Vicente Javier Clemente-Suarez , Eduardo Navarro-Jiménez , Juan Camilo Benitez-Agudelo , Ana Isabel Beltrán-Velasco , Pedro Belinchón-deMiguel , Domingo Jesús Ramos-Campo , Carlota Valeria Villanueva-Tobaldo , Alexandra Martín-Rodríguez , Jose Francisco Tornero-Aguilera
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Modern societal patterns—shift work, artificial light at night, and irregular sleep schedules—have exacerbated these risks.</div></div><div><h3>Methods</h3><div>We conducted a systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, screening over 500 studies published between 2003 and 2023 from PubMed, Scopus, Embase, ScienceDirect, and Web of Science. Inclusion criteria focused on peer-reviewed epidemiological and mechanistic studies linking circadian disruption with cancer risk. The Newcastle-Ottawa Scale was used for methodological quality assessment.</div></div><div><h3>Results</h3><div>A total of 75 high-quality studies were included. Strong evidence supports associations between circadian disruption and breast, prostate, and colorectal cancers, with limited but emerging evidence for melanoma and bladder cancer. Mechanistic pathways involve melatonin suppression, dysregulation of CLOCK and BMAL1 genes, reduced natural killer cell activity, and chronic inflammation due to metabolic imbalance. Light-at-night (LAN) exposure and prolonged night shift work were consistently identified as major risk factors. Furthermore, economic analyses reveal a substantial burden due to increased healthcare costs and productivity losses, particularly in shift work-dominated sectors.</div></div><div><h3>Conclusions</h3><div>Circadian misalignment is a critical, yet often overlooked, contributor to cancer incidence and associated economic burdens. Public health strategies—such as regulating shift schedules, reducing LAN exposure, and promoting chronotherapy—are essential to mitigate these risks. Further research should address sex-based differences, improve exposure measurement, and extend investigations to low- and middle-income countries.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 5","pages":"Pages 524-536"},"PeriodicalIF":9.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The multifaceted impact of circadian disruption on cancer risk: a systematic review of insights and economic implications\",\"authors\":\"Vicente Javier Clemente-Suarez , Eduardo Navarro-Jiménez , Juan Camilo Benitez-Agudelo , Ana Isabel Beltrán-Velasco , Pedro Belinchón-deMiguel , Domingo Jesús Ramos-Campo , Carlota Valeria Villanueva-Tobaldo , Alexandra Martín-Rodríguez , Jose Francisco Tornero-Aguilera\",\"doi\":\"10.1016/j.jncc.2025.04.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Circadian disruption has emerged as a significant risk factor for cancer, driven by mechanisms such as hormonal imbalances, impaired DNA repair, immune suppression, and metabolic dysregulation. 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Mechanistic pathways involve melatonin suppression, dysregulation of CLOCK and BMAL1 genes, reduced natural killer cell activity, and chronic inflammation due to metabolic imbalance. Light-at-night (LAN) exposure and prolonged night shift work were consistently identified as major risk factors. Furthermore, economic analyses reveal a substantial burden due to increased healthcare costs and productivity losses, particularly in shift work-dominated sectors.</div></div><div><h3>Conclusions</h3><div>Circadian misalignment is a critical, yet often overlooked, contributor to cancer incidence and associated economic burdens. Public health strategies—such as regulating shift schedules, reducing LAN exposure, and promoting chronotherapy—are essential to mitigate these risks. Further research should address sex-based differences, improve exposure measurement, and extend investigations to low- and middle-income countries.</div></div>\",\"PeriodicalId\":73987,\"journal\":{\"name\":\"Journal of the National Cancer Center\",\"volume\":\"5 5\",\"pages\":\"Pages 524-536\"},\"PeriodicalIF\":9.4000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the National Cancer Center\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2667005425000651\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the National Cancer Center","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667005425000651","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
在激素失衡、DNA修复受损、免疫抑制和代谢失调等机制的驱动下，昼夜节律紊乱已成为癌症的重要危险因素。现代社会模式——轮班工作、夜间人工照明和不规律的睡眠时间表——加剧了这些风险。方法：我们按照系统评价和荟萃分析（PRISMA）指南的首选报告项目进行了系统评价，筛选了2003年至2023年间发表在PubMed、Scopus、Embase、ScienceDirect和Web of Science上的500多项研究。纳入标准侧重于同行评审的流行病学和机制研究，将昼夜节律紊乱与癌症风险联系起来。采用纽卡斯尔-渥太华量表进行方法学质量评价。结果共纳入75项高质量研究。强有力的证据支持昼夜节律紊乱与乳腺癌、前列腺癌和结直肠癌之间的关联，而与黑色素瘤和膀胱癌相关的证据有限，但正在出现。机制途径包括褪黑激素抑制、CLOCK和BMAL1基因失调、自然杀伤细胞活性降低以及代谢失衡引起的慢性炎症。夜间光照和长时间的夜班工作一直被认为是主要的危险因素。此外，经济分析显示，由于医疗成本增加和生产力损失，特别是在轮班工作为主的部门，造成了巨大负担。结论昼夜节律失调是导致癌症发病率和相关经济负担的关键因素，但往往被忽视。公共卫生策略——如调节轮班时间表、减少局域网接触和促进时间疗法——对于减轻这些风险至关重要。进一步的研究应解决基于性别的差异，改进暴露测量，并将调查扩大到低收入和中等收入国家。
The multifaceted impact of circadian disruption on cancer risk: a systematic review of insights and economic implications
Background
Circadian disruption has emerged as a significant risk factor for cancer, driven by mechanisms such as hormonal imbalances, impaired DNA repair, immune suppression, and metabolic dysregulation. Modern societal patterns—shift work, artificial light at night, and irregular sleep schedules—have exacerbated these risks.
Methods
We conducted a systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, screening over 500 studies published between 2003 and 2023 from PubMed, Scopus, Embase, ScienceDirect, and Web of Science. Inclusion criteria focused on peer-reviewed epidemiological and mechanistic studies linking circadian disruption with cancer risk. The Newcastle-Ottawa Scale was used for methodological quality assessment.
Results
A total of 75 high-quality studies were included. Strong evidence supports associations between circadian disruption and breast, prostate, and colorectal cancers, with limited but emerging evidence for melanoma and bladder cancer. Mechanistic pathways involve melatonin suppression, dysregulation of CLOCK and BMAL1 genes, reduced natural killer cell activity, and chronic inflammation due to metabolic imbalance. Light-at-night (LAN) exposure and prolonged night shift work were consistently identified as major risk factors. Furthermore, economic analyses reveal a substantial burden due to increased healthcare costs and productivity losses, particularly in shift work-dominated sectors.
Conclusions
Circadian misalignment is a critical, yet often overlooked, contributor to cancer incidence and associated economic burdens. Public health strategies—such as regulating shift schedules, reducing LAN exposure, and promoting chronotherapy—are essential to mitigate these risks. Further research should address sex-based differences, improve exposure measurement, and extend investigations to low- and middle-income countries.
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