夜班工作与女性恶性肿瘤发生风险的初步分析:一项前瞻性队列研究OA
Preliminary analysis of night shift work and the risk of cancer in Chinese women:a prospective cohort study
背景与目的:夜班工作可能与癌症发生风险增加有关,但前瞻性人群研究证据缺乏,尤其是中国人群的证据.本研究旨在初步探讨夜班工作不同维度(包括是否参与夜班、夜班开始年龄、累计夜班年限及夜班频率)与女性癌症发生风险之间的关联.方法:本研究为前瞻性队列研究基于上海女性健康队列,通过问卷调查收集夜班暴露信息,并采用主动与被动随访相结合的方式确认新发癌症病例.该队列于 1996 年 12月—2000 年 5 月在上海市长宁区招募了符合纳入标准及排除标准且年龄在 40～70 岁的女性.采用Cox比例风险模型评估各夜班暴露变量与癌症发病风险之间的关联.对于连续性指标,直接纳入Cox模型以检验线性趋势;并采用限制性立方样条进一步探索潜在的非线性关联.本研究经上海交通大学医学院附属仁济医院伦理委员会批准(KY2024-050-C)并获得参与者知情同意.结果:共有69 244名女性纳入本研究.在经过了平均15.8年的随访后,共有8 442人发生了癌症.夜班经历、夜班开始年龄、累计夜班年限及夜班频率与癌症发病关系的多因素调整风险比没有统计学意义.夜班开始年龄、累计夜班年限和夜班频率与癌症的发病风险也未显示出线性趋势(P>0.05)或非线性关联(P>0.05).结论:未发现夜班经历、夜班开始年龄、累计夜班年限及夜班频率与女性癌症发生风险之间存在显著关联.仍需要开展更大规模、设计严谨的前瞻性研究,提供可靠的流行病学人群研究证据.
Background and purpose:Night shift work has been suggested to potentially increase the risk of cancer.However,prospective population-based evidence remains limited,particularly among Chinese populations.This study aimed to examine the associations between multiple dimensions of night shift work-including ever exposed to night shift work,age of starting night shift work,cumulative night shift work duration,and average monthly frequency of night shifts-and the risk of cancer incidence among Chinese women.Methods:A prospective study was conducted based on the Shanghai Women's Health Study.Night shift exposure was assessed via questionnaire,and incident cancer cases were identified through a combination of active and passive follow-up.The cohort was recruited from December 1996 to May 2000 in Changning District,Shanghai,comprising women aged 40-70 who met the inclusion and exclusion criteria.Associations between night shift exposure variables and cancer risk were evaluated using Cox proportional hazards regression models.Continuous night shift exposure variables were further incorporated into models as continuous form to test for linear trends,and restricted cubic splines were employed to explore the potential non-linear associations.This study was approved by the Renji Hospital Ethics Committee of Shanghai Jiao Tong University School of Medicine(KY2024-050-C)and acquired imformed consent.Results:This study included 69 244 women.With a mean follow-up of 15.8 years,8 442 cancer cases were documented.The multivariate adjusted hazard ratios of night shift exposure variables-ever exposed to night shift work,age of starting night shift work,cumulative night shift work duration,and average monthly frequency of night shifts-in relation to cancer risk were not statistically significant.Furthermore,no significant linear or non-linear associations were detected for any of these continuous night shift variables in relation to cancer incidence(P>0.05).Conclusion:This study did not identify significant associations between night shift work,in any of the dimensions examined,and cancer risk in Chinese women.Further large-scale and rigorously designed prospective studies are warranted to provide reliable population-based evidence.
沈秋明;谭玉婷;李卓颖;方婕;李泓澜;项永兵
上海交通大学医学院附属仁济医院肿瘤系统医学全国重点实验室,上海 200127||上海市肿瘤研究所流行病学研究室,上海 200032上海交通大学医学院附属仁济医院肿瘤系统医学全国重点实验室,上海 200127||上海市肿瘤研究所流行病学研究室,上海 200032上海交通大学医学院附属仁济医院肿瘤系统医学全国重点实验室,上海 200127||上海市肿瘤研究所流行病学研究室,上海 200032上海交通大学医学院附属仁济医院肿瘤系统医学全国重点实验室,上海 200127||上海市肿瘤研究所流行病学研究室,上海 200032上海交通大学医学院附属仁济医院肿瘤系统医学全国重点实验室,上海 200127||上海市肿瘤研究所流行病学研究室,上海 200032上海交通大学医学院附属仁济医院肿瘤系统医学全国重点实验室,上海 200127||上海市肿瘤研究所流行病学研究室,上海 200032
医药卫生
夜班癌症队列研究前瞻性研究女性
Night shiftCancerCohort studyProspective studyWomen
《中国癌症杂志》 2026 (2)
154-161,8
上海市抗癌协会"雏鹰"计划(SACA-CY23C03). Shanghai Anticancer Association EYAS PROJECT(SACA-CY23C03).
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