title: Risk of cancer among cardiologists who frequently perform percutaneous coronary interventions: a population-based study.
abstract: BACKGROUND
  Cardiologists who frequently perform percutaneous coronary interventions (PCIs) are exposed to high levels of radiation; therefore, their risk of cancer may be higher compared with other internists or cardiologists who perform fewer PCIs.
  
  
  METHODS
  Data were obtained from the Taiwan National Health Insurance Research Database for the 2000-2011 period. A cohort of 542 cardiologists was randomly frequency-matched according to age and sex with four other internists to form a cohort of noncardiologist controls. The incidence of cancer was measured for both cohorts, who were followed up until the end of 2011. Cox proportional hazards models were employed to analyse the risk of cancer between cardiologist and control cohorts.
  
  
  RESULTS
  In general, the cardiologists did not have a higher risk of cancer compared with the other internists. However, the cardiologists who worked in medical centres or regional hospitals had a higher risk of cancer than did the other internists in the same work settings. Furthermore, the cardiologists working in medical centres or regional hospitals (large hospitals) who performed >15 PCIs per year had a higher risk of cancer than did those working in district hospitals (small hospitals) or clinics who performed ≤15 PCIs per year.
  
  
  CONCLUSIONS
  Cardiologists who frequently perform PCIs have a higher risk of cancer compared with other internists or cardiologists who perform relatively fewer PCIs. Protection from radiation exposure should therefore be emphasized in coronary catheterization laboratories.
authors.affiliation: Department of Radiology, China Medical University Hospital, Taichung, Taiwan.|School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Tzu-Lung
authors.initials: TL
authors.lastname: Ho
authors.affiliation: Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan.|Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shwn-Huey
authors.initials: SH
authors.lastname: Shieh
authors.affiliation: School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Radiology, China Medical University Hospital, Taichung, Taiwan.|Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung, Taiwan.
authors.forename: Wu-Chung
authors.initials: WC
authors.lastname: Shen
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000072096:Cardiologists / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D011835:Radiation Protection; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Cancer risk; cardiologist; percutaneous coronary intervention