Night shift work and breast cancer risk: a meta-analysis of observational epidemiological studies

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.