Table 1.
Characteristics of included studies.
| References | Country | Study design | N of participants | Mean age | N of case | Occupations | Estimates of risk | Cancer | Covariates adjusted | Measurement of night-shift work |
|---|---|---|---|---|---|---|---|---|---|---|
| Hansen et al. (29) | Denmark | CC | 12,485 | NA | 6,281 | NA | OR = 1.5Δ▴ | Breast cancer | Age, social class, age at birth of first child, age at birth of last child, and number of children | Interview |
| Davis et al. (30) | US | CC | 1,606 | NA | 767 | NA | OR = 1.13Δ▴ | Breast cancer | Parity, family history of breast cancer, oral contraceptive use, and recent is continued use of hormone replacement therapy | Interview |
| Lie et al. (31) | Norway | NCC | 44,835 | NA | 537 | Nurses | 0–14 y: OR = 0.95Δ▴ 15–29 y: OR = 1.29Δ▴ ≥30 y: OR = 2.21Δ▴ |
Breast cancer | Total duration of work as a nurse and parity | Self-report |
| Kubo et al. (32) | Japan | CS | 14,052 | 52.14 | 31 | NA | Fixed NSW: RR = 2.3Δ▴ Rotating NSW: RR = 3.0Δ▴ |
Prostatic cancer | Age, study area, family history of prostate cancer, body mass index, smoking, alcohol drinking, job type, physical activity at work, workplace, perceived stress, educational level, and marriage status | Questionnaire |
| O'Leary et al. (33) | US | CC | 1,161 | 57.19 | 835 | NA | OR = 1.04Δ▴ | Breast cancer | Age at reference date, parity, family history, education, and history of benign breast disease. | In-house interview |
| Schwartzbaum et al. (34) | Sweden | CS | 3,250,787 | NA | 300,771 | NA | Female: OR = 1.00Δ▴ Male: OR = 1.02Δ▴ |
All cancer | Age, socioeconomic status, occupational position, and county of residence of residence | Personal interviews |
| Viswanathan et al. (4) | US | CS | 53,487 | 53.51 | 515 | Nurses | 0–9 y: RR = 0.89Δ▴ 10–19 y: RR = 1.06Δ▴ ≥20 y: RR = 1.47Δ▴ |
Uterus cancer | Age, age at menarche, age at menopause, parity, BMI, oral contraceptive use, use and duration of postmenopausal hormones, hypertension, diabetes, and smoking | Questionnaire |
| Marino et al. (35) | US | CC | 2,125 | NA | 812 | NA | OR = 1.2Δ▴ | Ovarian cancer | Multivariable adjustment | Interviews |
| Lahti et al. (36) | Finland | CS | 1,669,272 | NA | 3,813 | NA | RR = 1.10Δ▴ | Non-Hodgkin's lymphoma | Age, social class, and cohort period | Questionnaire |
| Pronk et al. (37) | China | CS | 73,049 | 52.50 | 717 | NA | 0–14 y: HR = 1.1Δ▴ 15–25 y: HR = 0.9Δ▴ >25 y: HR = 1.0Δ▴ |
Breast cancer | Age, education, family history of breast cancer, number of pregnancies, age at first birth, and occupational physical activity | Interview |
| Chu et al. (38) | China | NCC | 2,023 | NA | 408 | NA | HR = 2.54Δ▴ | Breast cancer | Potential cofounders | Interview |
| Pesch et al. (39) | Germany | CC | 1,749 | NA | 857 | NA | >0–4 y: OR = 0.64Δ▴
5–9 y: OR = 0.93Δ▴ 10–19 y: OR = 0.91Δ▴ ≥20 y: OR = 2.49Δ▴ |
Breast cancer | A potential selection bias using bootstrapping, family history of breast cancer, hormone replacement use, and number of mammograms | Interview |
| Poole et al. (40) | US | CS | 181,548 | 57.21 | 718 | Nurses | 1–2 y: HR = 1.07Δ▴ 3–5 y: HR = 0.90Δ▴ 6–9 y: HR = 0.92Δ▴ 10–14 y: HR = 1.14Δ▴ 15–19 y: HR = 1.28Δ▴ ≥20 y: HR = 0.80Δ▴ |
