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Wang H, Reid BM, Richmond RC, Lane JM, Saxena R, Gonzalez BD, Fridley BL, Redline S, Tworoger SS, Wang X. Impact of insomnia on ovarian cancer risk and survival: a Mendelian randomization study. EBioMedicine 2024; 104:105175. [PMID: 38823087 DOI: 10.1016/j.ebiom.2024.105175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Insomnia is the most common sleep disorder in patients with epithelial ovarian cancer (EOC). We investigated the causal association between genetically predicted insomnia and EOC risk and survival through a two-sample Mendelian randomization (MR) study. METHODS Insomnia was proxied using genetic variants identified in a genome-wide association study (GWAS) meta-analysis of UK Biobank and 23andMe. Using genetic associations with EOC risk and overall survival from the Ovarian Cancer Association Consortium (OCAC) GWAS in 66,450 women (over 11,000 cases with clinical follow-up), we performed Iterative Mendelian Randomization and Pleiotropy (IMRP) analysis followed by a set of sensitivity analyses. Genetic associations with survival and response to treatment in ovarian cancer study of The Cancer Genome Atlas (TCGA) were estimated controlling for chemotherapy and clinical factors. FINDINGS Insomnia was associated with higher risk of endometrioid EOC (OR = 1.60, 95% CI 1.05-2.45) and lower risk of high-grade serous EOC (HGSOC) and clear cell EOC (OR = 0.79 and 0.48, 95% CI 0.63-1.00 and 0.27-0.86, respectively). In survival analysis, insomnia was associated with shorter survival of invasive EOC (OR = 1.45, 95% CI 1.13-1.87) and HGSOC (OR = 1.4, 95% CI 1.04-1.89), which was attenuated after adjustment for body mass index and reproductive age. Insomnia was associated with reduced survival in TCGA HGSOC cases who received standard chemotherapy (OR = 2.48, 95% CI 1.13-5.42), but was attenuated after adjustment for clinical factors. INTERPRETATION This study supports the impact of insomnia on EOC risk and survival, suggesting treatments targeting insomnia could be pivotal for prevention and improving patient survival. FUNDING National Institutes of Health, National Cancer Institute. Full funding details are provided in acknowledgments.
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Affiliation(s)
- Heming Wang
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Brett M Reid
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Rebecca C Richmond
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Oxford Health Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Jacqueline M Lane
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA; Children's Mercy Hospital, Kansas City, MO, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Xuefeng Wang
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA.
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Houot MT, Tvardik N, Cordina-Duverger E, Guénel P, Pilorget C. A 34-year overview of night work by occupation and industry in France based on census data and a sex-specific job-exposure matrix. BMC Public Health 2022; 22:1441. [PMID: 35906586 PMCID: PMC9336015 DOI: 10.1186/s12889-022-13830-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Night work has been increasing in the last decades due to new working arrangements for good and services production. Numerous studies have shown that night shift work causes disruptions in circadian rhythms that may affect health. In 2019, night shift work was classified as probably carcinogenic to humans by the International Agency for Research on Cancer, and may contribute to other health disorders. In this context, we assessed the number and proportion of workers exposed to night work today and investigated time trends by occupation and industry in France since 1982 in terms of prevention. Methods Using the data on work time schedules collected in the French Labour Force Surveys, sex- and period-specific job-exposure matrices (JEMs) to night work (working between midnight and 5 AM) were developed. After linkage of the JEMs with data of the national censuses of 1982, 1990, 1999, 2007 and 2015, the numbers and proportions of workers usually or occasionally exposed to night work were estimated. Results The number of night workers (usual and occasional) increased from 3.67 million in 1982 to 4.37 million in 2015 (15.8% vs 16.4%). Night work was more common in men than in women (e.g. 22.4% vs 10.0% in 2015), and usual night work largely increased after 2000 (4.4% in 1999, 7.2% in 2007). In 2015, 1.29 million men worked usually at night, including 882,000 workers in the service sector (63%) and 360,000 in the manufacturing and extracting industries (28%). For the same period, 581,000 women were usual night workers, most of them being employed in the service sector (90%). Among women, a 97% increase of usual night work was observed between 1982 and 2015. Conclusions This study shows that night work involves a growing number of workers in France, particularly in women in the service sector. These results raise concern about the public health impact of night work and particularly about the numbers of outcomes attributable to this exposure such as breast or prostate cancers. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13830-5.
