Shift work, night work, and the risk of prostate cancer: A meta-analysis based on 9 cohort studies

BACKGROUND: Epidemiology studies suggested that shift work or night work may be linked to prostate cancer (PCa); the relationship, however, remains controversy. METHODS: PubMed, ScienceDirect, and Embase (Ovid) databases were searched before (started from the building of the databases) February 4, 2017 for eligible cohort studies. We pooled the evidence included by a random- or fixed-effect model, according to the heterogeneity. A predefined subgroup analysis was conducted to see the potential discrepancy between groups. Sensitivity analysis was used to test whether our results were stale. RESULTS: Nine cohort studies were eligible for meta-analysis with 2,570,790 male subjects. Our meta-analysis showed that, under the fixed-effect model, the pooled relevant risk (RR) of PCa was 1.05 (95% confidence interval [CI]: 1.00, 1.11; P = .06; I(2) = 24.00%) for men who had ever engaged in night shift work; and under the random-effect model, the pooled RR was 1.08 (0.99, 1.17; P = .08; I(2) = 24.00%). Subgroup analysis showed the RR of PCa among males in western countries was 1.05 (95% CI: 0.99, 1.11; P = .09; I(2) = 0.00%), while among Asian countries it was 2.45 (95% CI: 1.19, 5.04; P = .02; I(2) = 0.00%); and the RR was 1.04 (95% CI: 0.95, 1.14; P = .40; I(2) = 29.20%) for the high-quality group compared with 1.21 (95% CI: 1.03, 1.41; P = .02; I(2) = 0.00%) for the moderate/low-quality group. Sensitivity analysis showed robust results. CONCLUSIONS: Based on the current evidence of cohort studies, we found no obvious association between night shift work and PCa. However, our subgroup analysis suggests that night shift work may increase the risk of PCa in Asian men. Some evidence of a small study effect was observed in this meta-analysis.