Ovarian cancer | Age, duration of oral contraceptive use, parity, BMI, smoking status, tubal ligation history, menopausal status, family history of ovarian cancer, duration of breast treating, and cohort | Questionnaire |
| Kubo et al. (41) | Japan | CS | 4,995 | 55.5 | 17 | NA | RR = 1.79Δ▴ | Prostate cancer | Age, body mass index, alcohol intake, smoking, exercise, and marital status | Questionnaire |
| Lie et al. (26) | Norway | NCC | 1,594 | 54.46 | 699 | Nurses | 1–14 y: OR = 1.2Δ▴ 15–29 y: OR = 1.2Δ▴ ≥30 y: OR = 0.8Δ▴ |
Breast cancer | Age, period of diagnosis, parity, family history of breast cancer in mother or sister (no/yes), and frequency of alcohol consumption at time of diagnosis | Telephone interview |
| Hansen et al. (29) | Denmark | CS | 1,117 | NA | 141 | Women military | OR = 1.4Δ▴ | Breast cancer | Age, hormone replacement therapy, number of childbirths, age at menarche, years of education, occasional sunbathing frequency, tobacco smoking status | Questionnaire |
| Parent et al. (42) | Canada | CC | 3,670 | 59.18 | 761 | NA | <5 y: OR = 1.93Δ▴ 5–10 y: OR = 1.51Δ▴ >10 y: OR = 1.67Δ▴ |
Lung cancer | None | Interview |
| Natti et al. (43) | Finland | CS | 3,095 | 36.68 | 51 | NA | Men: HR = 1.78Δ▴ Women: HR = 2.82Δ▴ |
All cancer | Age, and smoking status, and health- and work-related factors | Interview |
| Lin et al. (44) | Japan | CS | 22,224 | 52.19 | 16 | Industry | Fixed NSW: RR = 0.61Δ▴ Rotating NSW: RR = 0.83Δ▴ |
Pancreatic cancer | Age, body mass index, history of diabetes, alcohol drinking, cigarette smoking, perceived stress, and sleep time. | Questionnaire |
| Knutsson et al. (45) | Sweden | CS | 4,036 | 42.31 | 94 | NA | HR = 2.02Δ▴ | Breast cancer | Number of children, alcohol consumption, BMI, height, weight, waist, hip circumference, educational level, smoking menopausal status, status of oral contraceptive use, and hormones other than contraceptives | Questionnaire |
| Bhatti et al. (46) | US | CC | 3,322 | NA | 1,490 | NA | Invasive: OR = 1.24Δ Borderline: OR = 1.48Δ | Ovarian cancer | Age at reference, county, reference year, duration of oral contraceptive use, number of full-term pregnancies, and BMI at age 30 | Interviews self-reported |
| Fritschi et al. (47) | Australian | CC | 2,987 | NA | 1,202 | NA | OR = 1.16Δ▴ | Breast cancer | Night shift work | Questionnaire |
| Menegaux et al. (48) | France | CC | 2,549 | NA | 1,232 | NA | OR = 1.27Δ▴ | Breast cancer | Age, study area, parity, age at first full term pregnancy, age at menarche, family history of breast cancer, current hormonal replacement therapy, BMI, tobacco, and alcohol | Interview |
| Grundy et al. (49) | Canada | CC | 2,313 | 57.03 | 1,134 | NA | 0–14 y: OR = 0.95Δ▴ 15–29 y: OR = 0.93Δ▴ ≥30 y: OR = 2.21Δ▴ |
Breast cancer | Years of night shift history | Questionnaire |
| Rabstein et al. (50) | Germany | CC | 1,749 | NA | 857 | NA | OR = 1.01Δ▴ | Breast cancer | Family history of breast cancer, hormone replacement use, number of mammograms, and estrogen receptor status | Interview |
| Koppes et al. (51) | Netherland | CS | 285,723 | NA | 2,531 | Employed women | HR = 0.87Δ▴ | Breast cancer | Age, origin, children in household education, occupation, job tenure (years) | Interview |
| Gapstur et al. (52) | US | CS | 305,057 | 51.44 | 4,836 | NA | Fixed NSW: RR = 0.72Δ▴ Rotating NSW: RR = 1.08Δ▴ |
