Shift work and cancer – considerations on rationale, mechanisms, and epidemiology
Scandinavian Journal of Work Environment & HealthPublished 2 February 2010Open access
Giovanni Costa, Erhard Haus, Richard G. Stevens
Citations236
SJR quartileQ1
SJR score2.18
SNIP1.61
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TL;DR
The rationale for, possible mechanisms of, and problems related to risk assessment of the association between shift work and cancer are summarized.
Abstract
This paper summarizes the rationale for, possible mechanisms of, and problems related to risk assessment of the association between shift work and cancer. The mechanisms by which circadian disruption may favor the induction and/or promotion of malignant tumors are complex and multifactorial. The multilevel endocrine changes caused by circadian disruption with melatonin suppression through light at night (LAN) lead to the oncogenic targeting of the endocrine-responsive breast in women and possibly the prostate in men. Repeated phase shifting with internal desynchronization may lead to defects in the regulation of the circadian cell cycle, thus favoring uncontrolled growth. Sleep deprivation leads to the suppression of immune surveillance that may permit the establishment and/or growth of malignant clones. The epidemiological studies published so far, although dealing with large cohorts and controlling for several personal confounders, have defined the exposure to shift and/or night work rather loosely and consequently do not allow for the proper assessment of the risk connected with circadian disruption.
Keywords
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There is some evidence to suggest that the pineal gland influences neoplastic growth, but it is not clear whether melatonin inhibits mammary cancer growth via an indirect neuroendocrine mechanism or via an action directly on the cancer cells themselves.
Immunology and Cell BiologyTowards a unified model of neuroendocrine–immune interaction
162 Citations2001Nikolai Petrovsky
Current knowledge of neuroendocrine–immune interaction is reviewed and the example of T‐cell subset differentiation is used to show the previously under‐appreciated importance of neuro endocrine influences in the regulation of immune function and, in particular, Th1/Th2 balance and diurnal variation there of.
ErgonomicsShort and Long-term Adjustment of Circadian Rhythms in ‘ Permanent ’ Night Nurses
161 Citations1978Simon Folkard, Timothy H. Monk +1 more
Two studies are described in which differences were found in the adjustment of the circadian rhythms of full and part-time night nurses to night work, and it is suggested that these differences in long-term adjustment may take the form of a permanent ‘flattening’ of the rhythm, or of a facilitation of short- term adjustment.
American Journal of EpidemiologyShift Work, Light at Night, and Breast Cancer on Long Island, New York
156 Citations2006Erin O’Leary, Elinor Schoenfeld +6 more
The hypothesized association between breast cancer and circadian disruption was evaluated in the Electromagnetic Fields and Breast Cancer on Long Island Study, and results suggest positive associations with residential light-at-night exposure, or they could reflect response biases.
Current Opinion in LipidologyChronobiology, genetics and metabolic syndrome
155 Citations2009Marta Garaulet, Juan Antonio Madrid
Although the precise mechanism linking the MetS to chronodisruption is not well known, hypotheses point to the internal desynchronization between different circadian rhythms.
International Journal of CancerNight‐time work predisposes to non‐Hodgkin lymphoma
151 Citations2008Tuuli Lahti, Timo Partonen +3 more
Night‐time workers are cancer prone and have a greater risk of NHL than population on average, and the overall relative risk being 1.10 (95% confidence interval of 1.03–1.19).
Journal of Circadian RhythmsNPAS2 and PER2 are linked to risk factors of the metabolic syndrome
148 Citations2009Ani Englund, Leena Kovanen +6 more
The findings support the view that relevant relationships between circadian clocks and the metabolic syndrome in humans exist.
JNCI Journal of the National Cancer InstituteMelatonin and Breast Cancer: A Prospective Study
146 Citations2004Ruth C. Travis, DS Allen +2 more
No evidence is found that the level of melatonin is strongly associated with the risk for breast cancer, and data from premenopausal and postmenopausal women were combined in a multivariable analysis adjusted for potential confounders.
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