Sleep

Sleep midpoint, social jetlag, and cancer risk in the Cancer Prevention Study-3.

TL;DR

Sleep midpoint and social jetlag were not significantly associated with overall cancer or breast cancer-specific risk among US adults in the Cancer Prevention Study-3.

Key Findings

No statistically significant association was found between sleep midpoint and overall cancer risk.

  • Sleep midpoint was calculated as a 5:2 weekday:weekend weighted average and categorized as <2:30AM, 2:30-<3:30AM (referent), and ≥3:30AM.
  • The study included 145,386 CPS-3 participants with 5,537 incident cancer cases.
  • Multivariable Cox proportional hazards models were used, adjusted for socio-demographics, socioeconomic status, comorbidities, and lifestyle behaviors.
  • Follow-up time ended at cancer diagnosis, death, or December 31, 2020.

No statistically significant association was found between social jetlag and overall cancer risk.

  • Social jetlag was calculated as the difference in sleep midpoint between weekend and weekday, categorized as <1 hour (referent), 1-<2 hours, and ≥2 hours.
  • The analysis covered US adults aged 30-65 years enrolled in CPS-3.
  • Sleep timing data were self-reported at the first triennial follow-up in 2015.
  • Cancer incidence was determined via linkage to state cancer registries.

No statistically significant association was found between sleep midpoint or social jetlag and breast cancer-specific risk.

  • Breast cancer was analyzed as a cancer-site-specific outcome in addition to overall cancer incidence.
  • The same multivariable Cox proportional hazards modeling approach was used for breast cancer analyses.
  • A total of 5,537 incident cancer cases were reported across the full cohort during follow-up.
  • Participants reported average sleep duration on weekdays and weekends separately, from which midpoints were derived.

The study population consisted of US adults aged 30-65 years who were surveyed on sleep timing at the 2015 triennial follow-up of CPS-3.

  • CPS-3 is described as a large prospective study of US adults.
  • Sleep data were collected via self-report of average time spent sleeping during a 24-hour weekday and weekend period.
  • The cohort included 145,386 participants with available sleep and follow-up data.
  • Participants were recruited at ages 30-65 years, providing a broad adult age range.

Sleep timing and regularity have been associated with various health and performance outcomes, but limited prior research had investigated their relationship with cancer incidence.

  • The study was motivated by a gap in the literature linking sleep timing dimensions (midpoint and social jetlag) to cancer risk.
  • Social jetlag reflects circadian misalignment between biological and social schedules.
  • The authors note that sleep timing and regularity are established correlates of other health outcomes.
  • This study aimed to address the limited evidence base by leveraging a large prospective cohort with registry-confirmed cancer outcomes.

What This Means

This research suggests that the timing of sleep — specifically when during the night a person sleeps (sleep midpoint) and how much that timing shifts between weekdays and weekends (social jetlag) — is not meaningfully associated with the risk of developing cancer. The study followed nearly 145,400 adults in the United States over several years, tracking who developed cancer through official state cancer registries, and found no statistically significant links between these sleep timing measures and either overall cancer risk or breast cancer risk specifically. The study used a large, prospective design, meaning participants were enrolled before they developed cancer and followed over time, which is considered a strong approach for studying risk factors. Sleep information was collected through self-reported surveys in 2015, and researchers accounted for many other factors that could influence cancer risk, such as demographics, socioeconomic status, health conditions, and lifestyle behaviors. Over the follow-up period ending in 2020, more than 5,500 cancer cases were identified. This research suggests that, at least based on self-reported sleep timing data, people who sleep at different clock times or who experience significant shifts in their sleep schedule between work and non-work days are not at measurably higher or lower risk for cancer compared to those with more typical or consistent sleep timing. These findings add important null evidence to a field where prior research on sleep and cancer has largely focused on sleep duration and quality rather than timing.

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Citation

Donzella S, VoPham T, Weaver M, Patel A, Phipps A, Zhong C. (2026). Sleep midpoint, social jetlag, and cancer risk in the Cancer Prevention Study-3.. Cancer causes &amp; control : CCC. https://doi.org/10.1007/s10552-025-02116-x