Prostate cancer | Age, race, education, BMI, smoking status, family history of prostate cancer, and painful/frequent urination | Questionnaire |
| Carter et al. (53) | US | CS | 161,004 | 50.28 | 1,253 | Employed women | Fixed NSW: R = 1.12Δ▴ Rotating NSW: RR = 1.27Δ▴ |
Ovarian cancer | Oral contraceptive use, age at menarche and menopause, tubal ligation, parity, postmenopausal estrogen use, race, family history of breast/ovarian cancers, exercise, BMI, and height | Questionnaire |
| Yong et al. (54) | Germany | CS | 27,828 | 40.05 | 1,073 | Chemical workers | HR = 1.04Δ | All cancer | Age, job level, cigarette smoking, and employment duration in categories | Questionnaire |
| Ren et al. (55) | China | CC | 1,454 | NA | 712 | NA | OR = 1.34Δ▴ | Breast cancer | Age, education, BMI, marital status, age at menarche, menopausal status, parity, activity, breastfeeding, family history of breast cancer, and other sleep factors | Database |
| Datta et al. (56) | India | CC | 150 | NA | 50 | NA | OR = 1.51Δ▴ | Breast cancer | Age, obesity factors, and food habits | Interview |
| Kwon et al. (57) | China | CS | 4,471 | 54.01 | 1,451 | Textile workers | 0–17.1 y: HR = 0.76Δ▴ 17.1–24.9 y: HR = 0.89Δ▴ 24.9–30.6 y: HR = 0.94Δ▴ >30.6 y: HR = 0.82Δ▴ |
Lung cancer | Age, smoking, parity, and endotoxin | Factory record |
| Gu et al. (58) | US | CS | 71,857 | 63.98 | 5,413 | Nurses | 1-5 y: HR = 1.03Δ▴ 6–14 y: HR=1.04Δ▴ ≥15 y: HR = 1.08Δ▴ |
All cancer | Age, alcohol consumption, physical exercise, multivitamin use, menopausal status and postmenopausal hormone use, physical exam in the past 2 years, healthy eating score (quintiles), smoking status, pack-years; BMI, and husband's education | Questionnaire |
| Hammer et al. (59) | Germany | CS | 27,828 | NA | 337 | NA | HR = 0.93Δ▴ | Prostatic cancer | Age and professional status | Questionnaire |
| Lin et al. (60) | Japan | CS | 22,224 | 52.00 | 165 | NA | NSW: HR = 0.86Δ▴ Rotating NSW: HR = 1.50Δ▴ |
Biliary tract cancer | Age, BMI, history of cholelithiasis, history of diabetes, cigarette smoking, alcohol drinking, perceived stress, and sleep time | Questionnaire |
| Akerstedt et al. (61) | Sweden | CS | 13,656 | 51.50 | 463 | NA | HR = 0.96Δ▴ | Breast cancer | Age, education level, tobacco consumption, BMI, having children, coffee consumption, previous cancer, use of hormones including oral contraceptives Physical activity Alcohol consumption | Interview |
| Li et al. (62) | China | NCC | 6,489 | 53.40 | 1,709 | Textile workers | >0–12.8 y: HR = 0.99Δ▴ >12.8–19.92 y: HR = 0.97Δ▴ >19.92–27.67 y: HR = 0.90Δ▴ >27.67 y: HR = 0.88Δ▴ |
Breast cancer | Age at the beginning of follow-up | Factory records and in-person interviews |
| Papantoniou et al.(63) | Spanish | CC | 3,486 | 57.37 | 1,708 | NA | OR = 1.18Δ▴ | Breast cancer | Age, center, educational level, parity, menopausal status, family history of breast cancer, BMI, smoking status, oral contraceptive use, leisure time physical activity, alcohol consumption, and sleep duration | Interview |
| Santi et al. (64) | Canada | CC | 1,519 | 58.00 | 744 | Nurses | OR = 1.39Δ▴ | Breast cancer | Age, family history, level of education, oral contraception use, alcohol consumption, number of births, and age of first menstruation | Questionnaire |
