title: Cancer incidence and cause-specific mortality in male and female physicians: a cohort study in Estonia.
abstract: OBJECTIVE
  To evaluate whether the presumed knowledge of physicians about healthier lifestyle decreases their risk of cancer and mortality, a retrospective cohort study of male and female physicians was conducted in Estonia.
  
  
  METHODS
  The cancer incidence and cause-specific mortality of 3,673 physicians (870 M, 2,803 F) in Estonia was compared with the rates of the general population. Information on cancer cases and deaths in the cohort between 1983 and 1998 was obtained from the Estonian Cancer Registry and the mortality database of Estonia.
  
  
  RESULTS
  The standardized incidence ratio (SIR) for all cancers was 1.32 (95% confidence interval (CI) 1.15-1.48) in women and 0.92 (95% CI 0.73-1.13) in men. Female physicians had an elevated risk for breast cancer (SIR 2.03, 95% CI 1.62-2.51) and myeloid leukaemia (SIR 3.69, 95% CI 1.35-8.02). Male physicians had an excess of skin melanoma (SIR 4.88, 95% CI 1.58-11.38). A large deficit of lung cancer was observed (SIR 0.24, 95% CI 0.11-0.48). The very low all-cause mortality in the cohort (standardized mortality ratio 0.55, 95% CI 0.50-0.61) was mainly due to large deficits in deaths from lung cancer, cardiovascular diseases and external causes. The suicide rate in the cohort was lower than in the general population.
  
  
  CONCLUSIONS
  No health risks were observed in the cohort that could be linked to the occupational exposures of physicians. The pattern of cancer incidence and mortality seen in physicians in Estonia is similar to the pattern seen among professional classes in other countries.
authors.affiliation: Institute of Experimental and Clinical Medicine, Tallinn, Estonia.
authors.forename: Kaire
authors.initials: K
authors.lastname: Innos
authors.forename: Kaja
authors.initials: K
authors.lastname: Rahu
authors.forename: Aleksei
authors.initials: A
authors.lastname: Baburin
authors.forename: Mati
authors.initials: M
authors.lastname: Rahu
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D004957:Estonia / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D016273:Occupational Exposure; D010820:Physicians / Q000523:psychology*; D010822:Physicians, Women / Q000523:psychology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects