Cancer Incidence and Mortality Among Fighter Aviators in the United States Air Force

Abstract

Objective: This study sought to clarify cancer risk in fighter aviators. Methods: US Air Force officers who served between 1970 and 2004 were followed through 2018 for incidence and mortality of 10 cancers: colon and rectum; pancreas; melanoma skin; prostate; testis; urinary bladder; kidney and renal pelvis; brain and other nervous system; thyroid; and non-Hodgkin lymphoma. Fighter aviators were compared with other officers and the general US population. Results: Compared with other officers, male fighter aviators had greater adjusted odds of developing testis, melanoma skin, and prostate cancers; mortality odds were similar for all cancers. When compared with the US population, male fighter aviators were more likely to develop and die from melanoma skin cancer, prostate cancer, and non-Hodgkin lymphoma. Conclusions: Military fighter aviation may be associated with slightly increased risk of certain cancers.

Military occupation and testicular germ cell tumour risk among US Air Force servicemen

“…One of our most consistent findings of elevated TGCT risk for pilots is comparable with the findings of some of the previous studies conducted among USAF servicemen,14–16 although not all 29. Previous studies that found elevated risk/odds of TGCT among aviators slightly differed with respect to the exposure metrics.…”

“…We, therefore, primarily relied on occupational information at time 2, on average 8.2 years post-accession, when approximately only 3% of the population was non-occupationally qualified. For selected occupations of interest based on prior literature (ie, pilot, fighter pilot, firefighting and aircraft maintenance),8 16 25–27 we additionally created occupational groupings that indicated being in a given occupation at both time points (eg, pilot at time 1 and at time 2, aircraft maintenance at time 1 and at time 2). We did not have information on occupation timing and duration (eg, when a serviceman started or ended a job).…”

“…The predominantly young and male US military population, where military personnel may experience different occupational exposures throughout their career/deployments, is valuable for studying occupational risk factors for TGCT. Prior epidemiological studies reported elevated risk of TGCT in military pilots and aircrew,15 and fighter pilots16; however, to our knowledge, no peer-reviewed studies to date have investigated associations of different types of jobs performed during military service with TGCT risk. To address this research gap, the primary aim of the present study was to investigate associations between military occupations and TGCT risk among active duty US Air Force (USAF) servicemen.…”

“…Events in utero almost certainly influence TGCT risk7; however, recent evidence suggests that adolescent and adult risk factors may also play an important role in TGCT aetiology 8. Certain occupations have been associated with increased TGCT risk, including firefighting,9 10 aircraft maintenance among both military11 12 and civilian populations,13 as well as service as a military pilot and aircrew,14 15 and as a fighter pilot 16. Despite inconsistencies, these occupational associations led to hypotheses that job-related chemical exposures, such as to perfluoroalkyl and polyfluoroalkyl substances (PFAS),17–19 solvents, paints, and hydrocarbons in degreasing/lubricating agents and lubricating oils (eg, methylcholantene),11 12 may increase TGCT risk, although confounding from factors related to socioeconomic status (SES) may also play a role 15 16…”

Circadian Rhythm Disruption as a Contributor to Racial Disparities in Prostate Cancer

“…Longer air hours, number of employment years, and radiation exposure positively correlate with increased PCa risk [ 19 , 67 ]. Male pilots are at least twice as likely to develop PCa than men in the general population, and several subgroups, including AA pilots and military pilots, were found to have an increased riskforf PCa [ 18 , 68 ].…”