Nested case–control study of night shift work and breast cancer risk among women in the Danish military
- Correspondence to Dr Johnni Hansen, Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, Copenhagen DK2100, Denmark;
Contributors JH and CFL have contributed to the study regarding: (1) conception and design or analysis and interpretation of data (2) drafting the article or revising it critically for important intellectual content and (3) final approval of the version to be published. JH and CFL have designed and planned the study and developed the protocol. CFL made the data collection. JH and CFL made the statistical analyses. JH and CFL interpreted the final data analyses and JH wrote the manuscript.
- Accepted 6 February 2012
- Published Online First 29 May 2012
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.
Funding This study was supported by a grant from the Danish Ministry of Defence. The funding source had no role in the design or analysis of the study or in the decision to submit the manuscript for publication.
Competing interests None.
Ethics approval Approved by Danish Data Protection Agency.
Provenance and peer review Not commissioned; externally peer reviewed.