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Affiliation(s)
- Marie-Tülin Houot
- Santé publique France, The French Public Health Agency, 12 rue du val d'osne, 94415, Saint-Maurice, France.
| | - Nastassia Tvardik
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Inserm, Université Paris-Saclay, Institut Gustave-Roussy, 94807, Villejuif, France
| | - Emilie Cordina-Duverger
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Inserm, Université Paris-Saclay, Institut Gustave-Roussy, 94807, Villejuif, France
| | - Pascal Guénel
- Santé publique France, The French Public Health Agency, 12 rue du val d'osne, 94415, Saint-Maurice, France.,Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Inserm, Université Paris-Saclay, Institut Gustave-Roussy, 94807, Villejuif, France
| | - Corinne Pilorget
- Santé publique France, The French Public Health Agency, 12 rue du val d'osne, 94415, Saint-Maurice, France
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Niedhammer I, Coutrot T, Geoffroy-Perez B, Chastang JF. Shift and Night Work and All-Cause and Cause-Specific Mortality: Prospective Results From the STRESSJEM Study. J Biol Rhythms 2022; 37:249-259. [PMID: 35502698 PMCID: PMC9149517 DOI: 10.1177/07487304221092103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The literature remains sparse and inconclusive about the impact of shift and
night work on mortality, and still more on specific causes of death. The
objectives were to explore the prospective associations between exposure to
shift and night work and all-cause and cause-specific mortality. The study was
based on a large national representative French prospective cohort of 1,511,456
employees followed up from 1976 to 2002. Exposure to shift and night work relied
on a job-exposure matrix, and 3 time-varying measures (current, cumulative, and
recency-weighted cumulative exposure) were constructed. Mortality and causes of
death were provided by the national registry, and all-cause, cardiovascular,
cancer and preventable mortality, and suicide were studied. Cox proportional
hazards models were performed to study the associations between shift and night
work and mortality. During follow-up, 22,105 deaths occurred for all-cause
mortality. In the study of mortality until the end of last job during follow-up,
shift and/or night work were associated with all-cause, cardiovascular, cancer
and preventable mortality, and suicide (except night without shift work with
cancer mortality and suicide) among men. Shift work (especially shift without
night work) was associated with all-cause, cancer and preventable mortality
among women. The results were similar for current, cumulative, and
recency-weighted cumulative exposure. Associations were found for more detailed
causes of death: cerebrovascular diseases for both genders, ischemic heart
diseases, respiratory cancers, smoking-related mortality, and external causes of
death among men, and breast cancer among women. In the study of mortality until
the end of follow-up, some additional associations were found among women
between night work and all-cause and preventable mortality, and suicide,
suggesting long-term or delayed exposure effects. The study may, however, be
underpowered to detect all the exposure-outcome associations, especially among
women. More research and prevention are needed to reduce mortality among shift
and night workers.
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Affiliation(s)
- Isabelle Niedhammer
- INSERM, Univ Angers, Univ Rennes, EHESP, Institut de Recherche en Santé, Environnement et Travail (IRSET) - UMR_S 1085, Epidemiology in Occupational Health and Ergonomics Team (ESTER), Angers, France
| | - Thomas Coutrot
- Direction de l'Animation de la Recherche, des Etudes et des Statistiques (DARES), Ministère du Travail, Paris, France
| | | | - Jean-François Chastang
- INSERM, Univ Angers, Univ Rennes, EHESP, Institut de Recherche en Santé, Environnement et Travail (IRSET) - UMR_S 1085, Epidemiology in Occupational Health and Ergonomics Team (ESTER), Angers, France
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Hong J, He Y, Fu R, Si Y, Xu B, Xu J, Li X, Mao F. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies. Open Med (Wars) 2022; 17:712-731. [PMID: 35702390 PMCID: PMC8995855 DOI: 10.1515/med-2022-0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/01/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to investigate the relationship between night shift work and breast cancer (BC) incidence. A search was performed in PubMed, EBSCO, Web of Science, and Cochrane Library databases before June 2021. The exposure factor of this study is night shift work, the primary outcome is the risk of BC. A total of 33 observational studies composed of 4,331,782 participants were included. Night shift work increases the risk of BC in the female population (hazard ratio [HR] = 1.20, 95% confidence interval [Cl] = 1.10–1.31, p < 0.001), especially receptor-positive BC, including estrogen receptor (ER)+ BC (HR = 1.35, p < 0.001), progesterone receptor (PR)+ BC (HR = 1.30, p = 0.003), and human epidermal growth factor receptor 2 (HER2)+ BC (HR = 1.42, p < 0.001), but has no effect on HER2− BC (HR = 1.10, p = 0.515) and ER−/PR− BC (HR = 0.98, p = 0.827). The risk of BC was positively correlated with night shift working duration, frequency, and cumulative times. For women who start night work before menopause, night work will increase the incidence of BC (HR = 1.17, p = 0.020), but for women who start night work after menopause, night work does not affect BC (HR = 1.04, p = 0.293). Night work can increase the incidence of BC in the female population. The effect of long working hours, frequency, and the cumulative number of night shifts on BC is influenced by menopausal status.
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Affiliation(s)
- Jiaze Hong
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Yujing He
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Rongrong Fu
- The First Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Yuexiu Si
- School of Basic Medical Sciences, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Binbin Xu
- Department of Nutrition, HwaMei Hospital, University of Chinese Academy of Sciences , Ningbo , Zhejiang , China
| | - Jiaxuan Xu
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Xiangyuan Li
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Feiyan Mao
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences , Northwest Street 41, Haishu District, Ningbo, 315010 , Zhejiang , China
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Palagini L, Miniati M, Massa L, Folesani F, Marazziti D, Grassi L, Riemann D. Insomnia and circadian sleep disorders in ovarian cancer: Evaluation and management of underestimated modifiable factors potentially contributing to morbidity. J Sleep Res 2021; 31:e13510. [PMID: 34716629 DOI: 10.1111/jsr.13510] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/13/2021] [Accepted: 09/26/2021] [Indexed: 12/21/2022]
Abstract
Ovarian cancer is the leading cause of gynaecological cancer deaths and the seventh most commonly diagnosed cancer among women worldwide, so that, as it is related to substantial and increasing disease burden, the management of ovarian cancer survivors should be a priority. Such issues involve prevention and management of emotional distress, anxiety/depressive symptoms, and maintenance of quality of life from initial diagnosis to post-treatment. Within this framework, sleep disturbances, in particular insomnia, are emerging as modifiable determinants of mental health, also contributing to substantial morbidity among cancer, including ovarian cancer. To this aim we conducted a systematic review according to PRISMA guidelines on prevalence and management of insomnia and circadian sleep disorders in ovarian cancer, while selecting 22 papers. Insomnia was evaluated in ovarian cancer and, while circadian sleep disturbances were poorly assessed in ovarian cancer, insomnia increased from 14% to 60% of patients. Insomnia was associated with cancer-related comorbid conditions such as emotional distress, anxiety/depressive symptoms and low quality of life. Despite this evidence, no studies have been conducted about insomnia treatment in ovarian cancer. The burden of insomnia and circadian sleep disorders in patients with ovarian cancer still needs to be addressed, and requires a call to action for the evaluation and management of these potential modifiable factors that might contribute to ovarian cancer morbidity.
