Night work and cancer risk: results from the ELSA-Brasil worker cohort

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DOI:

https://doi.org/10.11606/s15188787.2026060007579

Keywords:

Night Work, Occupational Exposure, Occupational Cancer, Cancer, Cohort Studies

Abstract

OBJECTIVE: To estimate the association between exposure to night work and the incidence of breast, prostate, and colorectal cancer among participants in the Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil – Longitudinal Study of Adult Health).  METHODS: ELSA-Brasil is a multicenter cohort study conducted in the Northeast, South, and Southeast regions of Brazil. A total of 14,787 participants were included at baseline (2008–2010) and followed through 2023, with a mean follow-up duration of 13 years (SD = 2.22). Exposure to night work was defined based on self-reported occupational history, considering cumulative duration. Incidence cases of cancer were identified during follow-up. Associations were estimated using Cox regression models, adjusted for sociodemographic, behavioral, and occupational variables. RESULTS: Exposure to night work for more than ten years was associated with an increased risk of prostate cancer (HR = 1.38; 95% CI 1.09–1.75) and colorectal cancer (HR = 1.35; 95% CI 1.09–1.68), compared with exposure to day work. No association was observed between breast cancer and night work (HR = 0.89; 95% CI 0.65–1.22). CONCLUSION: The results suggest that prolonged exposure to night work may increase the risk of cancer, particularly prostate and colorectal cancer. This is the first study from the  ELSA-Brasil cohort to analyze cancer incidence, expanding knowledge on work-related  cancer and reinforcing the carcinogenic potential of night work, with implications for occupational health surveillance and cancer prevention policies in public health.

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References

1. International Agency for Research on Cancer. Night shift work. Lyon: IARC; 2020.

2. Chopra R, Li H, Xie W, Lam DHT, Chan FL. Arrhythmic expression signatures of circadian clock-associated transcription factors and chronic circadian disruption contribute to advanced prostate cancer growth. Int J Cancer. 2025;158(3):775-89. https://doi.org/10.1002/ijc.70149

3. Li DD, Zhou T, Gao J, Wu GL, Yang GR. Circadian rhythms and breast cancer: from molecular level to therapeutic advancements. J Cancer Res Clin Oncol. 2024;150(9):419. https://doi.org/10.1007/s00432-024-05917-w

4. Hong J, He Y, Fu R, Si Y, Xu B, Xu J et al. The relationship between night shift work and breast cancer incidence: a systematic review and meta-analysis of observational studies. Open Med (Wars). 2022;17(1):712-31. https://doi.org/10.1515/med-2022-0470

5. Lorca ML, Olmedo-Requena R, Vega-Galindo MV, Vázquez-Alonso F, Jiménez-Pacheco A, Salcedo-Bellido I et al. Night shift work, chronotype, sleep duration, and prostate cancer risk: CAPLIFE study. Int J Environ Res Public Health. 2020;17(17):6300. https://doi.org/10.3390/ijerph17176300

6. Rivera AS, Akanbi M, O’Dwyer LC, McHugh M. Shift work and long work hours and their association with chronic health conditions: a systematic review of systematic reviews with meta-analyses. PLoS One. 2020;15(4):e0231037. https://doi.org/10.1371/journal.pone.0231037

7. Sweeney MR, Sandler DP, Niehoff NM, White AJ. Shift work and working at night in relation to breast cancer incidence. Cancer Epidemiol Biomarkers Prev. 2020;29(3):687-9. https://doi.org/10.1158/1055-9965.EPI-19-1314

8. Shi Y, Liu L, Hamada T, Nowak JA, Giannakis M, Ma Y et al. Night-shift work duration and risk of colorectal cancer according to IRS1 and IRS2 expression. Cancer Epidemiol Biomarkers Prev. 2020;29(1):133-40. https://doi.org/10.1158/1055-9965.EPI-19-0325

9. Wichert K, Rabstein S, Stang A, Erbel R, Eisele L, Arendt M et al. Associations between shift work and risk of colorectal cancer in two German cohort studies. Chronobiol Int. 2020;37(8):1235-43. https://doi.org/10.1080/07420528.2020.1782930

10. Fernandes GA, Wünsch-Filho V. Ocupação e câncer no Brasil: um desafio perene. Rev Bras Saude Ocup. 2023;48:edcinq10. https://doi.org/10.1590/2317-6369/35422pt2023v48edcinq10

11. Schmidt MI, Griep RH, Passos VM, Luft VC, Goulart AC, Menezes GMS et al. Estratégias e desenvolvimento de garantia e controle de qualidade no ELSA-Brasil. Rev Saúde Pública. 2013;47(Suppl 2):105-12. https://doi.org/10.1590/S0034-8910.2013047003889

12. Aquino EML, Barreto SM, Bensenor IM, Carvalho MS, Chor D, Duncan BB et al. Brazilian longitudinal study of adult health (ELSA-Brasil): objectives and design. Am J Epidemiol. 2012;175(4):315-24. https://doi.org/10.1093/aje/kwr294

13. Instituto Nacional de Câncer. Estimativa 2023: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2022 [citado 2023 mar 2]. Disponível em: https://bvsms.saude.gov.br/inca-lanca-aestimativa-2023-incidencia-de-cancer-no-brasil/

14. Silva-Costa A. Trabalho noturno e diabetes tipo 2: resultados da linha de base do estudo longitudinal de saúde do adulto ELSA-Brasil [tese]. Rio de Janeiro: Escola Nacional de Saúde Pública Sergio Arouca; 2015 [citado 2023 fev 1]. Disponível em: https://www.arca.fiocruz.br/ handle/icict/12853

15. International Consensus Group Workig Group. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ): short and long forms. Geneva: International Consensus Group Workig Group; 2005.

