Cancer Management and Research · 2020 · 17 citations · 33 references
MedicineHealth BehaviorOncologyCancer ControlCancer EpidemiologyCancer PreventionBreast Cancer Risk AssessmentCancer RiskSleep HealthCancer-related Sleep DisturbanceCase-control Study DesignSleep QualitySleep Quality AssessmentSubjective Sleep Quality
INTRODUCTION: Breast cancer is a common malignancy worldwide. Smartphones have gradually become indispensable to our modern lives and have already changed lifestyles of human beings. To our best knowledge, no study has investigated the relationship between smartphone use and breast cancer. This case-control study purposely investigated the relationship between smartphone use and breast cancer risk. MATERIALS AND METHODS: This was a case-control study comprising 894 healthy controls and 211 patients with breast cancer. All participants were asked to respond to standard questionnaires to collect information on sleep quality, smartphone addiction, and smartphone use. RESULTS: Participants with smartphone addiction had a significantly higher 1.43-fold risk of breast cancer. Individuals with the habitual behavior of smartphone use >4.5 minutes before bedtime had a significantly increased 5.27-fold risk of breast cancer compared to those who used a smartphone for ≤4.5 minutes before bedtime. Additionally, a closer distance between the smartphone and the breasts when using the smartphone exhibited a significantly increased 1.59-fold risk. Participants who carried their smartphone near their chest or waist-abdomen area had significantly increased 5.03-fold and 4.06-fold risks of breast cancer, respectively, compared to those who carried the smartphone below the waist. Moreover, there was a synergistic effect of smartphone addiction and smartphone use of >4.5 minutes before bedtime which increased the breast cancer risk. CONCLUSION: Excessive smartphone use significantly increased the risk of breast cancer, particularly for participants with smartphone addiction, a close distance between the breasts and smartphone, and the habit of smartphone use before bedtime.
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The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research
Daniel J. Buysse, Charles F. Reynolds, T. H. Monk et al. · Psychiatry Research · 1989 · 34.7K citations
Medicine, Psychiatry, Psychology +16
Purposeful selection of variables in logistic regression
Zoran Bursac, C. Heath Gauss, David Williams et al. · Source Code for Biology and Medicine · 2008 · 3.9K citations · Full text