title: Long-term Mortality in 43 763 U.S. Radiologists Compared with 64 990 U.S. Psychiatrists.
abstract: Purpose To compare mortality rates from all causes, specific causes, total cancers, and specific cancers to assess whether differences between radiologists and psychiatrists are consistent with known risks of radiation exposure and the changes in radiation exposure to radiologists over time. Materials and Methods The authors used the American Medical Association Physician Masterfile to construct a cohort of 43 763 radiologists (20% women) and 64 990 psychiatrists (27% women) (comparison group) who graduated from medical school in 1916-2006. Vital status was obtained from record linkages with the Social Security Administration and commercial databases, and cause of death was obtained from the National Death Index. Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for all causes and specific causes of death. Results During the follow-up period (1979-2008), 4260 male radiologists and 7815 male psychiatrists died. The male radiologists had lower death rates (all causes) compared with the psychiatrists (RR = 0.94; 95% CI: 0.90, 0.97), similar cancer death rates overall (RR = 1.00; 95% CI: 0.93, 1.07), but increased acute myeloid leukemia and/or myelodysplastic syndrome death rates (RR = 1.62; 95% CI: 1.05, 2.50); these rates were driven by those who graduated before 1940 (RR = 4.68; 95% CI: 0.91, 24.18). In these earliest workers (before 1940) there were also increased death rates from melanoma (RR = 8.75; 95% CI: 1.89, 40.53), non-Hodgkin lymphoma (NHL) (RR = 2.69; 95% CI: 1.33, 5.45), and cerebrovascular disease (RR = 1.49; 95% CI: 1.11, 2.01). The 208 deaths in female radiologists precluded detailed investigation, and the number of female radiologists who graduated before 1940 was very small (n = 47). Conclusion The excess risk of acute myeloid leukemia and/or myelodysplastic syndrome mortality in radiologists who graduated before 1940 is likely due to occupational radiation exposure. The melanoma, NHL, and cerebrovascular disease mortality risks are possibly due to radiation. The authors found no evidence of excess mortality in radiologists who graduated more recently, possibly because of increased radiation protection and/or lifestyle changes.©RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.).
authors.forename: Amy
authors.initials: A
authors.lastname: Berrington de González
authors.affiliation: From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.).
authors.forename: Estelle
authors.initials: E
authors.lastname: Ntowe
authors.affiliation: From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.).
authors.forename: Cari M
authors.initials: CM
authors.lastname: Kitahara
authors.affiliation: From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.).
authors.forename: Ethel
authors.initials: E
authors.lastname: Gilbert
authors.affiliation: From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.).
authors.forename: Donald L
authors.initials: DL
authors.lastname: Miller
authors.affiliation: From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.).
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Kleinerman
authors.affiliation: From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.).
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
mesh_terms: D000328:Adult; D017677:Age Distribution; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011570:Psychiatry / Q000706:statistics & numerical data*; D000072177:Radiologists / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology