Night work and breast cancer risk in a cohort of female healthcare employees in Stockholm, Sweden

Occup Environ Med. 2023 Jul;80(7):372-376. doi: 10.1136/oemed-2022-108673. Epub 2023 May 3.


Objectives: Night work has been classified as probably carcinogenic to humans by the International Agency for Research on Cancer, but epidemiological evidence was considered limited due to variability in findings and potential bias. This study aimed to investigate the risk of breast cancer in a cohort with detailed and registry-based data on night work.

Methods: The cohort comprised 25 585 women (nurses and nursing assistants) employed 1 year or more between 2008 and 2016 in the healthcare sector in Stockholm. Information on work schedules was obtained from employment records. Breast cancer cases were identified from the national cancer register. HRs were estimated by a discrete time proportional hazards model, adjusting for age, country of birth, profession and childbirth.

Results: There were 299 cases of breast cancer, 147 in premenopausal and 152 in postmenopausal women. The adjusted HR of postmenopausal breast cancer in association with ever versus never working nights was 1.31 (95% CI 0.91 to 1.85). Eight or more years of night work was associated with an increased risk of postmenopausal breast cancer, HR=4.33 (95% CI 1.45 to 10.57), based on five cases only, though.

Conclusions: This study is limited by a short period of follow-up and a lack of information on night work before 2008. Most exposure metrics showed no association with breast cancer risk, but there was an elevated risk of postmenopausal breast cancer in women after 8 or more years of night work.

Keywords: Cancer; Epidemiology; Health Personnel; Occupational Health; Shift Work Schedule.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms* / epidemiology
  • Breast Neoplasms* / etiology
  • Delivery of Health Care
  • Female
  • Humans
  • Risk Factors
  • Sweden / epidemiology
  • Work Schedule Tolerance