Domestic light at night and breast cancer risk: a prospective analysis of 105 000 UK women in the Generations Study
Domestic light at night and breast cancer risk: a prospective analysis of 105 000 UK women in the Generations Study
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DOI：
10.1038/bjc.2017.359
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发表时间：
2018-02-20
影响因子：
8.8
通讯作者：
Swerdlow, Anthony J.
中科院分区：
文献类型：
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作者：
Johns, Louise E.;Jones, Michael E.;Swerdlow, Anthony J.
背景：夜间光照(LAN)引起的昼夜节律紊乱已被认为是乳腺癌的危险因素和发病率长期增加的原因之一。到目前为止，研究主要是在设计上的生态或病例对照研究，结果是混合的。方法：我们在英国世代研究中调查了局域网与乳腺癌风险的关系。通过问卷调查获得了20岁时和研究招募时的卧室光线水平和睡眠模式。研究人员对105 866名无乳腺癌病史的参与者进行了分析。在平均6.1年的随访中，共诊断出1775例乳腺癌。结果：局域网水平与乳腺癌总体风险(与招募时最低局域网水平相比：HR-1.01，95%可信区间(CI)：0.88-1.15)、浸润性乳腺癌(HR-0.98，95%CI：0.85-1.13)或原位乳腺癌(HR-0.96，95%CI：0.83-1.11)或雌激素受体(ER)阳性(HR=0.98，95%CI：0.85-1.13)无关。95%可信区间：0.84~1.14；或阴性(HR=1.16，95%CI：0.82~1.65)。这些发现与绝经状态没有什么不同。调整睡眠时间、非正常时间睡眠(非高峰睡眠)和夜间工作史对结果没有影响。发生在20岁左右的夜间醒来暴露在阳光下与绝经前乳腺癌风险的降低有关(乳腺癌的总体HR=0.74，95%CI：0.55-0.99；ER阳性乳腺癌的HR=0.69，95%CI：0.49-0.97)。结论：在这项关于局域网的前瞻性队列分析中，没有证据表明局域网暴露于局域网会增加继发乳腺癌的风险，尽管有20多岁夜间醒来病史的绝经前女性患乳腺癌风险较低的建议值得进一步研究。
Background: Circadian disruption caused by exposure to light at night (LAN) has been proposed as a risk factor for breast cancer and a reason for secular increases in incidence. Studies to date have largely been ecological or case-control in design and findings have been mixed.Methods: We investigated the relationship between LAN and breast cancer risk in the UK Generations Study. Bedroom light levels and sleeping patterns at age 20 and at study recruitment were obtained by questionnaire. Analyses were conducted on 105 866 participants with no prior history of breast cancer. During an average of 6.1 years of follow-up, 1775 cases of breast cancer were diagnosed. Cox proportional hazard models were used to calculate hazard ratios (HRs), adjusting for potential confounding factors.Results: There was no association between LAN level and breast cancer risk overall (highest compared with lowest LAN level at recruitment: HR - 1.01, 95% confidence interval (CI): 0.88-1.15), or for invasive (HR - 0.98, 95% CI: 0.85-1.13) or in situ (HR - 0.96, 95% CI: 0.83-1.11) breast cancer, or oestrogen-receptor (ER) positive (HR = 0.98, 95% CI: 0.84-1.14); or negative (HR = 1.16, 95% CI: 0.82-1.65) tumours separately. The findings did not differ by menopausal status. Adjusting for sleep duration, sleeping at unusual times (non-peak sleep) and history of night work did not affect the results. Night waking with exposure to light, occurring around age 20, was associated with a reduced risk of premenopausal breast cancer (HR for breast cancer overall = 0.74, 95% CI: 0.55-0.99; HR for ER-positive breast cancer = 0.69, 95% CI: 0.49-0.97).Conclusions: In this prospective cohort analysis of LAN, there was no evidence that LAN exposure increased the risk of subsequent breast cancer, although the suggestion of a lower breast cancer risk in pre-menopausal women with a history of night waking in their twenties may warrant further investigation.