title: Increased breast cancer prevalence among female orthopedic surgeons.
abstract: BACKGROUND
  As a result of low-dose ionizing radiation exposure during clinical practice, female orthopaedic surgeons may be at increased risk for breast cancer.
  
  
  METHODS
  The 2009 American Academy of Orthopaedic Surgeons (AAOS) membership directory was used to mail a survey to all female AAOS fellows. Survey responses were collected between June 2009 and June 2010 among 505 (69.7%) of the eligible women. We calculated standardized prevalence ratios (SPRs) and 95% confidence intervals (CIs) by dividing the observed number of cancers among female orthopaedic surgeons by the expected number, based on the gender-specific, age-specific, and race-specific cancer prevalence statistics in the general U.S. population. We compared the distribution of breast cancer risk factors in our study population to that of the women in the 2007 California Health Interview Survey (CHIS, n=30,541).
  
  
  RESULTS
  Twenty-four women reported a prior diagnosis of invasive cancer. Female orthopaedic surgeons had a prevalence of cancer that was 85% higher than that of the general U.S. female population (SPR 1.85, 95% CI 1.19-2.76). Orthopaedic surgeons in our study also had a statistically significant 2.9-fold higher prevalence of breast cancer compared to the general U.S. female population (SPR 2.9, 95% CI 1.66-4.71). Survey respondents had a higher prevalence of both protective and predisposing breast cancer factors compared to California women.
  
  
  CONCLUSIONS
  Our findings confirm that breast cancer prevalence is elevated among female orthopaedic surgeons. Although further research is needed to determine the factors behind this population's hypothesized increased risk, taken together, our results and others suggest that the orthopaedic community consider educating current practitioners of the use of protective shielding and other modifiable breast cancer risk factors.
authors.affiliation: Department of Orthopaedic Surgery, Stanford University, Stanford, CA 94063, USA. Ichou@stanford.edu
authors.forename: Loretta B
authors.initials: LB
authors.lastname: Chou
authors.forename: Sheena
authors.initials: S
authors.lastname: Chandran
authors.forename: Alex H S
authors.initials: AH
authors.lastname: Harris
authors.forename: Joanna
authors.initials: J
authors.lastname: Tung
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Butler
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D015914:Estrogen Replacement Therapy; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008572:Menarche; D008593:Menopause; D008875:Middle Aged; D009985:Orthopedics / Q000706:statistics & numerical data*; D010822:Physicians, Women / Q000706:statistics & numerical data*; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology