Outdoor light at night and breast cancer incidence in the Danish Nurse Cohort

Background: Knowledge of the role of melatonin, xenograft experiments, and epidemiological studies suggests that exposure to light at night (LAN) may disturb circadian rhythms, possibly increasing the risk of developing breast cancer. Objectives: We examined the association between residential outdoor LAN and the incidence of breast cancer: overall and subtypes classified by estrogen (ER) and progesterone (PR) receptor status. Methods: We used data on 16,941 nurses from the Danish Nurse Cohort who were followed-up from the cohort baseline in 1993 or 1999 through 2012 in the Danish Cancer Registry for breast cancer incidence and the Danish Breast Cancer Cooperative Group for breast cancer ER and PR status. LAN exposure data were obtained from the U.S. Defense Meteorological Satellite Program (DMSP) available for 1996, 1999, 2000, 2003, 2004, 2006, and 2010 in nW/cm(2)/sr unit, and assigned to the study participants' residence addresses during the follow-up. Time varying Cox regression models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between LAN and breast cancer, adjusting for individual characteristics, road traffic noise, and air pollution. Results: Of 16,941 nurses, 745 developed breast cancer in total during 320,289 person-years of follow-up. We found no association between exposure to LAN and overall breast cancer. In the fully adjusted models, HRs for the highest (65.8-446.4 nW/cm(2)/sr) and medium (22.0-65.7 nW/cm(2)/sr) LAN tertiles were 0.97 (95% CI: 0.77, 1.23) and 1.09 (95% CI: 0.90, 1.31), respectively, compared to the lowest tertile of LAN exposure (0-21.9 nW/cm(2)/sr). We found a suggestive association between LAN and ER-breast cancer. Conclusion: This large cohort study of Danish female nurses suggests weak evidence of the association between LAN and breast cancer incidence.

Automated summary

A large cohort study of Danish female nurses found weak evidence of the association between exposure to light at night (LAN) and breast cancer incidence, with no significant association found overall but a suggestive association with ER-negative breast cancer.