title: The risk of prostate cancer in pilots: a meta-analysis.
abstract: BACKGROUND
  Aviation exposes pilots to various occupationally related hazards, including ionizing radiation and chemical combustion. The possible increased risk of prostate cancer among pilots in comparison to the general population is a subject of debate. This systematic review and meta-analysis aimed to determine the quality of supporting evidence and magnitude of this association.
  
  
  METHODS
  All studies pertaining to prostate cancer in pilots were retrieved from multiple databases and from a manual search. Any study that assessed the incidence of prostate cancer relative to the incidence in the general population was included regardless of language or size. A random effect model was used to pool relative risks (RR) across studies. Heterogeneity was assessed using the Q statistic and I².
  
  
  RESULTS
  Eight studies with a low risk of bias were included in the meta-analysis. Pilots had an increased risk of developing prostate cancer compared to the general population [RR 2.0; 95% confidence interval (CI), 1.5-2.7]. The analysis was associated with substantial heterogeneity (I² = 79%). Several subgroups had significantly increased risk, such as African American pilots (RR 10.00; 95% CI, 5.04-19.86) and military pilots (RR 3.30; 95% CI, 2.03-5.39).
  
  
  CONCLUSIONS
  Pilots are at least twice as likely to develop prostate cancer compared to the general population. The implications of these findings are important considering the high prevalence of prostate cancer and the large number of pilots in the workforce.
authors.forename: David
authors.initials: D
authors.lastname: Raslau
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Summerfield
authors.forename: Abd M
authors.initials: AM
authors.lastname: Abu Dabrh
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Steinkraus
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Murad
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000368:Aged; D000369:Aged, 80 and over; D064870:Air Travel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D012306:Risk; D055815:Young Adult