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Cancer Epidemiol Biomarkers Prev. 2017 Jun;26(6):905-913. doi: 10.1158/1055-9965.EPI-16-0507. Epub 2017 Mar 23.

High Mammographic Density in Long-Term Night-Shift Workers: DDM-Spain/Var-DDM.

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Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
PhD student. Complutense University, Madrid, Spain.
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y SaludPública), CIBERESP, Spain.
Balearic Islands Breast Cancer Screening Program, Health Promotion for Women and Childhood, General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs, Balearic Islands, Palma de Mallorca, Spain.
Galicia Breast Cancer Screening Program, Regional Authority of Health, Galicia Regional Government, Corunna, Spain.
Castile-Leon Breast Cancer Screening Program, General Directorate Public Health SACYL, Burgos, Castile-Leon, Spain.
Aragon Breast Cancer Screening Program, Health Service of Aragon, Zaragoza, Spain.
Navarra Breast Cancer Screening Program, Public Health Institute, Pamplona, Spain.
Valencia Breast Cancer Screening Program, General Directorate Public Health, Valencia, Spain.
Cancer Prevention and Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain.
Institute of Computer Technology, Universitat Politècnica de València.
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.


Background: Night-shift work (NSW) has been suggested as a possible cause of breast cancer, and its association with mammographic density (MD), one of the strongest risk factors for breast cancer, has been scarcely addressed. This study examined NSW and MD in Spanish women.Methods: The study covered 2,752 women aged 45-68 years recruited in 2007-2008 in 7 population-based public breast cancer screening centers, which included 243 women who had performed NSW for at least one year. Occupational data and information on potential confounders were collected by personal interview. Two trained radiologist estimated the percentage of MD assisted by a validated semiautomatic computer tool (DM-scan). Multivariable mixed linear regression models with random screening center-specific intercepts were fitted using log-transformed percentage of MD as the dependent variable and adjusting by known confounding variables.Results: Having ever worked in NSW was not associated with MD [Formula: see text]:0.96; 95% confidence interval (CI), 0.86-1.06]. However, the adjusted geometric mean of the percentage of MD in women with NSW for more than 15 years was 25% higher than that of those without NSW history (MD>15 years:20.7% vs. MDnever:16.5%;[Formula: see text]:1.25; 95% CI,1.01-1.54). This association was mainly observed in postmenopausal participants ([Formula: see text]:1.28; 95% CI, 1.00-1.64). Among NSW-exposed women, those with ≤2 night-shifts per week had higher MD than those with 5 to 7 nightshifts per week ([Formula: see text]:1.42; 95% CI, 1.10-1.84).Conclusions: Performing NSW was associated with higher MD only in women with more than 15 years of cumulated exposure. These findings warrant replication in futures studies.Impact: Our findings suggest that MD could play a role in the pathway between long-term NSW and breast cancer. Cancer Epidemiol Biomarkers Prev; 26(6); 905-13. ©2017 AACR.

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