背景:这项研究的假设是夜班工作暴露会增加女性乳腺癌的风险。为了验证这个假设,作者对该主题进行了两阶段剂量-反应荟萃分析,提高了质量.
方法:医学图书馆员搜索PubMed,EMBASE,和12月30日的Cochrane图书馆,2022年。确定了八项纳入标准,并将其严格应用于选择过程。采用可靠的剂量-反应荟萃分析方法。
结果:可靠的10个队列(总病例:15,953,总人年:6,812,138)和11个病例对照报告(总病例:9196,总对照:12,210)包括在最终分析中。夜班工作暴露1、10、20和30年女性乳腺癌(来自队列研究)的合并风险比(RR)为1.0042(95%CI1.0014-1.0070),1.0425(95%CI1.0138-1.0719),1.0867(95%CI1.0278-1.1490),和1.1328(95%CI1.0419-1.2317),分别。夜班工作暴露1、10、20和30年女性乳腺癌(来自病例对照研究)的合并比值比(OR)为1.0213(95%CI1.0108-1.0319),1.2346(95%CI1.1129-1.3695),1.5242(95%CI1.2386-1.8756),和1.8817(95%CI1.3784-2.5687),分别。
结论:从剂量-反应荟萃分析的角度来看,这项研究有几个优点:严格应用8项纳入标准,来自队列研究的单独合成的RR和来自病例对照研究的OR,明确定义的暴露剂量,每个风险估计都需要多年的夜班工作,可靠的剂量-反应荟萃分析方法,仔细考虑选择,暴露,以及每项研究的结果偏差和混淆调整。对潜在偏见和混淆的仔细考虑导致排除了不可靠的两个队列和五个病例对照研究。
BACKGROUND: The hypothesis of this study is night shift work exposure can increase the risk of female breast cancer. To validate this hypothesis, the authors conducted a two-stage dose-response meta-analysis with improved quality on this topic.
METHODS: The medical librarian searched PubMed, EMBASE, and the Cochrane Library on December 30th, 2022. The eight inclusion criteria were determined and strictly applied to the selection process. A reliable dose-response meta-analysis methodology was applied.
RESULTS: Reliable 10 cohort (total cases: 15,953, and total person-years: 6,812,138) and 11 case-control reports (total cases: 9196, and total controls:12,210) were included in the final analysis. The pooled risk ratio (RR) of female breast cancer (from cohort studies) for 1, 10, 20, and 30 years of night shift work exposure was 1.0042 (95% CI 1.0014-1.0070), 1.0425 (95% CI 1.0138-1.0719), 1.0867 (95% CI 1.0278-1.1490), and 1.1328 (95% CI 1.0419-1.2317), respectively. The pooled odds ratio (OR) of female breast cancer (from case-control studies) for 1, 10, 20, and 30 years of night shift work exposure was 1.0213 (95% CI 1.0108-1.0319), 1.2346 (95% CI 1.1129-1.3695), 1.5242 (95% CI 1.2386-1.8756), and 1.8817 (95% CI 1.3784-2.5687), respectively.
CONCLUSIONS: This study has several strengths from the perspective of a dose-response meta-analysis: Strictly applied eight inclusion criteria, separately synthesized RRs from cohort studies and ORs from case-control studies, clearly defined exposure dose, years of night shift work for each risk estimate, a reliable dose-response meta-analysis methodology, and careful considering of selection, exposure, and outcome biases and confounder adjustment for each study. This careful consideration of potential biases and confounding led to the exclusion of unreliable two cohort and five case-control studies.