title: Cancer Incidence in Physicians: A Taiwan National Population-based Cohort Study.
abstract: Cancer has been the leading cause of death in Taiwan since 1982. Physicians have many health-related risk factors which may contribute to cancer, such as rotating night shift, radiation, poor lifestyle, and higher exposure risk to infection and potential carcinogenic drugs. However, the cancer risk in physicians is not clear. In Taiwan's National Health Insurance Research Database, we identified 14,889 physicians as the study cohort and randomly selected 29,778 nonmedical staff patients as the comparison cohort for this national population-based cohort study. Cox proportional-hazard regression was used to compare the cancer risk between physicians and comparisons. Physician subgroups were also analyzed. Physicians had a lower all-cancer risk than did the comparisons (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.76-0.97). In the sex-based analysis, male physicians had a lower all-cancer risk than did male comparisons (HR 0.82, 95% CI 0.73-0.94); and female physicians did not (HR 1.29, 95% CI 0.88-1.91). In the cancer-type analysis, male physicians had a higher risk of prostate cancer (HR 1.72, 95% CI 1.12-2.65) and female physicians had twice the risk of breast cancer (HR 2.00, 95% CI 1.11-3.62) than did comparisons. Cancer risk was not significantly associated with physician specialties. Physicians in Taiwan had a lower all-cancer risk but higher risks for prostate and breast cancer than did the general population. These new epidemiological findings require additional study to clarify possible mechanisms.
authors.affiliation: From the Department of Emergency Medicine, Chi-Mei Medical Center (Y-SL, C-CH, H-JL, C-CH); Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan (C-CH, H-JL); Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung (S-FW); Department of Emergency Medicine, Taipei Medical University, Taipei (H-JL); Department of Medical Research, Chi-Mei Medical Center (J-JW); Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology (S-BS); Department of Occupational Medicine, Chi-Mei Medical Center (S-BS, C-CH); Department of Medical Research, Chi-Mei Medical Center, Liouying (S-BS); Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University (C-CH, H-RG); Department of Child Care and Education, Southern Taiwan University of Science and Technology (C-CH); Department of Geriatrics and Gerontology, Chi-Mei Medical Center (C-CH); and Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan (H-RG).
authors.forename: Yu-Sung
authors.initials: YS
authors.lastname: Lee
authors.forename: Chien-Chin
authors.initials: CC
authors.lastname: Hsu
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Lin
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology