Shift Work and Prostate Cancer: An Updated Systematic Review and Meta-Analysis

Rivera-Izquierdo, Mario; Martínez-Ruiz, Virginia; Castillo-Ruiz, Elena Mercedes; Manzaneda-Navío, Miriam; Pérez‐Gómez, Beatriz; Jiménez-Moleón, José Juan

doi:10.3390/ijerph17041345

Cited by 23 publications

(14 citation statements)

References 60 publications

(135 reference statements)

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“…Recent meta-analyses evaluating occupational exposure proposed asbestos, organochlorine pesticides, chromium, and shift work as risk factors for PCa incidence [7,64,65]. Conversely, these studies were unable to show an association between rotating/night shift work and PCa [66]. A wide variety of dietary factors have been proposed to be associated with the risk of overall and aggressive PCa.…”

Section: Environmental and Occupational Exposurementioning

confidence: 99%

Epidemiology and Prevention of Prostate Cancer

Gandaglia

Leni

Bray

et al. 2021

European Urology Oncology

312

131

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Context: Worldwide, prostate cancer (PCa) represents the second most common solid tumor in men. Objective: To assess the geographical distribution of PCa, epidemiological differences, and the most relevant risk factors for the disease. Evidence acquisition: Estimated incidence, mortality, and prevalence of PCa for the year 2020 in 185 countries were derived from the IARC GLOBOCAN database. A review of English-language articles published between 2010 and 2020 was conducted using MEDLINE, EMBASE, and Scopus to identify risk factors for PCa. Evidence synthesis: In the year 2020, there were over 1 414 000 estimated new cases of PCa worldwide, with an age-standardized rate (ASR) incidence of 31 per 100 000 (lifetime cumulative risk: 3.9%). Northern Europe has the highest all-age incidence ASR (83), while the lowest ASR was in South-Central Asia (6.3). In the year 2020, there were over 375 000 estimated deaths worldwide, and the overall mortality ASR was 7.7 per 100 000, with the highest ASR in the Caribbean (28) and the lowest in South-Central Asia (3.1). Family history, hereditary syndromes, and race are the strongest risk factors for PCa. Metabolic syndrome was associated with the risk of developing PCa, high-grade disease, and adverse pathology. Diabetes and exposure to ultraviolet rays were found to be inversely associated to PCa incidence. Cigarette smoking and obesity may increase PCa-specific mortality, while regular physical activity may reduce disease progression. Although 5-alpha reductase inhibitors are known to be associated with a reduced incidence of PCa, available studies failed to show an effect on overall mortality. Conclusions: Family history, race, and hereditary syndromes are well-established risk factors for PCa. Modifiable risk factors may impact the risk of developing PCa and that of dying from the disease, but little evidence exist for any clear indication for prevention other than early diagnosis to reduce PCa mortality. Patient summary: Prostate cancer (PCa) rates vary profoundly worldwide, with incidence and mortality rates being highest in Northern Europe and Caribbean, respectively. South-Central Asia has the lowest epidemiological burden. Family history, race, and hereditary syndromes are well-established risk factors for PCa. Modifiable risk factors

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Section: Environmental and Occupational Exposurementioning

confidence: 99%

Epidemiology and Prevention of Prostate Cancer

Gandaglia

Leni

Bray

et al. 2021

European Urology Oncology

312

131

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“…It was noted that studies with lower population samples were of 'fair' quality and also reported higher incidence rates than the 'good' quality study. This phenomenon of likelihood of publishing studies with lower sample sizes and positive associations has been previously described by researchers [70]. Additionally, studies with fair quality were also older (published in the 1990s) than the 'good' quality study (published in 2003) [25].…”

Section: Other Considerationsmentioning

confidence: 61%

Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis

Khanani¹,

McClintock²,

Fernando³

et al. 2022

SIUJ

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Commercial airline cockpit crew (CCC) are potentially exposed to occupational risk factors that may have detrimental health effects. However, available literature on prostate cancer (PCa) as a health outcome is conflicted. Therefore, this review of cohort studies aims to evaluate the incidence of and mortality from PCa in CCC based on studies published to date. PubMed, Medline, EMBASE and SCOPUS were searched from 1946 to April 2021. Cohort studies reporting standardized incidence ratios (SIR) and/or standardized mortality ratios (SMR) of PCa in CCC were included. Military, cabin crew and service personnel data were excluded. Independent data extraction was conducted, and study quality assessed. Standardized ratios were pooled using a fixed effects model and expressed with 95% confidence intervals. 75 studies were assessed for eligibility from which 6 involving 129 374 licensed CCC were included in the final analysis: Two reported incidence only, 1 incidence and mortality and 3 reported mortalities only. The pooled SIR for PCa in CCC was 1.41 (95% CI 1.17 to 1.71) with moderate heterogeneity (I2 = 53%) however, the pooled SMR was not statistically significant (1.08; 95% CI 0.94 to 1.24) also with moderate heterogeneity (I2 = 70%). The available evidence shows that CCC are at a higher risk of developing PCa but there is no evidence to suggest a similarly higher risk of death from the disease. The effect of early detection through PSA testing in this cohort is unclear. Occupational exposure to radiation and sleep disturbance may play a role, but clear evidence of additional risk is lacking. Our review indicates that most evidence is dated and to confidently assess contemporary health outcomes of CCC, further research is required.

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“…16,17 However, this stands in contrast with the most recent systematic reviews and meta-analyses, in which no associations were found between night shift work and prostate cancer. 14,15 Based on autopsy findings, prostate cancers may have latency times of up to 15-20 years, the estimated time period from the first malignant transformation of cells to clinical diagnosis. 36 The effect estimates in our analysis indicated that the hazard of aggressive prostate cancer is not affected by 10, 15 and 20 years of f Cox regression adapted to a case cohort design with age as the time scale.…”

Section: Discussionmentioning

confidence: 99%

“…6 The International Agency for Research on Cancer (IARC) recently reconfirmed its classification of night shift work as a probable human carcinogen (group 2A), with limited positive evidence for prostate cancer. 6 Individual studies [7][8][9][10][11][12][13] as well as systematic reviews and meta-analyses 14,15 have shown inconsistent results, although positive associations have been found for aggressive prostate cancer and longer durations of night shift work exposure. 10,11 A positive association with prostate cancer has also been found in relation to rotating shift work (day and night shift rotation).…”

Section: Introductionmentioning

confidence: 99%