Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Night shift work and breast cancer: a pooled analysis of population-based case–control studies with complete work history


Night shift work has been suspected to increase breast cancer risk but epidemiological studies have been inconsistent due to heterogeneous assessment of exposure to night work. To overcome this limitation, we pooled data of five population-based case–control studies from Australia, Canada, France, Germany, and Spain into a single harmonized dataset using a common definition of night work including 6093 breast cancer cases and 6933 population controls. The odds ratio for breast cancer in women who ever worked at night for at least 3 h between midnight and 5 a.m. as compared to never night workers was 1.12 (95% CI 1.00–1.25). Among pre-menopausal women, this odds ratio was 1.26 [1.06–1.51], increasing to 1.36 [1.07–1.74] for night shifts ≥ 10 h, 1.80 [1.20–2.71] for work ≥ 3 nights/week, and 2.55 [1.03–6.30] for both duration of night work ≥ 10 years and exposure intensity ≥ 3 nights/week. Breast cancer risk in pre-menopausal women was higher in current or recent night workers (OR = 1.41 [1.06–1.88]) than in those who had stopped night work more than 2 years ago. Breast cancer in post-menopausal women was not associated with night work whatever the exposure metric. The increase in risk was restricted to ER+ tumors, particularly those who were both ER+ and HER2+ . These results support the hypothesis that night shift work increases the risk of breast cancer in pre-menopausal women, particularly those with high intensity and long duration of exposure. Risk difference between pre- and post-menopausal women deserves further scrutiny.

This is a preview of subscription content, log in to check access.


  1. 1.

    IARC. Monographs on the evaluation of carcinogenic risks to humans. In: Painting, Firefighting, and Shiftwork. Lyon: International Agency for Research on Cancer. 2010; Vol. 98.

  2. 2.

    Fritschi L, Glass DC, Heyworth JS, Aronson K, Girschik J, Boyle T, et al. Hypotheses for mechanisms linking shiftwork and cancer. Med Hypotheses. 2011;77(3):430–6.

  3. 3.

    Schernhammer ES, Kroenke CH, Laden F, Hankinson SE. Night work and risk of breast cancer. Epidemiology. 2006;17(1):108–11.

  4. 4.

    Pesch B, Harth V, Rabstein S, Baisch C, Schiffermann M, Pallapies D, et al. Night work and breast cancer—results from the German GENICA study. Scand J Work Environ Health. 2010;36(2):134–41.

  5. 5.

    Lie JA, Kjuus H, Zienolddiny S, Haugen A, Stevens RG, Kjaerheim K. Night work and breast cancer risk among Norwegian nurses: assessment by different exposure metrics. Am J Epidemiol. 2011;173(11):1272–9.

  6. 6.

    Hansen J, Lassen CF. Nested case–control study of night shift work and breast cancer risk among women in the Danish military. Occup Environ Med. 2012;69(8):551–6.

  7. 7.

    Grundy A, Richardson H, Burstyn I, Lohrisch C, SenGupta SK, Lai AS, et al. Increased risk of breast cancer associated with long-term shift work in Canada. Occup Environ Med. 2013;70(12):831–8.

  8. 8.

    Menegaux F, Truong T, Anger A, Cordina-Duverger E, Lamkarkach F, Arveux P, et al. Night work and breast cancer: a population-based case-control study in France (the CECILE study). Int J Cancer J Int du Cancer. 2013;132(4):924–31.

  9. 9.

    Fritschi L, Erren TC, Glass DC, Girschik J, Thomson AK, Saunders C, et al. The association between different night shiftwork factors and breast cancer: a case–control study. Br J Cancer. 2013;109(9):2472–80.

  10. 10.

    Wang P, Ren FM, Lin Y, Su FX, Jia WH, Su XF, et al. Night-shift work, sleep duration, daytime napping, and breast cancer risk. Sleep Med. 2015;16(4):462–8.

  11. 11.

    Papantoniou K, Castano-Vinyals G, Espinosa A, Aragones N, Perez-Gomez B, Ardanaz E, et al. Breast cancer risk and night shift work in a case–control study in a Spanish population. Eur J Epidemiol. 2016;31(9):867–78.

  12. 12.

    Pronk A, Ji BT, Shu XO, Xue S, Yang G, Li HL, et al. Night-shift work and breast cancer risk in a cohort of Chinese women. Am J Epidemiol. 2010;171(9):953–9.

  13. 13.

    Knutsson A, Alfredsson L, Karlsson B, Akerstedt T, Fransson EI, Westerholm P, et al. Breast cancer among shift workers: results of the WOLF longitudinal cohort study. Scand J Work Environ Health. 2013;39(2):170–7.

  14. 14.

    Li W, Ray RM, Thomas DB, Davis S, Yost M, Breslow N, et al. Shift work and breast cancer among women textile workers in Shanghai, China. Cancer Causes Control CCC. 2015;26(1):143–50.

