title: Cancer Risks in U.S. Radiologic Technologists Working With Fluoroscopically Guided Interventional Procedures, 1994-2008.
abstract: OBJECTIVE
  The purpose of this study was to examine risks of cancer incidence and mortality among U.S. radiation technologists performing or assisting with fluoroscopically guided interventional procedures.
  
  
  METHODS
  A nationwide prospective cohort of 90,957 radiologic technologists, who responded to a 1994-1998 survey that collected information on whether they had ever worked with fluoroscopically guided interventional procedures, was followed through completion of a subsequent cohort survey during 2003-2005 (for cancer incidence) or December 31, 2008 (for cancer mortality). Sex-adjusted hazard ratios (HRs) and 95% CIs were calculated by use of Cox proportional hazards models for incidence and mortality from all cancers other than nonmelanoma skin cancer and for specific cancer outcomes in participants who reported ever performing fluoroscopically guided interventional procedures compared with technologists who never performed these procedures.
  
  
  RESULTS
  The analysis showed an approximately twofold increased risk of brain cancer mortality (HR, 2.55; 95% CI, 1.48-4.40) and modest elevations in incidence of melanoma (HR, 1.30; 95% CI, 1.05-1.61) and in breast cancer incidence (HR, 1.16; 95% CI, 1.02-1.32) but not mortality (HR, 1.07; 95% CI, 0.69-1.66) among technologists who performed fluoroscopically guided interventional procedures compared with those who never performed these procedures. Although there was a small suggestive increase in incidence of all cancers combined, excluding nonmelanoma skin cancers (HR, 1.08; 95% CI, 1.00-1.17), mortality from all cancers combined, excluding nonmelanoma skin cancers, was not elevated (HR, 1.00; 95% CI, 0.88-1.14). We similarly observed no elevated risk of cancers of the thyroid, skin other than melanoma, prostate, lung, or colon and rectum or of leukemia that was not chronic lymphocytic leukemia among workers who performed fluoroscopically guided interventional procedures.
  
  
  CONCLUSIONS
  We observed elevated risks of brain cancer, breast cancer, and melanoma among technologists who performed fluoroscopically guided interventional procedures. Although exposure to low-dose radiation is one possible explanation for these increased risks, these results may also be due to chance or unmeasured confounding by nonradiation risk factors. Our results must be confirmed in other studies, preferably with individual radiation dose data.
authors.affiliation: 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20892-9778.|2 Center for Global Health, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, Rockville, MD.
authors.forename: Preetha
authors.initials: P
authors.lastname: Rajaraman
authors.affiliation: 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20892-9778.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Doody
authors.affiliation: 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20892-9778.
authors.forename: Chu Ling
authors.initials: CL
authors.lastname: Yu
authors.affiliation: 3 Hirosoft International, Eureka, CA.
authors.forename: Dale L
authors.initials: DL
authors.lastname: Preston
authors.affiliation: 4 Information Management Systems, Inc., Calverton, MD.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Miller
authors.affiliation: 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20892-9778.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Sigurdson
authors.affiliation: 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20892-9778.
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
authors.affiliation: 5 Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Alexander
authors.affiliation: 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20892-9778.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Little
authors.affiliation: 6 Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Miller
authors.affiliation: 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U. S. Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20892-9778.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
mesh_terms: D000328:Adult; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology* / Q000401:mortality; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D015641:Radiography, Interventional / Q000009:adverse effects*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: brain; breast; cancer; fluoroscopically guided interventional procedures; interventional radiology; radiologic procedures