Does night-shift work increase the risk of prostate cancer? a systematic review and meta-analysis

Dapang Rao, Haifeng Yu, Yu Bai, Xiangyi Zheng, Liping Xie, Dapang Rao, Haifeng Yu, Yu Bai, Xiangyi Zheng, Liping Xie

Abstract

Background: Night-shift work is suggested to be associated with an increased risk of breast cancer, but its association with prostate cancer is still controversial. We examined this association by conducting a systematic review and meta-analysis.

Methods: Studies were identified by searching PubMed, EMBASE, Ovid, Web of Science, the Cochrane register, and the China National Knowledge Infrastructure databases through December 25, 2014. Summary relative risks (SRRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random effects or fixed effects model. Heterogeneity and publication bias were also evaluated.

Results: A total of 2,459,845 individuals from eight published studies were included in this meta-analysis. Analysis of all studies suggested that night-shift work was associated with a significantly increased risk of prostate cancer (RR: 1.24, 95% CI: 1.05-1.46; P=0.011). Sensitivity analysis showed that the association remained significant when repeating the analysis after removing one study each time. Dose-response meta-analysis suggested that an increase in night-shift work of 5 years duration was statistically significantly associated with a 2.8% (95% CI: 0.3, 5.4%, P=0.030) increase in the risk of prostate cancer. There was no significant publication bias.

Conclusion: Based on a meta-analysis, night-shift work is associated with an increased risk of prostate cancer. Because of the limited number of included studies and the large level of heterogeneity, further well-designed studies are still warranted to confirm the findings of our analysis.

Keywords: meta-analysis; prostate cancer; risk; shift work.

Figures

Figure 1
Figure 1
Flowchart of study assessment and selection. Abbreviation: CNKI, China National Knowledge Infrastructure.
Figure 2
Figure 2
Summary risk estimates and 95% CIs for night-shift work and prostate cancer. Notes:aAdjusted variables (AFSAB): A, age; F, family history of prostate cancer; S, smoking; A, alcohol; B, body mass index. For example, Kubo et al adjusted for age, family history of prostate cancer, smoking, alcohol, body mass index, and seven other factors. Weights are from random effect analysis. Abbreviations: RR, relative risk; CI, confidence interval.
Figure 3
Figure 3
Dose–response analysis of the association between night-shift work and prostate cancer risk. Note: Solid line represents the estimated odds ratios and the dotted lines represent the 95% confidence intervals.
Figure 4
Figure 4
Trim-and-fill analysis identified one imputed study, which is represented by a hollow square. Abbreviation: SE, standard error.

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