  15. 15.

    Koppes LL, Geuskens GA, Pronk A, Vermeulen RC, de Vroome EM. Night work and breast cancer risk in a general population prospective cohort study in The Netherlands. Eur J Epidemiol. 2014;29(8):577–84.

  16. 16.

    Akerstedt T, Knutsson A, Narusyte J, Svedberg P, Kecklund G, Alexanderson K. Night work and breast cancer in women: a Swedish cohort study. BMJ Open. 2015;5(4):e008127.

  17. 17.

    Travis RC, Balkwill A, Fensom GK, Appleby PN, Reeves GK, Wang XS, et al. Night shift work and breast cancer incidence: three prospective studies and meta-analysis of published studies. J Natl Cancer Inst. 2016;108(12):9.

  18. 18.

    Davis S, Mirick DK, Stevens RG. Night shift work, light at night, and risk of breast cancer. J Natl Cancer Inst. 2001;93(20):1557–62.

  19. 19.

    Jia Y, Lu Y, Wu K, Lin Q, Shen W, Zhu M, et al. Does night work increase the risk of breast cancer? a systematic review and meta-analysis of epidemiological studies. Cancer Epidemiol. 2013;37(3):197–206.

  20. 20.

    Ijaz S, Verbeek J, Seidler A, Lindbohm ML, Ojajarvi A, Orsini N, et al. Night-shift work and breast cancer—a systematic review and meta-analysis. Scand J Work Environ Health. 2013;39(5):431–47.

  21. 21.

    Kamdar BB, Tergas AI, Mateen FJ, Bhayani NH, Oh J. Night-shift work and risk of breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat. 2013;138(1):291–301.

  22. 22.

    Wang F, Yeung KL, Chan WC, Kwok CC, Leung SL, Wu C, et al. A meta-analysis on dose-response relationship between night shift work and the risk of breast cancer. Ann Oncol. 2013;24(11):2724–32.

  23. 23.

    Stevens RG, Hansen J, Costa G, Haus E, Kauppinen T, Aronson KJ, et al. Considerations of circadian impact for defining ‘shift work’ in cancer studies: IARC Working Group Report. Occup Environ Med. 2011;68(2):154–62.

  24. 24.

    Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60.

  25. 25.

    Hansen J, Stevens RG. Case–control study of shift-work and breast cancer risk in Danish nurses: impact of shift systems. Eur J Cancer. 2012;48(11):1722–9.

  26. 26.

    Hansen J. Increased breast cancer risk among women who work predominantly at night. Epidemiology. 2001;12(1):74–7.

  27. 27.

    Schwartzbaum J, Ahlbom A, Feychting M. Cohort study of cancer risk among male and female shift workers. Scand J Work Environ Health. 2007;33(5):336–43.

  28. 28.

    Schernhammer ES, Laden F, Speizer FE, Willett WC, Hunter DJ, Kawachi I, et al. Rotating night shifts and risk of breast cancer in women participating in the nurses’ health study. J Natl Cancer Inst. 2001;93(20):1563–8.

  29. 29.

    Gu F, Han J, Laden F, Pan A, Caporaso NE, Stampfer MJ, et al. Total and cause-specific mortality of U.S. nurses working rotating night shifts. Am J Prev Med. 2015;48(3):241–52.

  30. 30.

    Lie JA, Roessink J, Kjaerheim K. Breast cancer and night work among Norwegian nurses. Cancer Causes Control CCC. 2006;17(1):39–44.

  31. 31.

    Tynes T, Hannevik M, Andersen A, Vistnes AI, Haldorsen T. Incidence of breast cancer in Norwegian female radio and telegraph operators. Cancer Causes Control CCC. 1996;7(2):197–204.

  32. 32.

    Wegrzyn LR, Tamimi RM, Rosner BA, Brown SB, Stevens RG, Eliassen AH, et al. Rotating night shift work and risk of breast cancer in the nurses’ health studies. Am J Epidemiol. 2017;186(5):532–40.

  33. 33.

    Stevens RG. RE: night shift work and breast cancer incidence: three prospective studies and meta-analysis of published studies. J Natl Cancer Inst. 2017;109(4).

  34. 34.

    Straif K, Baan R, Grosse Y, Secretan B, Ghissassi FE, Bouvard V, et al. Carcinogenicity of shift-work, painting, and fire-fighting. Lancet Oncol. 2007;8(12):1065–6.

Download references

Author information

Correspondence to Pascal Guénel.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (XLSX 89 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cordina-Duverger, E., Menegaux, F., Popa, A. et al. Night shift work and breast cancer: a pooled analysis of population-based case–control studies with complete work history. Eur J Epidemiol 33, 369–379 (2018).

Download citation


  • Night shift work
  • Breast cancer
  • Pooled analysis
  • Case–control study
  • Circadian disruption