Review Article

Does the association of prostate cancer with night-shift work differ according to rotating vs. fixed schedule? A systematic review and meta-analysis

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Abstract

Background

Recent studies suggested that the relation between night-shift work and prostate cancer may differ between rotating and fixed schedules.

Objectives

We aimed to quantify the independent association between night-shift work and prostate cancer, for rotating and fixed schedules.

Methods

We searched MEDLINE for studies assessing the association of night-shift work, by rotating or fixed schedules, with prostate cancer. We computed summary relative risk (RR) estimates with 95% confidence intervals (95% CI) using the inverse variance method and quantified heterogeneity using the I2 statistic. Meta-regression analysis was used to compare the summary RR estimates for rotating and fixed schedules, while reducing heterogeneity.

Results

A total of nine studies assessed the effect of rotating and, in addition, four of them provided the effect of fixed night-shift work, in relation to daytime workers. Rotating night-shift work was associated with a significantly increased risk of prostate cancer (RR = 1.06, 95% CI of 1.01 to 1.12; I2 = 50%), but not fixed night-shift work (RR of 1.01, 95% CI of 0.81 to 1.26; I2 = 33%). In meta-regression model including study design, type of population, and control of confounding, the summary RR was 20% higher for rotating vs. fixed schedule, with heterogeneity fully explained by these variables.

Conclusions

This is the first meta-analysis suggesting that an increased risk of prostate cancer may be restricted to workers with rotating night shifts. However, the association was weak and additional studies are needed to further clarify this relation before it can be translated into measures for risk reduction in occupational settings.

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References

  1. 1.

    Straif K, Baan R, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, et al. Carcinogenicity of shift-work, painting, and fire-fighting. Lancet Oncol. 2007;8:1065–6.

  2. 2.

    Megdal SP, Kroenke CH, Laden F, Pukkala E, Schernhammer ES. Night work and breast cancer risk: a systematic review and meta-analysis. Eur J Cancer. 2005;41:2023–32.

  3. 3.

    Schernhammer ES, Kroenke CH, Laden F, Hankinson SE. Night work and risk of breast cancer. Epidemiol (Camb, Mass). 2006;17:108–11.

  4. 4.

    Filipski E, Lévi F. Circadian disruption in experimental cancer processes. Integr Cancer Ther. 2009;8:298–302.

  5. 5.

    Sainz RM, Mayo JC, Dx Tan, León J, Manchester L, Reiter RJ. Melatonin reduces prostate cancer cell growth leading to neuroendocrine differentiation via a receptor and PKA independent mechanism. Prostate. 2005;63:29–43.

  6. 6.

    Zhou W, Zhang X, Zhu C-L, He Z-Y, Liang J-P, Song Z-C. Melatonin receptor agonists as the “perioceutics” agents for periodontal disease through modulation of porphyromonas gingivalis virulence and inflammatory response. PLoS ONE. 2016;11:e0166442.

  7. 7.

    Du HB, Bin KY, Liu WH, Yang FS. Shift work, night work, and the risk of prostate cancer: A meta-analysis based on 9 cohort studies. Medicine. 2017;96:e8537.

  8. 8.

    Gan Y, Li L, Zhang L, et al. Association between shift work and risk of prostate cancer: a systematic review and meta-analysis of observational studies. Carcinogenesis. 2018;39:87–97.

  9. 9.

    Rao D, Yu H, Bai Y, Zheng X, Xie L. Does night-shift work increase the risk of prostate cancer? a systematic review and meta-analysis. Onco Targets Ther. 2015;8:2817–26.

  10. 10.

    Kubo T, Ozasa K, Mikami K, Wakai K, Fujino Y, Watanabe Y, et al. Prospective cohort study of the risk of prostate cancer among rotating-shift workers: findings from the Japan collaborative cohort study. Am J Epidemiol. 2006;164:549–55.

  11. 11.

    Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264–9.

  12. 12.

    Borenstein M, Hedges LV, Higgins J, Rothstein HR. Introduction to Meta-analysis. Front matter: Wiley Online Library; 2009. https://doi.org/10.1002/9780470743386.

  13. 13.

    Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–101.

  14. 14.

    Higgins J, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Stat Med. 2002;21:1539–58.

  15. 15.

    Hsu FM, Hou WH, Huang CY, Wang CC, Tsai CL, Tsai YC, et al. Differences in toxicity and outcome associated with circadian variations between patients undergoing daytime and evening radiotherapy for prostate adenocarcinoma. Chronobiol Int. 2016;33:210–9.

  16. 16.

    Parent ME, El-Zein M, Rousseau MC, Pintos J, Siemiatycki J. Night work and the risk of cancer among men. Am J Epidemiol. 2012;176:751–9.

  17. 17.

    Yong M, Nasterlack M, Messerer P, Oberlinner C, Lang S. A retrospective cohort study of shift work and risk of cancer-specific mortality in German male chemical workers. Int Arch Occup Environ Health. 2014;87:175–83.

  18. 18.

    Sigurdardottir LG, Markt SC, Rider JR, Haneuse S, Fall K, Schernhammer ES, et al. Urinary melatonin levels, sleep disruption, and risk of prostate cancer in elderly men. Eur Urol. 2015;67:191–4.

  19. 19.

    Dickerman BA, Markt SC, Koskenvuo M, Hublin C, Pukkala E, Mucci LA, et al. Sleep disruption, chronotype, shift work, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins. Cancer Causes Control. 2016;27:1361–70.

