Abstract 855: Is shift-work associated with increased risk of gastric cancer? A meta-analysis

Abstract Introduction: Gastric cancer remains one of the most common cancers worldwide. Shift-work involving circadian disruption was designated as a probable cause of cancer by The International Agency for Research on Cancer. Several studies have investigated the impact of shift work on gastric cancer, however, most of them are with small sample size. Thus, this meta-analysis was conducted. Method: A comprehensive literature search on PubMed was conducted to identify all relevant studies published prior to September 2020 according to the established inclusion criteria. The quality assessment was performed by the Newcastle-Ottawa Scale (NOS). The pooled relative risk (RR) and 95% confidence intervals (CI) were calculated to estimate the association between the shift-work and gastric cancer risk. A random-effect or fixed-effect model was used to calculate the pooled RR, based on heterogeneity significance. Subgroup analysis was performed based on rotating-shift versus permanent-shift. Sensitivity analysis and publication bias detection were also performed. All statistical analyses were performed using RevMan software (version 5.3; Cochrane library) and STATA 12.0 statistical software (Stata Corp., College Station, TX), and all P values were two-tailed, the test level was 0.05. Result: 51 articles were obtained from the database search, and 7 articles obtained from other sources. 4 articles involving 36,574 participants were included. All studies were considered moderate to high quality. A non-statistically significant association between shift-work and increased gastric cancer risk was found (RR 1.15, 95%CI: 0.95, 1.37, P=0.14, I2=0%). In the subgroup analysis, neither rotating-shift (RR 1.24, 95%CI: 0.92, 1.67, P=0.16, I2=0%) nor permanent-shift (RR 1.13, 95%CI: 1.10, 0.90, P=0.12, I2=0%) were found to be associated with an increased risk of gastric cancer. Sensitivity analysis by changing fixed-effect models to random-effect models and by omitting each study at a time confirmed the stability of the result. Funnel plot, Egger's test (t=0.70, P=0.554), and Begg's test (z=0.68, P=0.497) found no publication bias of analysis. Conclusion: The current meta-analysis demonstrates that shift-work is not associated with increased gastric cancer risk. However, only four studies were included. More original studies are needed to further explore shift-work impacts on gastric cancer risk. Citation Format: Chenyu Sun, Ce Cheng, Chandur Bhan, Mubashir Ayaz Ahmed, Nimararta Bheesham, Jannell F. Lising. Is shift-work associated with increased risk of gastric cancer? A meta-analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 855.