目的:目的是进行系统评价和荟萃分析,以研究夜间工作与前列腺癌发展之间的关系。
方法:在CINAHL中进行了系统的文献检索,Embase,MEDLINE,和WebofScience。包括基于PECOS的研究;人群包括工作年龄以上的男性,暴露定义为夜间工作,结果定义为前列腺癌,研究设计仅限于队列研究。排除条款,偏见风险评估,数据提取由两名评审员进行。使用随机效应模型进行了荟萃分析,包括基于偏差风险评估分层的敏感性分析。我们使用漏斗图和Egger检验来评估发表偏差,并使用GRADE评估证据水平。
结果:共鉴定出528篇文章,纳入了8项队列研究.三项研究有中等偏倚风险,而5项研究有较高的偏倚风险.荟萃分析显示,合并风险比(HR)为1.0(95%CI0.6-1.7)。在敏感性分析中,中度vs.高偏倚风险研究显示,合并的HR为1.2(95%CI0.3-4.1)和0.9(95%CI0.6-1.3),分别。基于等级,证据水平被评为较低.
结论:我们发现夜间工作与前列腺癌的发生没有关联。证据被评估为有限且不一致。未来的研究包括一致的夜间工作定义,包括客观暴露数据,是非常有保证的。
OBJECTIVE: The aim was to conduct a systematic
review and meta-analysis to study the association between night work and the development of prostate cancer.
METHODS: A systematic literature search was conducted in CINAHL, Embase, MEDLINE, and Web of Science. Studies were included based on a PECOS; the population included men in/above the working age, exposure defined as night work, outcome defined as prostate cancer, and study design restricted to cohort studies. The exclusion of articles, risk-of-bias assessment, and data extraction were performed by two reviewers. A meta-analysis was conducted using a random-effects model, including a sensitivity analysis stratified based on the risk-of-bias assessment. We evaluated publication bias using a funnel plot and Egger´s test, and the level of evidence was assessed using GRADE.
RESULTS: A total of 528 articles were identified, and eight cohort studies were included. Three studies had a moderate risk of bias, while five studies had a high risk of bias. The meta-analysis showed a pooled hazard ratio (HR) of 1.0 (95% CI 0.6-1.7). In the sensitivity analysis, moderate vs. high risk-of-bias studies showed a pooled HR of 1.2 (95% CI 0.3-4.1) and 0.9 (95% CI 0.6-1.3), respectively. Based on GRADE, the level of evidence was rated low.
CONCLUSIONS: We found no association between night work and the development of prostate cancer. The evidence was assessed as limited and inconsistent. Future studies encompassing consistent definitions of night work, including objective exposure data, are highly warranted.