Night shift work and risk of total and site-specific cancer: results from a prospective cohort study among Chinese men

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OBJECTIVE: Epidemiological evidence on the association between night shift work and cancer risk remains limited and inconsistent. This study aimed to systematically investigate this association among Chinese men. METHODS: This population-based prospective cohort study included 61 078 men from the Shanghai Men's Health Study. Detailed information on night shift work was collected at baseline using a structured questionnaire. Cox regression model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for total cancer and ten major site-specific cancers. Restricted cubic spline functions were used to characterize the dose-response associations for key metrics. Further analysis was conducted with lag periods of 5, 10, 15 and 20 years, and potential effect modification by lifestyle factors was tested. RESULTS: During a median follow-up period of 16.1 years, 8202 incident cancer cases were identified. Participants with 11-20 years of cumulative night shift work had a higher risk of pancreatic cancer compared with never-shift workers (HR 1.59, 95% CI 1.09-2.31). This association persisted across all lag periods tested, peaking at a 15-year lag (HR 1.82, 95% CI 1.25-2.64). No significant associations were found between night shift work metrics, including night shift work experience, starting age, cumulative duration, and frequency, and the risk of total and other major site-specific cancers. No evidence of effect modification by lifestyle factors was observed. CONCLUSIONS: Night shift work was not associated with the risk of overall or some common cancers among Chinese men. However, an increased risk of pancreatic cancer was associated with intermediate-to-long-term night shift work.

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