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Int J Cancer. 2015 Sep 1;137(5):1147-57. doi: 10.1002/ijc.29400. Epub 2015 Jan 12.

Night shift work, chronotype and prostate cancer risk in the MCC-Spain case-control study.

Papantoniou K1,2,3,4, Castaño-Vinyals G1,2,3,4, Espinosa A1,2,3,4, Aragonés N4,5,6, Pérez-Gómez B4,5,6, Burgos J4,7,8,9, Gómez-Acebo I4,10,11, Llorca J4,10,11, Peiró R4,12, Jimenez-Moleón JJ4,13, Arredondo F4,14,15, Tardón A4,16, Pollan M4,5,6, Kogevinas M1,2,3,4,17.

Author information

Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Bioanalysis Research Group, IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
Environmental and Cancer Epidemiology Area, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain.
Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta De Hierro, Madrid, Spain.
Servicio De Urología, Hospital Ramón Y Cajal, Madrid, Spain.
Instituto Ramón Y Cajal De Investigación Sanitaria (IRYCIS), Madrid, Spain.
Universidad De Alcalá De Henares, Madrid, Spain.
University of Cantabria, Santander, Spain.
IDIVAL, Santander, Spain.
Fundación Para El Fomento De La Investigación Sanitaria Y Biomédica De La Comunidad Valenciana (FISABIO), Valencia, Spain.
Department of Preventive Medicine and Public Health, Instituto De Investigación Biosanitaria Ibs.GRANADA, Hospitales Universitarios De Granada/Universidad De Granada, Granada, Spain.
Hospital Infanta Elena, Huelva, Spain.
Centro De Investigación En Salud Y Medio Ambiente (CYSMA), Universidad De Huelva, Spain.
IUOPA, Universidad De Oviedo, Asturias, Spain.
National School of Public Health, Athens, Greece.


Night shift work has been classified as a probable human carcinogen based on experimental studies and limited human evidence on breast cancer. Evidence on other common cancers, such as prostate cancer, is scarce. Chronotype is an individual characteristic that may relate to night work adaptation. We evaluated night shift work with relation to prostate cancer, taking into account chronotype and disease severity in a population based case-control study in Spain. We included 1,095 prostate cancer cases and 1,388 randomly selected population controls. We collected detailed information on shift schedules (permanent vs. rotating, time schedules, duration, frequency), using lifetime occupational history. Sociodemographic and lifestyle factors were assessed by face-to-face interviews and chronotype through a validated questionnaire. We used unconditional logistic regression analysis adjusting for potential confounders. Subjects who had worked at least for one year in night shift work had a slightly higher prostate cancer risk [Odds Ratio (OR) 1.14; 95%CI 0.94, 1.37] compared with never night workers; this risk increased with longer duration of exposure (≥ 28 years: OR 1.37; 95%CI 1.05, 1.81; p-trend = 0.047). Risks were more pronounced for high risk tumors [D'Amico classification, Relative Risk Ratio (RRR) 1.40; 95%CI 1.05, 1.86], particularly among subjects with longer duration of exposure (≥28 years: RRR 1.63; 95%CI 1.08, 2.45; p-trend = 0.027). Overall risk was higher among subjects with an evening chronotype, but also increased in morning chronotypes after long-term night work. In this large population based study, we found an association between night shift work and prostate cancer particularly for tumors with worse prognosis.


chronotype; night shift work; prognosis; prostate cancer; survival

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