TY - JOUR T1 - Shift work and cancer – considerations on rationale, mechanisms, and epidemiology JO - Scandinavian Journal of Work, Environment & Health PY - 2010/3VL - 36 IS - 2 SP - 163 EP - 179 AU - Costa, Giovanni AU - Haus, Erhard AU - Stevens, Richard M3 - doi: 10.5271/sjweh.2899 UR - https://www.sjweh.fi/show_abstract.php?abstract_id=2899 KW - breast cancer KW - cancer KW - circadian rhythm KW - circadian rhythm disruption KW - discussion paper KW - epidemiology KW - exposure KW - health KW - health KW - LAN KW - light KW - light at night KW - mechanism KW - melatonin KW - night KW - night work KW - occupational exposure KW - prostate cancer KW - risk assessment KW - shift work KW - sleep KW - sleep deprivation N2 -

This paper summarizes the rationale for, possible mechanisms of, and problems related to risk assessment of the association between shift work and cancer. The mechanisms by which circadian disruption may favor the induction and/or promotion of malignant tumors are complex and multifactorial. The multilevel endocrine changes caused by circadian disruption with melatonin suppression through light at night (LAN) lead to the oncogenic targeting of the endocrine-responsive breast in women and possibly the prostate in men. Repeated phase shifting with internal desynchronization may lead to defects in the regulation of the circadian cell cycle, thus favoring uncontrolled growth. Sleep deprivation leads to the suppression of immune surveillance that may permit the establishment and/or growth of malignant clones. The epidemiological studies published so far, although dealing with large cohorts and controlling for several personal confounders, have defined the exposure to shift and/or night work rather loosely and consequently do not allow for the proper assessment of the risk connected with circadian disruption.

SN - 0355-3140 ER -