Cancer Prevalence among a Cross-sectional Survey of Female Orthopedic, Urology, and Plastic Surgeons in the United States.
BACKGROUND
Exposure to ionizing radiation from fluoroscopy performed during surgery, although low and within established limits, remains a health concern among surgeons. Estimates of breast cancer prevalence among women across surgery specialties with different patterns of fluoroscopy use are needed to evaluate this concern.


METHODS
Female U.S. surgeons in urology, plastics, and orthopedics were identified using national directories and mailed surveys to collect information on occupational and medical history, including cancer diagnoses. Standardized prevalence ratios (SPRs) and 95% CIs were calculated by dividing the observed number of cancers among female surgeons in each specialty by the expected number, based on the gender-specific, age-specific, and race-specific cancer prevalence statistics in the general U.S.


RESULTS
Standard fluoroscopy use more than once per week was common among urologists (54%) and orthopedists (37%); the same frequency of mini fluoroscopy use was only common among orthopedics (31%) and hardly ever used by urologists. Plastic surgeons reported very infrequent use of any fluoroscopy. For orthopedic surgeons, a significantly greater than expected prevalence of any cancer (SPR, 1.85; 95% CI, 1.19-2.76) and breast cancer (SPR, 2.90; 95% CI, 1.66-4.71) were observed. There was no difference between the observed and expected prevalence of any cancer or breast cancer for urology or plastics.


CONCLUSIONS
Using the first available cancer prevalence data comparing female surgeons across three specialties, we report that orthopedic surgeons have a greater than expected prevalence of cancer that may or may not be owing to occupational exposure to ionizing radiation.
Department of Orthopaedic Surgery, Stanford School of Medicine, Palo Alto, California. Electronic address: lchou@stanford.edu.
Loretta B
LB
Chou
Department of Surgery, VA Boston Healthcare System, Boston, Massachusetts.
Lori B
LB
Lerner
Department of Orthopaedic Surgery, Stanford School of Medicine, Palo Alto, California.
Alex H S
AH
Harris
Department of Surgery, VA Boston Healthcare System, Boston, Massachusetts.
Ashley J
AJ
Brandon
Department of Oral Medicine and Maxillofacial Surgery, Stanford University, Palo Alto, California.
Sabine
S
Girod
Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
Lesley M
LM
Butler
D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D016273:Occupational Exposure; D009985:Orthopedics; D010822:Physicians, Women / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D066231:Surgeons / Q000706:statistics & numerical data*; D013518:Surgery, Plastic; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014572:Urology