Veille documentaire MTPH

Auteur     Eva S Schernhammer
Auteur     Diane Feskanich
Auteur     Geyu Liang
Auteur     Jiali Han
Volume     178
Numéro     9
Pages     1434-1441
Publication     American journal of epidemiology
ISSN     1476-6256
Date     Nov 1, 2013
Extra     PMID: 24049158 PMCID: PMC3813313
Abrév. de revue     Am. J. Epidemiol.
DOI     10.1093/aje/kwt155
Catalogue de bibl.     NCBI PubMed
Langue     eng
Résumé     The risk of lung cancer among night-shift workers is unknown. Over 20 years of follow-up (1988-2008), we documented 1,455 incident lung cancers among 78,612 women in the Nurses’ Health Study. To examine the relationship between rotating night-shift work and lung cancer risk, we used multivariate Cox proportional hazard models adjusted for detailed smoking characteristics and other risk factors. We observed a 28% increased risk of lung cancer among women with 15 or more years spent working rotating night shifts (multivariate relative risk (RR) = 1.28, 95% confidence interval (CI): 1.07, 1.53; Ptrend = 0.03) compared with women who did not work any night shifts. This association was strongest for small-cell lung carcinomas (multivariate RR = 1.56, 95% CI: 0.99, 2.47; Ptrend = 0.03) and was not observed for adenocarcinomas of the lung (multivariate RR = 0.91, 95% CI: 0.67, 1.24; Ptrend = 0.40). Further, the increased risk associated with 15 or more years of rotating night-shift work was limited to current smokers (RR = 1.61, 95% CI: 1.21, 2.13; Ptrend < 0.001), with no association seen in nonsmokers (Pinteraction = 0.03). These results suggest that there are modestly increased risks of lung cancer associated with extended periods of night-shift work among smokers but not among nonsmokers. Though it is possible that this observation was residually confounded by smoking, our findings could also provide evidence of circadian disruption as a « second hit » in the etiology of smoking-related lung tumors.