Breast cancer and circadian disruption from electric lighting in the modern world.
Breast cancer and circadian disruption from electric lighting in the modern world.
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DOI：
10.3322/caac.21218
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发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
Motta ME
中科院分区：
文献类型：
--
作者：
Stevens RG;Brainard GC;Blask DE;Lockley SW;Motta ME
乳腺癌是全世界女性癌症死亡的主要原因，但对其原因的解释有限。工业化程度最高的国家的风险最高，但发展中国家的风险也迅速上升。已知的危险因素仅占高危人群发病率的一部分，并且对于其他可能的主要风险决定因素（例如膳食脂肪）存在大量猜测和许多错误的线索。工业化的一个标志是越来越多地使用电力来照明，无论是在家庭内部还是外部。直到最近才清楚地表明，这种进化上新的、因此不自然的暴露会扰乱人类的昼夜节律，其中三个显着特征是褪黑激素的产生、睡眠和生物钟。对细胞、啮齿动物和人类的多项研究表明，昼夜节律紊乱可能对健康造成严重后果。一项创新的实验模型表明，夜间光线可显着促进大鼠体内人类乳腺癌异种移植物的生长。在人类中，夜间光照会增加患乳腺癌风险的理论导致了具体的预测，这些预测正在流行病学上得到检验：关于轮班工人的风险、盲人女性的风险以及睡眠时间对风险的影响的证据已经积累。如果夜间电灯确实可以解释部分乳腺癌负担，那么可以采取实际的干预措施，包括更有选择性地使用光，以及采用照明技术和应用的最新进展。
Breast cancer is the leading cause of cancer death among women worldwide and there is only limited explanation of why. Risk is highest in the most industrialized countries but also rising rapidly in the developing world. Known risk factors account for only a portion of the incidence in the high risk populations, and there has been considerable speculation, and many false leads, on other possibly major determinants of risk such as dietary fat. A hallmark of industrialization is the increasing use of electricity to light the night, both within the home and without. It has only recently become clear that this evolutionarily new, and thereby unnatural exposure can disrupt human circadian rhythmicity, of which three salient features are melatonin production, sleep, and the circadian clock. A convergence of research in cells, rodents, and humans suggests that the health consequences of circadian disruption may be substantial. An innovative experimental model has shown that light at night markedly increases growth of human breast cancer xenografts in rats. In humans, the theory that light exposure at night increases breast cancer risk leads to specific predictions that are being tested epidemiologically: evidence has accumulated on risk in shift workers, risk in blind women, and impact of sleep duration on risk. If electric light at night does explain a portion of the breast cancer burden then there are practical interventions that can be implemented, including more selective use of light, and adoption of recent advances in lighting technology and application.
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