16. Instituto Nacional de Câncer. Dieta, nutrição, atividade física e câncer: uma perspectiva global – resumo do terceiro relatório de especialistas com uma perspectiva brasileira. Rio de Janeiro: INCA; 2020 [citado 2025 maio 29]. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca. local/files/media/document/dieta_nutricao_atividade_fisica_e_cancer_resumo_do_terceiro_ relatorio_de_especialistas_com_uma_perspectiva_brasileira.pdf

17. National Cancer Institute. Age and cancer risk. Bethesda: NCI; 2025 [citado 2025 jun 22]. Disponível em: https://www.cancer.gov/about-cancer/causes-prevention/risk/age

18. Barber LE, VoPham T, White LF, Roy HK, Palmer JR, Bertrand KA. Circadian disruption and colorectal cancer incidence in Black women. Cancer Epidemiol Biomarkers Prev. 2023;32(7):927-35. https://doi.org/10.1158/1055-9965.EPI-22-0808

19. Berge LAM, Liu FC, Grimsrud TK, Babigumira R, Støer NC, Kjærheim K et al. Night shift work and risk of aggressive prostate cancer in the Norwegian Offshore Petroleum Workers cohort. Int J Epidemiol. 2023;52(4):1003-14. https://doi.org/10.1093/ije/dyac235

20. Walasa WM, Carey RN, Si S, Fritschi L, Heyworth JS, Fernandez RC et al. Association between shiftwork and the risk of colorectal cancer in females: a population-based case-control study. Occup Environ Med. 2018;75(5):344-50. https://doi.org/10.1136/oemed-2017-104657

21. Åkerstedt T, Narusyte J, Svedberg P, Kecklund G, Alexanderson K. Night work and prostate cancer in men: a Swedish prospective cohort study. BMJ Open. 2017;7(6):e015751. https://doi.org/10.1136/bmjopen-2016-015751

22. Yang G, Yang Y, Lv K, Wu Y, Song T, Yuan Q. Night shift work and prostate cancer: a large cohort study from UK Biobank and Mendelian randomisation study. BMJ Open. 2024;14(12):e084401. https://doi.org/10.1136/bmjopen-2024-084401

23. Härmä M, Kecklund G, Tucker P. Working hours and health: key research topics in the past and future. Scand J Work Environ Health. 2024;50(4):233-43. https://doi.org/10.5271/sjweh.4157

24. Gustavsson P, Bigert C, Andersson T, Kader M, Härmä M, Selander J et al. Night work and breast cancer risk in a cohort of female healthcare employees in Stockholm, Sweden. Occup Environ Med. 2023;80(7):372-6. https://doi.org/10.1136/oemed-2022-108673

25. Bernardino DCDAM, Otero UB, Pimenta IT, Giatti L, Griep RH, Fonseca MDJM. Fatores ocupacionais e socioeconômicos e mortalidade por câncer em participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil): uma análise de correspondência múltipla. Rev Bras Epidemiol. 2025;28:e250022. https://doi.org/10.1590/1980-549720250022.2

26. Ribeiro R, Araújo GS. Segregação ocupacional no mercado de trabalho segundo cor e nível de escolaridade no Brasil contemporâneo. Nova Econ. 2016;26(1):147-77. https://doi.org/10.1590/0103-6351/2652

27. Szklo M, Nieto FJ. Epidemiology: beyond the basics. 4th ed. Burlington: Jones & Bartlett Learning; 2019.

28. Ferrell JM. Chronobiology of cancers in the liver and gut. Cancers (Basel). 2024;16(17):2925. https://doi.org/10.3390/cancers16172925

29. Zhu Y, Zheng Y, Dai R, Gu X. Crosstalk between circadian rhythm dysregulation and tumorigenesis, tumor metabolism and tumor immune response. Aging Dis. 2024;16(4):2073-99. https://doi.org/10.14336/AD.2024.0533

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Published

2026-09-01

Issue

Vol. 60 (2026)

Section

Original Articles

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Copyright (c) 2026 Débora Cristina de Almeida Mariano Bernardino, Ubirani Barros Otero, Isiyara Taverna Pimenta, Rosane Harter Griep, Luana Giatti, Sandhi Maria Barreto, Maria de Jesus Mendes da Fonseca

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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Bernardino, D. C. de A. M., Otero, U. B., Pimenta, I. T., Griep, R. H., Giatti, L., Barreto, S. M., & Fonseca, M. de J. M. da. (2026). Night work and cancer risk: results from the ELSA-Brasil worker cohort. Revista De Saúde Pública, 60, e40. https://doi.org/10.11606/s15188787.2026060007579