| Wang et al. (65) | China | CC | 1,454 | 47.50 | 712 | NA | OR = 1.34Δ▴ | Breast cancer | Age, education, BMI, age at menarche, menopausal status, parity, physical activity, breast-feeding, family history of breast cancer, and other sleep factors (24-h sleep duration, night-shift work, or daytime napping) | Interviews |
| Travis et al. (16) | UK | CS | 795,850 | 65.28 | 7,710 | NA | Million Women Study: RR = 1.00Δ▴ EPIC-Oxford: RR = 1.07Δ▴ UK Biobank: RR = 0.78Δ▴ |
Breast cancer | Socioeconomic status, parity and age at first birth, BMI, alcohol intake, strenuous physical activity, family history of breast cancer, age at menarche, oral contraceptive use, smoking, living, with a partner, and use of menopausal hormone therapy | Database |
| Heckman et al. (66) | US | CS | 74,323 | 46.67 | 212 | Nurses | <2 y: HR = 0.85Δ▴ 2–5.9 y: HR = 0.84Δ▴ 6–9.9 y: HR = 1.13Δ▴ ≥10 y: HR = 0.95Δ▴ |
Skin cancer | Years of shift work, hours of sleep, sleep adequacy, sleepy days per week, snoring, restless legs syndrome, family history of melanoma, hours spent in sun, number of severe sunburns, sunburn severity, artificial tanning frequency, annual UV at residence, moles on lower legs, natural hair color in adolescence, marital status, financial status, BMI, physical activity, smoking status, menopausal status, hormone use, and healthy eating index | Questionnaire |
| Dickerman et al. (67) | Swizerland | CS | 11,370 | 40 | 602 | NA | HR = 0.5Δ▴ Rotating NSW: HR = 1.0▴ |
Prostatic cancer | Age, education, BMI, physical activity, social class, smoking status, alcohol use, snoring, and zygosity | Questionnaire |
| Gyarmati et al. (68) | Spain | CC | 2,855 | 62.70 | 374 | NA | OR = 1.10Δ▴ | Stomach cancer | Age, sex, educational level, cent re, BMI, cigarette smoking status, family history, and physical activity level | Interviews |
| Bai et al. (69) | China | CS | 25,377 | 62.72 | 1,251 | NA | 0.1–9.9 y: HR = 1.19Δ▴ 10–19.9 y: HR = 1.06Δ▴ ≥20 y: HR = 1.08Δ▴ |
All cancer | Age, BMI, family history of cancer, alcohol drinking and smoking status, number of children, menopausal status, | Questionnaire |
| hormone replacement therapy, and contraception status | ||||||||||
| Costas et al. (70) | Spain | CC | 2,049 | 72.00 | 321 | NA | OR = 1.06Δ▴ | Leukemic cancer | Adjusted for region, age, sex, worked on a farm, family history of hematologic malignancies, body mass index, tobacco consumption, sleep problems, and education | Interview |
| Wegrzyn et al. (71) | US | CS | 193,075 | 54.72 | 9,159 | Nurses | NHS 1–14 y: HR = 1.01Δ▴ 15–29 y: HR =1 .06Δ▴ ≥30 y: HR = 0.95Δ▴ NHS2 1–9 y: HR = 1.04Δ▴ 10–19 y: HR = 0.94Δ▴ ≥20 y: HR = 1.40Δ▴ |
Breast cancer | Age, height, BMI, adolescent body size, age at menarche, age at first birth and parity combined, breast feeding, type of menopause and age duration mammography use activity, and current alcohol consumption, physical history of benign breast disease, family history of breast cancer, hormone therapy, first-degree progesterone menopausal duration of estrogen and hormone therapy | Database |
