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Night-shift work, breast cancer incidence, and all-cause mortality: an updated meta-analysis of prospective cohort studies

  • Sleep Breathing Physiology and Disorders • Review
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Abstract

Objectives

Night-shift work exposure is proposed to link to a wide range of health issues, especially cancer incidence, cancer-specific death, and all-cause death. However, the epidemiological associations among night-shift work exposure, breast cancer, breast cancer-specific death, and all-cause mortality remain inconclusive.

Methods

We performed an updated systematic review and meta-analysis to confirm potential associations among night-shift work exposure, breast cancer, and all-cause mortality.

Results

A total of 31 prospective cohort studies, involving 9.3 million participants, 31,244 incident breast cancer cases, 12,728 cancer-related deaths, 7882 cardiovascular deaths, and 30,807 all-cause mortalities were included. Overall, the summary RR of incident breast cancer in females for an increase of night-shift work was 1.029 (95% CI 1.003–1.055). Compared with standard day workers, night-shift workers had a statistically significantly increased RR (1.086, 95% CI 1.032–1.142) for breast cancer incidence in the subgroup of > 10 years exposure. Furthermore, a positive association was revealed in subgroup studies of rotating night-shift work (RR = 1.053, 95% CI 1.018–1.090). A significant increased risk of cardiovascular mortality was demonstrated in the night-shift work group (RR = 1.031; 95% CI 1.006–1.057).

Conclusion

Our systematic review and meta-analysis provided convincing evidence supporting positive associations among night-shift work exposure, breast cancer incidence, and cardiovascular mortality. Taken together, night-shift work exposure significantly increased the risk of breast cancer morbidity by 2.9% for total, 8.6% for the subgroup of more than 10 years night-shift work, and 5.3% for rotating night-shift work. In addition, night-shift work increased the risk of cardiovascular mortality by 3.1%.

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Author notes

  1. Fengqin Wei and Weiyu Chen contributed equally to the work

Authors and Affiliations

  1. Department of Geriatrics, Fujian Provincial 2Nd People’s Hospital, Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China

    Fengqin Wei

  2. Department of Physiology, Zhongshan Medical School, Sun Yat-Sen University, Guangzhou, China

    Weiyu Chen

  3. Department of Breast Surgery, Fujian Provincial Maternity and Children’s Hospital of Fujian Medical University, Fuzhou, China

    Xiaoti Lin

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  1. Fengqin Wei
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Wei, F., Chen, W. & Lin, X. Night-shift work, breast cancer incidence, and all-cause mortality: an updated meta-analysis of prospective cohort studies. Sleep Breath 26, 1509–1526 (2022). https://doi.org/10.1007/s11325-021-02523-9

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