Flight attendants showed an elevated incidence of several types of cancer compared with the general population, according to findings published by McNeely et al in Environmental Health.
“Our findings of higher rates of several cancers among flight attendants is striking given the low rates of overweight and smoking in our study population, which highlights the question of what can be done to minimize the adverse exposures and cancers common among the cabin crew,” said study coauthor Irina Mordukhovich, PhD, MSPH, a research fellow at Harvard T.H. Chan School of Public Health.
The researchers surveyed participants in the Harvard Flight Attendant Health Study from 2014 to 2015, using age-weighted standardized prevalence ratios (SPRs) to compare the prevalence of self-reported cancer diagnoses among flight attendants (n = 5,366) to that of a cohort from the general population (n = 2,729) in the National Health and Nutrition Examination Survey (NHANES 2013–2014). Dr. Mordukhovich and colleagues also evaluated associations between job tenure and cancer prevalence using logistic regression.
Flight attendants had higher incidences of every form of cancer included in the study—breast, uterine, gastrointestinal, thyroid, and cervical cancers, as well as melanoma and nonmelanoma skin cancers—compared with members of the general population of similar socioeconomic status.
Among female flight attendants, the elevated incidence appeared especially pronounced for breast cancer (SPR = 1.51, 95% confidence interval [CI] = 1.02–2.24), melanoma (SPR = 2.27, 95% CI = 1.27–4.06), and nonmelanoma skin cancer (SPR = 4.09, 95% CI = 4.7–6.2). Women who had three or more children had an increased incidence of breast cancer, which appeared consistent with previous studies.
Male flight attendants demonstrated a modest increase in the prevalence of melanoma (SPR = 1.47, 95% CI = 0.72–3.01) and nonmelanoma skin cancers (SPR = 1.11, 95% CI = 0.78–1.59).
Standardized prevalence ratios were increased among male and female flight attendants who had experienced significant job-related secondhand smoke.
Also, each 5-year increase in tenure as a flight attendant appeared to be associated with nonmelanoma skin cancer risk among women (odds ratio [OR] = 1.07, 95% CI = 1.01–1.13). Researchers observed borderline associations between each 5-year increase and risk for melanoma (OR = 1.23, 95% CI = 0.94–1.61) and nonmelanoma (OR = 1.17, 95% CI = 0.99–1.38) skin cancers among male flight attendants.
The researchers wrote that the results indicated flight attendants in the United States should be monitored for radiation exposure and should have their schedules arranged to minimize exposure to radiation and disruption to circadian rhythms.
“The [European Union] already evaluates radiation exposure among flight attendants, which our findings show may be an important step toward lowering cancer risk among this work population,” said Eileen McNeely, PhD, Co-Director of Harvard’s SHINE program and a coauthor of the study.
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