| Vistisen et al. (23) | Denmark | CS | 155,540 | 39.40 | 1,245 | Nurses | RR = 0.90Δ▴ | Breast cancer | Calendar year, age, age at birth of first child, number of births, family history of breast cancer or ovarian cancer, oral contraception, hormone replacement therapy, other sex hormones, medication, mammography screening attendance, and highest family educational level | Database |
| Jorgensen et al. (72) | Denmark | CS | 28,731 | 44.00 | 945 | Nurses | HR = 1.05Δ▴ Rotating NSW: HR = 0.91▴ |
All cancer | Age, smoking, pack-years, physical activity, BMI, alcohol consumption, diet (vegetables, fruit and fatty meat consumption), pre-existing diseases, health, stressful work environment, marital status, and female reproductive factors | Interviews self-reported |
| Akerstedt et al. (24) | Sweden | CS | 12,322 | 51.50 | 454 | NA | HR = 0.91Δ▴ | Prostatic cancer | Age, education level, tobacco consumption, BMI, having children, coffee consumption, previous cancer, BMI, body mass index. | Telephone interview |
| Behrens et al. (25) | Germany | CS | 1,757 | 66.80 | 76 | NA | HR = 2.18Δ▴ | Prostatic cancer | Age at event and adjusted for smoking (never, former smoker, current smoker) and family history of prostate cancer | Questionnaire |
| Tse et al. (73) | China | CC | 833 | 68.82 | 431 | NA | OR = 1.76Δ▴ | Prostatic cancer | Age at interview, marital status, unemployment status, family prostate cancer history, consumption of deeply fried food, consumption of pickled vegetable, and green tea drinking habits | Questionnaire |
| Papantoniou et al. (20) | US | CS | 190,810 | 42.87 | 1,965 | Nurses | NHS 1–14 y: RR = 1.04Δ▴ ≥15 y: RR = 1.15Δ▴ |
Colorectal cancer | Age, height, BMI, educational level, menopausal status, menopausal hormone | Questionnaires |
| NHS2 1–14 y: RR = 0.81Δ▴ ≥15 y: RR = 0.96Δ▴ |
therapy, first-degree family history of colorectal cancer, alcohol consumption, physical activity, smoking status, and medication | |||||||||
| Wendeu-Foyet et al. (21) | France | CC | 1,693 | NA | 818 | NA | OR = 0.97Δ▴ Fixed NSW: OR = 1.04▴ Rotating NSW: OR = 0.81▴ |
Prostatic cancer | Adjusted for age, family history of prostate cancer, race, and education level | Self-report |
| Walasa et al. (22) | Australia | CC | 760 | NA | 350 | NA | OR = 1.06Δ▴ | Colorectal cancer | Potential demographic, lifestyle, and medical confounders | Questionnaire |
| Jones et al. (74) | UK | CS | 102,869 | 45 | 2,059 | NA | HR = 1.00Δ▴ | Breast cancer | Age, time since recruitment, birth cohort, benign breast disease, family history of breast cancer in 1st degree relatives, socio-economic score, birth weight, height, BMI, age at first pregnancy, parity, breast-feeding, current oral contraceptive use before menopause, alcohol consumption, age started smoking, physical activity, etc. | Questionnaire |
| Leung et al. (19) | Canada | CC | 1,402 | NA | 496 | NA | <5.5 y: OR = 1.07Δ▴ ≥5.5 y: OR = 0.88Δ▴ |
Ovarian cancer | Adjusted for age (continuous), education (< high school, high school, college/technical, University undergraduate, University graduate) and parity (nulliparous, 1, 2, ≥3 full-term births) | Interview |
BMI, body mass index; CC, case-control study; CS, cohort study; HR, hazard ratio; N, number; NA, not available; NCC, nest case-control study; NSW, night-shift work; OR, odds ratio; RR, relative risk; NHS, nurses' health study;
Δ
data included in overall meta-analysis;
▴
data included in subgroup meta-analysis.