title: the risk of cancer among Taiwanese female registered nurses: a nationwide retrospective study.
abstract: BACKGROUND
  To evaluate the risk of cancer among Taiwanese female registered nurses (RNs) using a nationwide population-based dataset.
  
  
  METHODS
  We recruited female RNs without antecedent cancer from the Taiwan National Health Insurance Research database during 2000-2010. Standardized incidence ratios (SIRs) of cancer were calculated. We also compared rates of Papanicolaou (Pap) smear use between the RNs and the general population matched by age and sex.
  
  
  RESULTS
  A total of 2,077 cancers developed among 184,809 female RNs, with a follow-up of 1,371,910 person-years (median follow-up of 7.86 years), leading to an increased SIR of 1.10 [95% confidence interval (CI) 1.05-1.15]. RNs aged between 40-59 years also had a significantly increased SIR (1.14, 95% CI 1.08-1.21). For specific cancer types, RNs had an increased SIR for breast (1.28, 95% CI 1.19-1.37), thyroid (1.26, 95% CI 1.10-1.43), lung and mediastinum (1.36, 95% CI 1.13-1.62), and uterine cancers (1.23, 95% CI 1.01-1.49). A decreased SIR was found for cervix (0.48, 95% CI 0.37-0.61) and liver and biliary tract cancers (0.68, 95% CI 0.50-0.90). Pap smear use averaged 5.80 times per person among female RNs aged 35 years or older and 5.50 times per person in the age-matched control group (p = 0.009).
  
  
  CONCLUSIONS
  This study found that overall cancer risk was higher among female RNs than general population. For individual cancers, the risks of breast, lung, thyroid and uterine cancer were higher and the risks of cervix and liver cancer were lower than general population. The lower risk of cervical cancer might be partially explained by the increased use of Pap smears in the RNs group. Further large, unbiased population-based prospective studies are needed to investigate the association between nurses and cancer risk and identify the risk factors of cancer in nurses.
authors.affiliation: Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan.
authors.forename: Cheng-Che
authors.initials: CC
authors.lastname: Shen
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Hu
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Hu
authors.forename: Chin-Lin
authors.initials: CL
authors.lastname: Perng
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Teng
authors.forename: Sang-Hue
authors.initials: SH
authors.lastname: Yen
authors.forename: Cheng-Hwai
authors.initials: CH
authors.lastname: Tzeng
authors.forename: Tzeon-Jye
authors.initials: TJ
authors.lastname: Chiou
authors.forename: Chiu-Mei
authors.initials: CM
authors.lastname: Yeh
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Wei-Shu
authors.initials: WS
authors.lastname: Wang
authors.forename: Pan-Ming
authors.initials: PM
authors.lastname: Chen
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D009726:Nurses / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013964:Thyroid Neoplasms / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000453:epidemiology