Anastasia Bothou

University of West Attica, Greece

Title: Night Shift Work and Breast Cancer Risk: A Systematic Review of Current Evidence and Implications for Healthcare Professionals

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Biography

Anastasia Bothou is an Assistant Professor in the Department of Midwifery at the University of West Attica, specializing in Gynecological Care and Breast Health. She graduated first in her class from the Department of Midwifery at the Technological Educational Institute of Athens and holds two MSc degrees in Female Reproduction and Gynecologic & Breast Oncology, as well as a PhD from Democritus University of Thrace, with a focus on breast cancer risk factors. She has extensive clinical experience at “Alexandra” General Hospital and REA Maternity Hospital, providing midwifery, neonatal, and breast health care. Dr. Bothou has also taught in undergraduate and postgraduate programs in Greece and abroad. Her scientific work includes more than 112 peer-reviewed publications and numerous conference presentations in obstetrics, gynecology, and breast oncology.

Abstract

Background: Breast cancer remains the most commonly diagnosed malignancy among women worldwide and constitutes a major public health concern. Growing evidence suggests that night shift work may adversely affect human health through circadian rhythm disruption, hormonal imbalance, chronic sleep deprivation, and prolonged exposure to artificial light at night. Healthcare professionals, including midwives and nurses, are frequently assigned rotating night shifts, raising concerns about potential long-term occupational health consequences.

Aim: This systematic review aimed to investigate the association between night shift work and breast cancer risk and to explore its implications for healthcare professionals.

Methods: A systematic review of the international English-language literature was conducted using PubMed, EBSCOHost, and Up-to-date databases, following PRISMA guidelines. Studies published between 2015 and 2025 examining the association between night shift work and breast cancer incidence were screened according to predefined inclusion and exclusion criteria. Twelve epidemiological studies were included in the final analysis. Methodological quality and risk-of-bias assessment were performed using the Newcastle–Ottawa Scale (NOS).

Results: Most studies demonstrated a positive association between long-term night shift work and increased breast cancer risk. The risk appeared higher among individuals experiencing chronic sleep disturbances, circadian rhythm disruption, and prolonged exposure to rotating night schedules and artificial night-time light. However, some findings remained inconsistent in both the magnitude and the statistical significance of the association.

Conclusions:  Night shift work may represent a significant occupational risk factor for breast cancer development among healthcare professionals. Further high-quality research is required to clarify the underlying biological mechanisms and support effective occupational health prevention strategies.