Cancer Causes & Control

, Volume 27, Issue 11, pp 1361–1370 | Cite as

Sleep disruption, chronotype, shift work, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins

  • Barbra A. Dickerman
  • Sarah C. Markt
  • Markku Koskenvuo
  • Christer Hublin
  • Eero Pukkala
  • Lorelei A. Mucci
  • Jaakko KaprioEmail author
Original paper



Sleep disruption and shift work have been associated with cancer risk, but epidemiologic evidence for prostate cancer remains limited. We aimed to prospectively investigate the association between midlife sleep- and circadian-related parameters and later prostate cancer risk and mortality in a population-based cohort of Finnish twins.


Data were drawn from the Older Finnish Twin Cohort and included 11,370 twins followed from 1981 to 2012. Over the study period, 602 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between midlife sleep duration, sleep quality, chronotype, and shift work with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were employed to account for potential familial confounding.


Compared to “definite morning” types, “somewhat evening” types had a significantly increased risk of prostate cancer (HR 1.3; 95 % CI 1.1, 1.6). Chronotype significantly modified the relationship between shift work and prostate cancer risk (p-interaction <0.001). We found no significant association between sleep duration, sleep quality, or shift work and prostate cancer risk in the overall analyses and no significant association between any sleep- or circadian-related parameter and risk in co-twin analyses. Neither sleep- nor circadian-related parameters were significantly associated with prostate cancer-specific mortality.


The association between sleep disruption, chronotype, and shift work with prostate cancer risk and mortality has never before been studied in a prospective study of male twins. Our findings suggest that chronotype may be associated with prostate cancer risk and modify the association between shift work and prostate cancer risk. Future studies of circadian disruption and prostate cancer should account for this individual-level characteristic.


Prostate cancer Chronotype Shift work Sleep duration Sleep quality Prospective cohort study 



We are grateful to Kauko Heikkilä, Ph.Lic for assistance in database management.


BAD and SCM are supported by the National Cancer Institute at the National Institutes of Health Training Grant NIH T32 CA 009001. JK is supported by the Academy of Finland (Grants 265240 & 263278).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Barbra A. Dickerman
    • 1
  • Sarah C. Markt
    • 1
  • Markku Koskenvuo
    • 2
  • Christer Hublin
    • 3
  • Eero Pukkala
    • 4
    • 5
  • Lorelei A. Mucci
    • 1
  • Jaakko Kaprio
    • 2
    • 6
    • 7
    Email author
  1. 1.Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonUSA
  2. 2.Department of Public HealthUniversity of HelsinkiHelsinkiFinland
  3. 3.Finnish Institute of Occupational HealthCenter of Expertise for the Development of Work and OrganizationsHelsinkiFinland
  4. 4.Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
  5. 5.School of Health SciencesUniversity of TampereTampereFinland
  6. 6.Department of HealthNational Institute for Health and WelfareHelsinkiFinland
  7. 7.Institute for Molecular Medicine (FIMM)University of HelsinkiHelsinkiFinland

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