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Light at Night and Breast Cancer Risk Among California Teachers

Hurley, Susana; Goldberg, Debbiea; Nelson, Davida; Hertz, Andrewa; Horn-Ross, Pamela L.a; Bernstein, Leslieb; Reynolds, Peggya,c

doi: 10.1097/EDE.0000000000000137

Background: There is convincing evidence that circadian disruption mediated by exposure to light at night promotes mammary carcinogenesis in rodents. The role that light at night plays in human breast cancer etiology remains unknown. We evaluated the relationship between estimates of indoor and outdoor light at night and the risk of breast cancer among members of the California Teachers Study.

Methods: Indoor light-at-night estimates were based on questionnaire data regarding sleep habits and use of nighttime lighting while sleeping. Estimates of outdoor light at night were derived from imagery data obtained from the US Defense Meteorological Satellite Program assigned to geocoded addresses of study participants. Analyses were conducted among 106,731 California Teachers Study members who lived in California, had no prior history of breast cancer, and provided information on lighting while sleeping. Five thousand ninety-five cases of invasive breast cancer diagnosed 1995–2010 were identified via linkage to the California Cancer Registry. We used age-stratified Cox proportional hazard models to calculate hazard ratios (HRs) with 95% confidence intervals (CIs), adjusting for breast cancer risk factors and neighborhood urbanization and socioeconomic class.

Results: An increased risk was found for women living in areas with the highest quintile of outdoor light-at-night exposure estimates (HR = 1.12 [95% CI = 1.00–1.26]; test for trend, P = 0.06). Although more pronounced among premenopausal women (HR = 1.34 [95% CI = 1.07–1.69]; test for trend, P = 0.04), the associations did not differ statistically by menopausal status (test for interaction, P = 0.34).

Conclusions: Women living in areas with high levels of ambient light at night may be at an increased risk of breast cancer. Future studies that integrate quantitative measurements of indoor and outdoor light at night are warranted.

From the aCancer Prevention Institute of California, Berkeley, CA; bDepartment of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA; and cDivision of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA.

Submitted 19 December 2013; accepted 03 April 2014.

Supported by funds provided by The Regents of the University of California, California Breast Cancer Research Program (grant number 16IB-0071) and National Cancer Institute grants R01 CA77398 and K05 CA136967.

The opinions, findings, and conclusions herein are those of the author and not necessarily represent those of The Regents of the University of California, or any of its programs. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000036C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #1U58 DP000807-01 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.

The authors report no conflicts of interest.

Correspondence: Susan Hurley, Cancer Prevention Institute of California, 2001 Center Street, Suite 700, Berkeley, CA 94704. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc