Night Work May Shift Prostate Level Higher
25% of US Is Not on a Regular 9 to 5
Men engaged in shift work, including working at night or on a rotating schedule, had an increased likelihood of having an elevated prostate-specific antigen (PSA) value, according to new American research.
Specifically, there was a statistically significant association between current shift work and an elevated PSA of 4.0 ng/mL or greater. The study is based on data from the National Health and Nutrition Examination Survey (NHANES).
The findings are consistent with prior reports that suggest shiftwork is a risk factor for prostate cancer and extend these findings by demonstrating that PSA level is elevated among shiftworkers compared to nonshiftworkers.
The study was published online August 13 in the Journal of the National Cancer Institute.
The authors acknowledge that the study may be a red herring because shift work might be a risk factor for prostatitis or benign prostatic hyperplasia, the 2 other conditions associated with elevated PSA.
However, there is enough evidence tying shift work and cancer that the World Health Organization categorized shift work (with circadian disruption) as a “probable carcinogen,” the authors point out.
Indeed, men working at night had approximately double the risk of those who did not work the night shift for a variety of malignancies, including prostate cancer, according to a 2012 Canadian case-control study. Much of the previous work on the link between cancer and night shifts has focused on breast cancer; there has even been compensation awarded to flight attendants in Europe. Recently, a study demonstrated a possible link between night shift work and ovarian cancer.
Approximately 25% of the US population either punches the clock at night or is on rotating shifts; so this issue, including its possible relation to developing prostate cancer.
Age, race, and family history are in need of supplementation as predictive factors, write Eric Singer, MD, and Robert DiPaola, MD, of the Rutgers Cancer Institute of New Jersey in New Brunswick.
Other research confirmed the link between shift work and PSA level as well as prostate cancer, then circadian rhythms could join other potential risk factors such as lifestyle (eg, exercise), nutrition (eg, diet content and caloric intake), and other medical conditions in a “more nuanced” predictive nomogram.
Two and a Half Times the Risk
NHANES, which provides a representative sample of adult, noninstitutionalized American men, is a “unique vehicle” for the new study, say the editorialists, because both occupational and PSA information are available for analysis.
The study authors accessed 3 years of data (ranging from 2005 – 2010 surveys) and found a total of 2017 men (aged 40 – 65 years) having a current PSA test result and no history of cancer.
Out of that group, which included a mix of men working regular jobs and those doing shift work, 3% of the men had a total PSA level of 4.0 ng/mL or greater.
A PSA result of 4.0 ng/mL or greater was considered elevated because this value has historically been used as the clinical threshold for screening.
The age-adjusted odds ratio for having a total PSA result of 4.0 ng/mL or greater among shift workers compared with non–shift workers was 2.48 (95% confidence interval [CI] = 1.08 – 5.70; P = .03).
J Natl Cancer Inst. Published online August 13, 2013. Abstract, Editorial
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