BACKGROUNDWorkers exposed to low doses of radiation can provide information regarding cancer risks that are of public concern. However, characterizing risk at low doses requires large populations and ideally should include a large proportion of women, both of which rarely are available.METHODSAmong 90,305 radiologic technologists in the U.S. (77% women) who were followed during 1983–1998, data concerning incident cancer occurrence was obtained from mailed questionnaires and from death records. Standardized incidence ratios (SIRs) were computed using age‐specific, gender‐specific, race‐specific, and calendar year‐specific cancer rates from the Surveillance, Epidemiology, and End Results Program.RESULTSThe SIR for all cancers in both genders combined was 1.04 (95% confidence interval [95% CI], 1.00–1.07; n = 3292 technologists). Female technologists had an elevated risk for all solid tumors combined (SIR = 1.06; 95% CI, 1.02–1.10; n = 2168 women) and for breast cancers (SIR = 1.16; 95% CI, 1.09–1.23; n = 970 women), melanoma (SIR = 1.66; 95% CI, 1.43–1.89; n = 181 women), and thyroid cancers (SIR = 1.54; 95% CI, 1.24–1.83; n = 107 women). Male technologists experienced a decreased risk for solid tumors (SIR = 0.92; 95% CI, 0.85–0.98; n = 755 men); however, melanoma (SIR = 1.39; 95% CI, 1.00–1.79; n = 56 men) and thyroid cancers (SIR = 2.23; 95% CI, 1.29–3.59; n = 17 men) were increased. Among both genders, the risks were decreased for buccal cavity/pharyngeal cancers (SIR = 0.73; 95% CI, 0.55–0.90; n = 54 technologists), rectal cancers (SIR = 0.62; 95% CI 0.48–0.76; n = 53 technologists), and lung cancers (SIR = 0.77, 95% CI, 0.70–0.85; n = 307 technologists).CONCLUSIONSThe elevated risk for breast cancer may have been related to occupational radiation exposure. The observed excesses of melanoma and thyroid cancers may reflect, at least in part, earlier detection among medical workers with easy access to health care. Cancer 2003;97:3080–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11444

None of the anthropometric or female reproductive/hormonal factors evaluated were related to melanoma risk. It is unclear whether the positive association with alcohol intake and inverse association with smoking for long duration are causal. The alcohol and smoking findings warrant detailed assessment in studies with substantial statistical power where potential biases can be more fully evaluated.

Context.-Recent epidemiologic studies have raised the concern that calcium channel blocker use may increase the risk of cancer overall and of several specific cancers. Objective.-To assess whether calcium channel blocker use increases the risk of cancer overall and of specific cancers. Design.-Case-control drug surveillance study based on data collected from 1983 to 1996. Setting.-Hospitals in Baltimore,

BACKGROUNDStudies of atomic bomb survivors and medically exposed populations have demonstrated an increased risk of breast cancer associated with acute or protracted, intermediate‐dose or high‐dose, ionizing radiation; however, the risks associated with low‐dose and low‐dose‐rate (protracted) exposures are less certain.METHODSThe authors evaluated incident breast cancer risks from 1983 to 1998 according to employment characteristics and a 4‐level proxy index for cumulative radiation exposure based on 2 mail surveys among 56,436 U.S. female radiologic technologists who were certified from 1925 to 1980, adjusting for established breast cancer risk factors.RESULTSDuring follow‐up, 1050 new breast cancer diagnoses were ascertained. Compared with radiologic technologists who began working in 1970 or later, adjusted breast cancer risks for those who first worked in the 1960s, 1950s, 1940s, from 1935 to 1939, and before 1935 were 1.0 (95% confidence interval [CI], 0.8‐1.2), 1.2 (95% CI, 0.9‐1.6), 1.0 (95% CI, 0.7‐1.5), 1.8 (95% CI, 1.0‐3.2), and 2.9 (95% CI, 1.3‐6.2), respectively. The risk rose with the number of years worked before 1940 (P value for trend = .002) and was elevated significantly among those who began working before age 17 years (relative risk, 2.6; 95% CI, 1.3‐5.1; 10 women) but was not related to the total years worked in the 1940s or later. Compared with technologists who had a Level 1 (minimal) proxy index for cumulative radiation exposure, breast cancer risks were 1.0 (95% CI, 0.9‐1.2), 1.0 (95% CI, 0.7‐1.3), and 1.5 (95% CI, 1.0‐2.2), respectively, for technologists who had Level 2, Level 3, and Level 4 (highest) exposure.CONCLUSIONSBreast cancer risk was elevated significantly in female radiologic technologists who experienced daily low‐dose radiation exposures over several years that potentially resulted in appreciable cumulative exposure. The increased risk for total years worked before 1940, but not later, was consistent with decreasing occupational radiation exposures, improvements in radiation technology, and more stringent radiation protection standards over time. Cancer 2006. © 2006 American Cancer Society.

