Cancer and other causes of mortality among radiologic technologists in the United States

Mohan, Aparna; Hauptmann, Michael; Freedman, D. Michal; Ron, Elaine; Matanoski, Genevieve M.; Lubin, Jay H.; Alexander, Bruce H.; Boice, John D.; Doody, Michele M.; Linet, Martha S.

doi:10.1002/ijc.10811

Cited by 104 publications

(75 citation statements)

References 28 publications

(62 reference statements)

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“…Complete study details have been described elsewhere (Boice et al, 1992;Doody et al, 1998;Mohan et al, 2002Mohan et al, , 2003Freedman et al, 2003;Sigurdson et al, 2003). Briefly, three questionnaires were mailed to individuals registered with the American Registry of Radiologic Technologists during 1983Technologists during -89, 1994Technologists during -98, and 2004.…”

Section: Methodsmentioning

confidence: 99%

Childhood cancer in the offspring born in 1921–1984 to US radiologic technologists

et al. 2008

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We examined the risk of childhood cancer (o20 years) among 105 950 offspring born in 1921 -1984 to US radiologic technologist (USRT) cohort members. Parental occupational in utero and preconception ionising radiation (IR) testis or ovary doses were estimated from work history data, badge dose data, and literature doses (the latter doses before 1960). Female and male RTs reported a total of 111 and 34 haematopoietic malignancies and 115 and 34 solid tumours, respectively, in their offspring. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. Leukaemia (n ¼ 63) and solid tumours (n ¼ 115) in offspring were not associated with maternal in utero or preconception radiation exposure. Risks for lymphoma (n ¼ 44) in those with estimated doses of o0.2, 0.2 -1.0, and 41.0 mGy vs no exposure were non-significantly elevated with HRs of 2.3, 1.8, and 2.7. Paternal preconception exposure to estimated cumulative doses above the 95th percentile (X82 mGy, n ¼ 6 cases) was associated with a non-significant risk of childhood cancer of 1.8 (95% CI 0.7 -4.6). In conclusion, we found no convincing evidence of an increased risk of childhood cancer in the offspring of RTs in association with parental occupational radiation exposure. British Journal of Cancer (2008) Exposure to in utero diagnostic ionising radiation (IR) is generally considered to increase the risk of childhood cancer, including solid and haematological malignancies (Brenner et al, 2003; Wakeford, 2004). Although cohort studies of medical radiation workers have reported increases in the incidence and mortality of skin cancer, breast cancer, and leukaemia, especially in individuals who started working before 1950 when both radiation doses and permitted levels of exposure were higher (Yoshinaga et al, 2004), the risk of cancer in their offspring associated with parental occupational exposure is unclear (Brenner et al, 2003). Radiation could increase offspring cancer risk through germline or in utero somatic mutations (Doll and Wakeford, 1997; UNSCEAR, 2001;Prasad et al, 2004). The only study of childhood cancer incidence in the offspring of medical radiographers found no significant excess (Roman et al, 1996).The US radiologic technologist (USRT) cohort is one of the largest groups of occupationally exposed medical personnel assembled for study. As 73% USRT cohort participants are female, both preconception and in utero occupational radiation exposure effects on offspring cancer risk could be studied. In addition, much effort was devoted to reconstructing probable dose levels during periods when workers were not routinely monitored (Simon et al, 2006), allowing quantitative evaluation of parental exposures. To date, this is the largest study of childhood cancer risk in RT offspring. METHODSThe University of Minnesota Institutional Review Board and the United States National Cancer Institute approved all protocols for data use. Complete study details have been described elsewhere (Boice et al, 1992;Doody et ...

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Section: Methodsmentioning

confidence: 99%

Childhood cancer in the offspring born in 1921–1984 to US radiologic technologists

et al. 2008

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“…Recently, Berrington et al (2001) presented the results of 100 years of observation of British radiologists, which showed a significant 41% increase in the cancer mortality rate over that for all medical practitioners combined for radiologists registered with a radiological society for more than 40 years, and a significant trend of this rate with time since first registration. In a study of radiological technologists conducted in the USA, Mohan et al (2003) found a marginally significant 28% increase in the rate of cancer mortality among those employed before 1940 relative to the rate for those employed after 1959, and a significant decreasing trend of the rate with later date of first employment. A similar pattern of breast cancer mortality was found for female technologists (Mohan et al, 2002), and Sigurdson et al (2003) have recently reported an excess of breast cancer incidence in this group.…”

Section: Introductionmentioning

confidence: 99%

“…In a study of radiological technologists conducted in the USA, Mohan et al (2003) found a marginally significant 28% increase in the rate of cancer mortality among those employed before 1940 relative to the rate for those employed after 1959, and a significant decreasing trend of the rate with later date of first employment. A similar pattern of breast cancer mortality was found for female technologists (Mohan et al, 2002), and Sigurdson et al (2003) have recently reported an excess of breast cancer incidence in this group. Wang et al (2002a) examined cancer incidence among medical X-ray workers in China during 1950-1995 and found a significant 20% excess of cases in comparison with other medical specialists.…”

Section: Introductionmentioning

confidence: 99%

The cancer epidemiology of radiation

2004

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“…While this is the first study of risk of total lung cancer risk (incidence and mortality) in the USRT cohort, previous analyses indicated that observed incident lung cancers and lung cancer deaths in the USRT cohort were lower than in the general US population, possibly because of lower prevalence of smoking in the USRT cohort than in the general population. 10,15 The USRT cohort is one of the largest prospective cohort studies of chronic low-to-moderate radiation exposure. The strengths of this analysis compared to previous lung cancer studies in medical radiation workers include the collection of incident cancers as well as cancer deaths, the ability to control for individual smoking history, and inclusion of a large number of women in the study population.…”

Section: Discussionmentioning

confidence: 99%

“…Published reports of lung cancer mortality and incidence among medical workers (radiologists and radiologic technologists) have been inconsistent, with studies reporting increased risk, decreased risk or no association. [6][7][8][9][10][11][12][13] Some of this inconsistency might reflect the inability of most studies to account for cigarette smoking, the strongest environmental risk factor for lung cancer.…”

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confidence: 99%

Lung cancer risk among US radiologic technologists, 1983–1998

Rajaraman

Sigurdson

Doody

et al. 2006

Intl Journal of Cancer

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While exposure to moderate to high-dose ionizing radiation is an established risk factor for lung cancer, the relationship between lung cancer and chronic low dose radiation remains uncertain. We examined lung cancer risk among 71,894 US radiologic technologists who were certified during 1926-1982, responded to a baseline questionnaire (1983)(1984)(1985)(1986)(1987)(1988)(1989), and were free of cancer other than non-melanoma skin cancer at baseline. Study participants were followed until completion of a second questionnaire (1994)(1995)(1996)(1997)(1998), death, or August 31, 1998. We identified 287 lung cancer cases: 66 incident cases and 221 decedents. Exposure to radiation was inferred based on work history information provided in the baseline questionnaire. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models adjusted for age, race/ethnicity and smoking. Smokingadjusted lung cancer risk was not related to working as a radiologic technologist in early years when radiation exposures were likely highest (RR 5 0.9; 95% CI, 0.5-1.8 for year first worked before 1940 compared to year first worked 1960), nor was risk related to the year first worked after 1940 or the number of years worked in any decade. While lung cancer risk was increased in radiologic technologists who held patients for X-rays, or who allowed others to take numerous practice X-rays on them, the trend was not statistically significant in either case. Although we adjusted for smoking, the possibility of residual confounding exists. Overall, we find very limited evidence that chronic low-tomoderate dose occupational exposure increased lung cancer risk in the US Radiologic Technologist cohort. ' 2006 Wiley-Liss, Inc.

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Cancer and other causes of mortality among radiologic technologists in the United States

Cited by 104 publications

References 28 publications

Childhood cancer in the offspring born in 1921–1984 to US radiologic technologists

Childhood cancer in the offspring born in 1921–1984 to US radiologic technologists

The cancer epidemiology of radiation

Lung cancer risk among US radiologic technologists, 1983–1998

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