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Nested case-control study of night shift work and breast cancer risk among women in the Danish military

机译：丹麦军队中女性夜班工作和乳腺癌风险的嵌套病例对照研究

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Objectives: Growing but limited evidence suggests that night shift work is associated with breast cancer. The authors conducted a nationwide case-control study nested within a cohort of 18 551 female military employees born in 1929-1968 to investigate the risk for breast cancer after night shift work and to explore the role of leisure time sun exposure and diurnal preference. Methods: The authors documented 218 cases of breast cancer (1990-2003) and selected 899 age-matched controls from the cohort by incidence density sampling. Information on shift work, sun exposure habits, diurnal preference and other potential confounders was obtained from a structured questionnaire. ORs were estimated by multivariate conditional logistic regression. Results: Overall, the authors observed an adjusted OR of 1.4 (95% CI 0.9 to 2.1) among women with ever compared with never night shifts. The RR for breast cancer tended to increase with increasing number of years of night shift work (p=0.03) and with cumulative number of shifts (p=0.02),with a neutral risk for fewer than three night shifts per week. The OR for the group with the highest tertile of cumulative exposure was 2.3 (95% CI 1.2 to 4.6). The most pronounced effect of night shift work on breast cancer risk was observed in women with morning chronotype preference and intense night shifts (OR=3.9, 95% CI 1.6 to 9.5). Night shift workers tended to sunbathe more frequently than day workers. Conclusions: The results indicate that frequent night shift work increases the risk for breast cancer and suggest a higher risk with longer duration of intense night shifts. Women with morning preference who worked on night shifts tended to have a higher risk than those with evening preference.
机译：目的：越来越多的证据表明夜班工作与乳腺癌有关。作者进行了一项全国性病例对照研究，该研究嵌套在1929年至1968年出生的18 551名女性军人的队列中，以研究夜班工作后患乳腺癌的风险，并探讨闲暇时间暴露在阳光下和昼夜偏好的作用。方法：作者记录了218例乳腺癌患者（1990-2003年），并通过发病率密度抽样从队列中选择了899个年龄匹配的对照。有关轮班工作，日晒习惯，昼夜偏好和其他潜在混杂因素的信息是从结构化问卷中获得的。通过多元条件对数回归估计OR。结果：总体而言，作者观察到与从未夜班相比，女性调整后的OR为1.4（95％CI为0.9至2.1）。乳腺癌的RR倾向于随着夜班工作年数的增加（p = 0.03）和累积的轮班次数（p = 0.02）而增加，而中性风险是每周少于三个夜班。累积暴露量最高的组的OR为2.3（95％CI为1.2至4.6）。夜班工作偏爱且夜班频繁的女性（OR = 3.9，95％CI 1.6至9.5）观察到夜班工作对乳腺癌风险的最明显影响。夜班工人比日班工人更喜欢日光浴。结论：结果表明，频繁的夜班工作会增加患乳腺癌的风险，并且提示长时间夜班时间较长，则患乳腺癌的风险会更高。早班的女性比上晚班的女性患病风险更高。

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