Domestic light at night and breast cancer risk: a prospective analysis of 105 000 UK women in the Generations Study

Background: Circadian disruption caused by exposure to light at night (LAN) has been proposed as a risk factor for breast cancer and a reason for secular increases in incidence. Studies to date have largely been ecological or case-control in design and findings have been mixed. Methods: We investigated the relationship between LAN and breast cancer risk in the UK Generations Study. Bedroom light levels and sleeping patterns at age 20 and at study recruitment were obtained by questionnaire. Analyses were conducted on 105 866 participants with no prior history of breast cancer. During an average of 6.1 years of follow-up, 1775 cases of breast cancer were diagnosed. Cox proportional hazard models were used to calculate hazard ratios (HRs), adjusting for potential confounding factors. Results: There was no association between LAN level and breast cancer risk overall (highest compared with lowest LAN level at recruitment: HR - 1.01, 95% confidence interval (CI): 0.88-1.15), or for invasive (HR - 0.98, 95% CI: 0.85-1.13) or in situ (HR - 0.96, 95% CI: 0.83-1.11) breast cancer, or oestrogen-receptor (ER) positive (HR = 0.98, 95% CI: 0.84-1.14); or negative (HR = 1.16, 95% CI: 0.82-1.65) tumours separately. The findings did not differ by menopausal status. Adjusting for sleep duration, sleeping at unusual times (non-peak sleep) and history of night work did not affect the results. Night waking with exposure to light, occurring around age 20, was associated with a reduced risk of premenopausal breast cancer (HR for breast cancer overall = 0.74, 95% CI: 0.55-0.99; HR for ER-positive breast cancer = 0.69, 95% CI: 0.49-0.97). Conclusions: In this prospective cohort analysis of LAN, there was no evidence that LAN exposure increased the risk of subsequent breast cancer, although the suggestion of a lower breast cancer risk in pre-menopausal women with a history of night waking in their twenties may warrant further investigation.