We found that the covariates that explain the disparity in screening rates between the white and the black population do not explain the disparity between the white and the Hispanic population. Knowing how much of a health disparity is explained by measured covariates can be used to develop more effective interventions and policies to eliminate disparity.

In laboratory studies, some antidepressants caused increased growth of mammary tumors. The relation of use of these drugs to the development of breast cancer was examined in a hospital-based case-control study. Information, including lifetime medication history, was collected by interview from 5,814 women with primary breast cancer diagnosed within the previous year, 5,095 women with primary malignancies of other sites, and 5,814 women with other conditions. Relative risks were estimated by using unconditional multiple logistic regression for regular use (> or =4 days per week for > or =4 weeks beginning > or =1 year before admission) of antidepressants and structurally similar drugs. With reference to never use of each drug, relative risks were statistically compatible with 1.0 for selective serotonin reuptake inhibitors (SSRI), tricyclics, other antidepressants, phenothiazines, and antihistamines; results were very similar using both control groups. There were no significant increases in risk for any category of regular use, stratified according to cumulative duration of use or time interval since the most recent use or for any individual drug within the broader classes. However, the estimate for regular SSRI use in the previous year, 1.8, was of borderline statistical significance (95% confidence interval: 1.0, 3.3). The findings do not support an overall association between the use of antidepressants, phenothiazines, or antihistamines and breast cancer. However, the results for SSRIs are not entirely reassuring.

Our study examines the risk of melanoma among medical radiation workers in the U.S. Radiologic Technologists (USRT) study. We evaluated 68,588 white radiologic technologists (78.8% female), certified during 1926 -1982, who responded to a baseline questionnaire (1983)(1984)(1985)(1986)(1987)(1988)(1989) and were free of cancer other than nonmelanoma skin at that time. Participants were followed through completion of a second questionnaire (1994 -1998). We identified 207 cases, 193 subjects who reported first primary melanoma and 14 decedents with melanoma listed as an underlying or contributory cause of death. We examined risks of occupational radiation exposures using work history information on practices, procedures, and protective measures reported on the baseline questionnaire. Based on Cox proportional hazards regression, melanoma was significantly associated with established risk factors, including constitutional characteristics (skin tone, eye and hair color), personal history of nonmelanoma skin cancer, family history of melanoma and indicators of residential sunlight exposure. Melanoma risk was increased among those who first worked before 1950 (RR ‫؍‬ 1.8, 95% CI ‫؍‬ 0.6 -5.5), particularly among those who worked 5 or more years before 1950 (RR ‫؍‬ 2.4; 0.7-8.7; p (trend) for years worked before 1950 ‫؍‬ 0.03), when radiation exposures were likely highest. Risk was also modestly elevated among technologists who did not customarily use a lead apron or shield when they first began working (RR ‫؍‬ 1.4; 0.8 -2.5). Clarifying the possible role of exposure to chronic ionizing radiation in melanoma is likely to require nested case-control studies within occupational cohorts, such as this one, which will assess individual radiation doses, and detailed information about sun exposure, sunburn history and skin susceptibility characteristics. The incidence of cutaneous malignant melanoma has been increasing rapidly in the white population of the United States (U.S.) 1 with a lifetime risk of melanoma of about 2.0% in white men and 1.4% in white women. 2 The major established environmental risk factor for melanoma is solar radiation. 3-5 Host susceptibility factors include fair skin; blue eyes; blond or red hair; high numbers of nevi; a family history of melanoma; a personal history of skin cancer; and immunosuppression. 3,6,7 Although acute and fractionated ionizing radiation have been linked to nonmelanoma skin cancer, 8 there is limited and inconsistent epidemiologic evidence concerning the relationship between ionizing radiation and cutaneous malignant melanoma, particularly at low-to-moderate, chronic doses. 8,9 In our study, we examined prospectively (1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)) the risk of cutaneous malignant melanoma from low-to-moderate, chronic exposure to ionizing radiation based on work history and other factors in the large U.S. Radiologic Technologists (USRT) cohort. MATERIAL AND METHODSThe USRT study, an ongoing collaboration of the ...

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