night (ALAN), has been associated with adverse health effects, ranging from disruption of circadian rhythms to cancer. Breast cancer incidence rates are also increasing worldwide. Objective This study aimed at finding a correlation between breast cancer and exposure to blue light from mobile phone. Material and Methods In this retrospective matched case-control study, we aimed to investigate whether exposure to blue light from mobile phone screens is associated with an increased risk of female breast cancer. We interviewed 301 breast cancer patients (cases) and 294 controls using a standard questionnaire and performed multivariate analysis, chi-square, and Fisher's exact tests for data analysis. Results Although heavy users in the case group of our study had a statistically significant higher mean 10-year cumulative exposure to digital screens compared to the control group (7089±14985 vs 4052±12515 hours, respectively, P=0.038), our study did not find a strong relationship between exposure to HEV and development of breast cancer. Conclusion Our findings suggest that heavy exposure to HEV blue light emitted from mobile phone screens at night might constitute a risk factor for promoting the development of breast cancer, but further large-scale cohort studies are warranted.
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Affiliation(s)
| | - Sedigheh Tahmasebi
- Breast Cancer Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - James C Lech
- Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam (UMC), Amsterdam, The Netherlands
- International EMF Project & Optical Radiation, World Health Organization, Pretoria, South Africa
| | - James S Welsh
- Department of Radiation Oncology, Stritch School of Medicine Loyola University Chicago, Maywood, IL, USA
- Department of Radiation Oncology, Edward Hines Jr Veterans Affairs Hospital, Maywood, Illinois, USA
| | - Abdorasoul Taleie
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ali Zamani
- Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kanu Mega
- School of Life Sciences, Manipal Academy of Higher Education, Dubai International Academic City, Dubai, UA
| | - Samaneh Nematollahi
- Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran
| | - Atefeh Zamani
- School of Mathematics and Statistics, University of New South Wales, Sydney, New South Wales, Australia
| | - Seyed Mohammad Javad Mortazavi
- Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lembit Sihver
- Department of Radiation Physics, Atominstitut, Technische Universität Wien, Vienna, Austria
- Department of Radiation Dosimetry, Nuclear Physics Institute of the Czech Academy of Sciences, Prague, Czech Republic
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Bostock F, Mortimore G. Considering the impact of shift working on health. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:120-124. [PMID: 38335102 DOI: 10.12968/bjon.2024.33.3.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Shift work is necessary for the provision of health services, especially in hospitals as it is the only way to provide continuous care to patients. Working at night is inconsistent with the body's biological clock and night shift working hugely disrupts the circadian and sleep wake cycles. In 2020, the World Health Organization classified night shift working as being a 'probable' class 2A carcinogen and a number of independent cohort studies of both night workers and shift workers have observed increased incidence of certain cancers. Altered sleep timing, food timing and light exposure typical for shift workers leads to an acute circadian disruption and misalignment of regulatory hormones. This straying from synchronisation has been shown to result in individuals being more vulnerable to a number of chronic health conditions. Night shift work disrupts the normal sleep-wake cycle, often leading to shortened sleep duration and excessive fatigue and the results of this are far reaching. This article will explore the full impact of shift working, questioning if current practices employed within the NHS should continue.
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Affiliation(s)
- Faye Bostock
- Trainee Advanced Clinical Practitioner, University Hospitals of Derby and Burton Foundation Trust
| | - Gerri Mortimore
- Associate Professor in Advanced Practice, Department of HPSC, University of Derby
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Gustavsson P, Bigert C, Andersson T, Kader M, Härmä M, Selander J, Bodin T, Albin M. Night work and breast cancer risk in a cohort of female healthcare employees in Stockholm, Sweden. Occup Environ Med 2023:oemed-2022-108673. [PMID: 37137691 DOI: 10.1136/oemed-2022-108673] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/21/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Night work has been classified as probably carcinogenic to humans by the International Agency for Research on Cancer, but epidemiological evidence was considered limited due to variability in findings and potential bias. This study aimed to investigate the risk of breast cancer in a cohort with detailed and registry-based data on night work. METHODS The cohort comprised 25 585 women (nurses and nursing assistants) employed 1 year or more between 2008 and 2016 in the healthcare sector in Stockholm. Information on work schedules was obtained from employment records. Breast cancer cases were identified from the national cancer register. HRs were estimated by a discrete time proportional hazards model, adjusting for age, country of birth, profession and childbirth. RESULTS There were 299 cases of breast cancer, 147 in premenopausal and 152 in postmenopausal women. The adjusted HR of postmenopausal breast cancer in association with ever versus never working nights was 1.31 (95% CI 0.91 to 1.85). Eight or more years of night work was associated with an increased risk of postmenopausal breast cancer, HR=4.33 (95% CI 1.45 to 10.57), based on five cases only, though. CONCLUSIONS This study is limited by a short period of follow-up and a lack of information on night work before 2008. Most exposure metrics showed no association with breast cancer risk, but there was an elevated risk of postmenopausal breast cancer in women after 8 or more years of night work.
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Affiliation(s)
- Per Gustavsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Carolina Bigert
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Tomas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Manzur Kader
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mikko Härmä
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jenny Selander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Theo Bodin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Maria Albin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Härmä M, Ojajärvi A, Koskinen A, Lie JA, Hansen J. Shift work with and without night shifts and breast cancer risk in a cohort study from Finland. Occup Environ Med 2023; 80:1-6. [PMID: 35948413 PMCID: PMC9763178 DOI: 10.1136/oemed-2022-108347] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/22/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To examine the association of shift work with and without night work with breast cancer among women in the public sector. METHODS Using the Finnish Public Sector cohort study (N=33 359, mean age of 40.6 years at baseline), we investigated the associations of shift work and potential confounders with incident breast cancer. Exposure to permanent day work or shift work was defined from first two consecutive surveys from 2000, 2004, 2008 or 2012 and past information on exposure in a subcohort (n=20 786). Incident cases of breast cancer (n=1129) were retrieved from the National Cancer Register and the cohort members were followed to the end of 2016. HR and 95% CI from Cox proportional hazard regression models were calculated. RESULTS Shift work with and without night shifts was not overall associated with breast cancer. When stratified according to age, both shift work without nights (HR 2.01, 95% CI 1.12 to 3.60) and shift work with nights (OR 2.05, 95% CI 1.04 to 4.01) were associated with an increased risk after a period of 10 years or more follow-up among women aged 50 years or older, when adjusted for age, socioeconomic status, children, smoking, alcohol and body mass index. In a subgroup with past information on exposure to shift work, the increased risk by longer exposure to shift work was not significant. CONCLUSIONS This study provides support for an increased risk of breast cancer among elderly shift workers. However, insufficient information on exposure and intensity of night work may attenuate the risk estimates.
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Affiliation(s)
- Mikko Härmä
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Anneli Ojajärvi
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aki Koskinen
- Digi and Data, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jenny-Anne Lie
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
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Sukhee E, Sovd T, Khaltar U, Hamajima N, Sereenen E, Davaakhuu N, Yamamoto E. Sickness absence among employees of healthcare organizations in the public sector in Mongolia: A cross-sectional study. J Occup Health 2023; 65:e12390. [PMID: 36855219 PMCID: PMC9975147 DOI: 10.1002/1348-9585.12390] [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] [Received: 09/16/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES This study aimed to understand the rate of sickness absence (SA) among employees of public healthcare organizations in Mongolia, to identify factors associated with long-term SA, and to estimate costs due to SA. METHODS This cross-sectional study included employees of public healthcare organizations who had certified SA from 2016 to 2018. Sociodemographic and occupational characteristics of absentees and the data on absences were collected. A logistic regression analysis was performed to identify factors associated with long-term SA (≥15 days) among employees who had SA. Absence parameters and the average costs due to SA were calculated and the total cost due to SA at all public healthcare organizations was estimated. RESULTS From 2016 to 2018, there were 13 653 absentees and 21 043 SA, and the absence rate was 0.9%. The average absence length per absence and absentee were 9.63 days and 14.85 days, respectively. Factors associated with long-term SA were age ≥40 years, 10-19 years in employment, working at the second and tertiary levels, and night shift. The average cost per absentee was 295.5 USD, and the estimated total cost for all health organizations was 1 796 993 USD per year. CONCLUSIONS The absence rate was 0.9% and older age, longer work experience, higher organizational level, and night shift were associated with taking a long-term SA. To reduce the costs of absenteeism and promote the health of employees in healthcare organizations, policymakers should review the policies related to SA and develop national guidelines on SA for employers, healthcare managers, and employees.
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Affiliation(s)
- Erdenetuya Sukhee
- Department of Healthcare AdministrationNagoya University Graduate School of MedicineNagoyaJapan
- Department of Public Administration and ManagementMinistry of HealthUlaanbaatarMongolia
| | - Tugsdelger Sovd
- Department of Monitoring and Evaluation and Internal AuditMinistry of HealthUlaanbaatarMongolia
| | - Ulzii‐Orshikh Khaltar
- Department of Monitoring and Evaluation and Internal AuditMinistry of HealthUlaanbaatarMongolia
| | - Nobuyuki Hamajima
- Department of Healthcare AdministrationNagoya University Graduate School of MedicineNagoyaJapan
| | - Enkhbold Sereenen
- The Digital Development and Marketing DepartmentMongolian National University of Medical SciencesUlaanbaatarMongolia
| | | | - Eiko Yamamoto
- Department of Healthcare AdministrationNagoya University Graduate School of MedicineNagoyaJapan
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Hong J, He Y, Fu R, Si Y, Xu B, Xu J, Li X, Mao F. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies. Open Med (Wars) 2022; 17:712-731. [PMID: 35702390 PMCID: PMC8995855 DOI: 10.1515/med-2022-0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/01/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to investigate the relationship between night shift work and breast cancer (BC) incidence. A search was performed in PubMed, EBSCO, Web of Science, and Cochrane Library databases before June 2021. The exposure factor of this study is night shift work, the primary outcome is the risk of BC. A total of 33 observational studies composed of 4,331,782 participants were included. Night shift work increases the risk of BC in the female population (hazard ratio [HR] = 1.20, 95% confidence interval [Cl] = 1.10–1.31, p < 0.001), especially receptor-positive BC, including estrogen receptor (ER)+ BC (HR = 1.35, p < 0.001), progesterone receptor (PR)+ BC (HR = 1.30, p = 0.003), and human epidermal growth factor receptor 2 (HER2)+ BC (HR = 1.42, p < 0.001), but has no effect on HER2− BC (HR = 1.10, p = 0.515) and ER−/PR− BC (HR = 0.98, p = 0.827). The risk of BC was positively correlated with night shift working duration, frequency, and cumulative times. For women who start night work before menopause, night work will increase the incidence of BC (HR = 1.17, p = 0.020), but for women who start night work after menopause, night work does not affect BC (HR = 1.04, p = 0.293). Night work can increase the incidence of BC in the female population. The effect of long working hours, frequency, and the cumulative number of night shifts on BC is influenced by menopausal status.
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Affiliation(s)
- Jiaze Hong
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Yujing He
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Rongrong Fu
- The First Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Yuexiu Si
- School of Basic Medical Sciences, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Binbin Xu
- Department of Nutrition, HwaMei Hospital, University of Chinese Academy of Sciences , Ningbo , Zhejiang , China
| | - Jiaxuan Xu
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Xiangyuan Li
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Feiyan Mao
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences , Northwest Street 41, Haishu District, Ningbo, 315010 , Zhejiang , China
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