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Affiliation(s)
- Laura Palagini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.,Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Federica Folesani
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy.,UniCamillus - Saint Camillus University of Health Sciences, Rome, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Van NTH, Hoang T, Myung SK. Night shift work and breast cancer risk: a meta-analysis of observational epidemiological studies. Carcinogenesis 2021; 42:1260-1269. [PMID: 34409980 DOI: 10.1093/carcin/bgab074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/28/2021] [Accepted: 08/17/2021] [Indexed: 12/09/2022] Open
Abstract
Previous observational epidemiological studies have reported inconsistently the association between night shift work (NSW) and the risk of breast cancer (BC). This study aimed to investigate those associations by using a meta-analysis of observational epidemiological studies. We searched PubMed and EMBASE using keywords related to this topic from inception till November 2020. The pooled effect sizes such as odds ratio (OR), hazard ratio (HR) or relative risk (RR) with 95% confidence interval (CI) were calculated using a random-effects model. In the meta-analysis of a total of 32 observational studies including 13 case-control studies, 4 nested case-control studies and 15 cohort studies, NSW significantly increased the risk of BC (OR/RR/HR, 1.11; 95% CI, 1.04-1.20; I2 = 72.4%). In the subgroup meta-analysis by type of study, NSW was also associated with the increased risk of BC in case-control studies (OR, 1.34; 95% CI, 1.17-1.53; I2 = 63.8%). However, no significant association was found in both nested case-control studies (OR, 1.14; 95% CI, 0.89-1.46; I2 = 65.8%) and cohort studies (RR/HR, 0.98; 95% CI, 0.93-1.03; I2 = 25.3%). Besides, there was no significant association between NSW for over 20 years and the risk of BC (OR/RR/HR, 1.03; 95% CI, 0.95-1.11; I2 = 36.6%, n = 14). Given that cohort studies provide higher evidence than case-control studies, there is no association between NSW and the risk of BC.
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Affiliation(s)
- Nhung Thi Hong Van
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do 10408, Republic of Korea
| | - Tung Hoang
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do 10408, Republic of Korea
| | - Seung-Kwon Myung
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do 10408, Republic of Korea.,Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do 10408, Republic of Korea.,Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do 10408, Republic of Korea
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Wu Y, Gui SY, Fang Y, Zhang M, Hu CY. Exposure to outdoor light at night and risk of breast cancer: A systematic review and meta-analysis of observational studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 269:116114. [PMID: 33280921 DOI: 10.1016/j.envpol.2020.116114] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 06/12/2023]
Abstract
Recent epidemiological studies have explored effects of light at night (LAN) exposure on breast cancer, but reported inconsistent findings. We performed a systematic review and meta-analysis of available evidence regarding the association of LAN assessed by satellite data with breast cancer. We conducted a systematic PubMed, Web of Science, and EMBASE database literature search until August 2020. Random-effects meta-analysis was applied to synthesis risk estimates. Heterogeneity was measured using statistics of Cochran's Q, I2, and Tau2 (τ2). We assessed publication bias through funnel plot and Egger's test. Moreover, subgroup analyses according to study design and menopausal status were performed. Risk of bias (RoB) of each included study was assessed using a domain-based RoB assessment tool. The confidence in the body of evidence was appraised using the GRADE approach for level-of-evidence translation. A total of 1157 studies were identified referring to LAN and breast cancer, from which 6 were included for quantitative synthesis. We found a significantly higher odds of breast cancer in the highest versus the lowest category of LAN exposure (OR = 1.11, 95% CI: 1.06, 1.16; I2 = 0.0%). In the subgroup analyses stratified by menopausal status and study design, significant association was found in postmenopausal women (OR = 1.07, 95% CI = 1.00, 1.13) and cohort studies (OR = 1.11, 95% CI = 1.05, 1.18), while the summary estimates of premenopausal women and case-control studies showed no significance. The level of evidence for the association of LAN exposure and breast cancer risk was graded as "moderate" with "probably low" RoB according to the NTP/OHAT framework. In conclusion, this study suggests a link of LAN exposure with risk of breast cancer. Further high-quality prospective studies, especially performed in low-to middle-income countries with improvement in the area of LAN exposure assessment are needed to advance this field.
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Affiliation(s)
- Yue Wu
- Oncology Department of Integrated Traditional and Western Medicine, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei 230022, China; The Integrated Traditional and Western Medicine Cancer Center of Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Si-Yu Gui
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Yuan Fang
- Department of Public health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Mei Zhang
- Oncology Department of Integrated Traditional and Western Medicine, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei 230022, China; The Integrated Traditional and Western Medicine Cancer Center of Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
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