  20. 20.

    Lee Y-S, Hsu C-C, Weng S-F, Lin H-J, Wang J-J, Su S-B, et al. Cancer incidence in physicians: A Taiwan National Population-based Cohort Study. Medicine. 2015;94:e2079.

  21. 21.

    Hammer GP, Emrich K, Nasterlack M, Blettner M, Yong M. Shift work and prostate cancer incidence in industrial workers: A Historical Cohort Study in a German chemical company. Dtsch Arztebl Int. 2015;112:463.

  22. 22.

    Papantoniou K, Castaño‐Vinyals G, Espinosa A, Aragonés N, Pérez‐Gómez B, Burgos J, et al. Night shift work, chronotype and prostate cancer risk in the MCC‐Spain case‐control study. Int J Cancer. 2015;137:1147–57.

  23. 23.

    Kubo T, Oyama I, Nakamura T, Kunimoto M, Kadowaki K, Otomo H, et al. Industry‐based retrospective cohort study of the risk of prostate cancer among rotating‐shift workers. Int J Urol. 2011;18:206–11.

  24. 24.

    Schwartzbaum J, Ahlbom A, Feychting M. Cohort study of cancer risk among male and female shift workers. Scand J Work Environ Health. 2007;33:336–43.

  25. 25.

    Gapstur SM, Diver WR, Stevens VL, Carter BD, Teras LR, Jacobs EJ. Work schedule, sleep duration, insomnia, and risk of fatal prostate cancer. Am J Prev Med. 2014;46:S26–33.

  26. 26.

    Conlon M, Lightfoot N, Kreiger N. Rotating shift work and risk of prostate cancer. Epidemiol (Camb, Mass). 2007;18:182–3.

  27. 27.

    Haus E, Smolensky M. Biological clocks and shift work: circadian dysregulation and potential long-term effects. Cancer Causes Control. 2006;17:489–500.

  28. 28.

    Sigurdardottir LG, Valdimarsdottir UA, Fall K, Rider JR, Lockley SW, Schernhammer E, et al. Circadian disruption, sleep loss, and prostate cancer risk: a systematic review of epidemiologic studies. Cancer Epidemiol Biomark Prev. 2012;21:1002–11.

  29. 29.

    James FO, Cermakian N, Boivin DB. Circadian rhythms of melatonin, cortisol, and clock gene expression during simulated night shift work. Sleep. 2007;30:1427–36.

  30. 30.

    Itoh H, Weng Z, Saito H, Ogawa Y, Nakayama K, Hasegawa-Ohira M, et al. Association between night-shift work and serum 25-hydroxyvitamin D levels in Japanese male indoor workers: a cross-sectional study. Ind Health. 2011;49:658–62.

  31. 31.

    Chiru AZ, Popescu C, Gheorghe D. Melatonin and cancer. J Med Life. 2014;7:373.

  32. 32.

    Haus EL, Smolensky MH. Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation. Sleep Med Rev. 2013;17:273–84.

  33. 33.

    Savvidis C, Koutsilieris M. Circadian rhythm disruption in cancer biology. Mol Med. 2012;18:1249–60.

  34. 34.

    Ombra MN, Paliogiannis P, Doneddu V, Sini MC, Colombino M, Rozzo C, et al. Vitamin D status and risk for malignant cutaneous melanoma: recent advances. Eur J Cancer Prev: Off J Eur Cancer Prev Organ (ECP). 2017;26:532–41.

  35. 35.

    Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–30.

  36. 36.

    Jarrard D, Konety B, Huang W, Downs T, Kolesar J, Kim KM, et al. Phase IIa, randomized placebo-controlled trial of single high dose cholecalciferol (vitamin D3) and daily Genistein (G-2535) versus double placebo in men with early stage prostate cancer undergoing prostatectomy. Am J Clin Exp Urol. 2016;4:17–27.

  37. 37.

    Wagner D, Trudel D, Van der Kwast T, Nonn L, Giangreco AA, Li D, et al. Randomized clinical trial of vitamin D3 doses on prostatic vitamin D metabolite levels and ki67 labeling in prostate cancer patients. J Clin Endocrinol Metab. 2013;98:1498–507.

  38. 38.

    Borugian MJ, Gallagher RP, Friesen MC, Switzer TF, Aronson KJ. Twenty-four-hour light exposure and melatonin levels among shift workers. J Occup Environ Med. 2005;47:1268–75.

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Funding

Mancio J is supported by the Fundação Portuguesa para a Ciência e Tecnologia (SFRH/BD/104369/2014) and by the Sociedade Portuguesa de Cardiologia (“Bolsa de investigação João Porto”).

Author information

Author notes

    Affiliations

    1. Department of Surgery and Physiology, Cardiovascular Research (UnIC), Faculty of Medicine, University of Porto, Porto, Portugal

      • Jennifer Mancio
    2. Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal

      • Jennifer Mancio
    3. EPIUnit - Institut of Public Health, University of Porto, Porto, Portugal

      • Cátia Leal
      • , Marta Ferreira
      • , Pedro Norton
      •  & Nuno Lunet
    4. Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal

      • Nuno Lunet

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    Conflict of interest

    The authors declare that they have no conflict of interest.

    Corresponding author

    Correspondence to Jennifer Mancio.

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