Melanoma incidence in Australian commercial pilots, 2011–2016

Abstract

ObjectivesOccupational exposure to cosmic and ultraviolet radiation may increase airline pilots’ risk of cutaneous melanoma. Meta-analyses of available data show a higher than average incidence of melanoma in airline pilots, but the most recent systematic review revealed that few contemporary data are available. Moreover, all relevant studies have been conducted in Northern Hemisphere populations. We therefore aimed to examine if Australian commercial pilots have a raised incidence of melanoma compared with the general population.MethodsWe examined all melanoma histologically diagnosed among Australian-licensed commercial pilots in the period 2011–2016 by manually reviewing de-identified data in the medical records system of the Australian Civil Aviation Safety Authority. We estimated age-specific incidence rates and compared these with corresponding population rates using standardised incidence ratios (SIRs) as measures of relative risk. Expected numbers were calculated by multiplying age- and calendar period-specific person-years (PYs) with corresponding rates from the entire Australian population; 95% CI were calculated assuming a Poisson distribution of the observed cases.ResultsIn this cohort of Australian-licensed commercial pilots observed for 91 370 PYs, 114 developed a melanoma (51 invasive, 63 in situ). More than 50% of melanomas occurred on the trunk, and the predominant subtype was superficial spreading melanoma. The SIR for invasive melanoma was 1.20 (95% CI 0.89 to 1.55) and for melanoma in situ, 1.39 (95% CI 1.08 to 1.78).ConclusionAustralian-licensed commercial pilots have a modestly raised risk of in situ melanoma but no elevation of invasive melanoma compared with the general population.

Cohort study of occupational cosmic radiation dose and cancer mortality in German aircrew, 1960–2014

“…Incidence studies from the Nordic countries, the UK and more recently from Australia also reported increased risks. Results from the earlier studies suggest that the increased risks may be attributed at least partly to leisure time behaviour including UV exposure rather than to occupational cosmic radiation, but this remains an open question 5 27–29. Preventive measures such as UV protection and skin cancer screening during regular health check-ups may improve the current situation as overall prognosis after early detection is good 30 31…”

Flying Hours of Australian Commercial Pilots and Risk of Cutaneous Melanoma

“…We used de-identified data from the Australian Civil Aviation Safety Authority (CASA) for commercial pilots who had a histologically diagnosed melanoma in the period 2011-2016, and estimated age-specific incidence rates. When we compared these with corresponding population rates, we found no significant increase in the incidence rate of invasive melanoma, and a modestly raised (by around 40%) incidence rate of in situ melanoma 8 . We interpreted the elevated recorded rates of in situ melanoma as reflecting the more frequent (at least annual) medical surveillance that pilots undergo compared with the general population.…”

“…We conducted a case-control study nested within a cohort of male commercial pilots in Australia (there were too few female pilots for meaningful analysis, and so they were excluded a priori). The cohort and data source have been described in detail previously 8 . Briefly, we ascertained the deidentified study population through the electronic Medical Record System (MRS) of CASA.…”

“…In order to address the issues of currency and local relevance, we recently conducted a study of the incidence of cutaneous melanoma in Australian commercial pilots compared with the general population 8 . We used de-identified data from the Australian Civil Aviation Safety Authority (CASA) for commercial pilots who had a histologically diagnosed melanoma in the period 2011-2016, and estimated age-specific incidence rates.…”

The Elevated Risk of Melanoma Among Pilots – Could Uva Be Implicated?

“…(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) A recent study of melanoma incidence in Australian certified commercial pilots found that pilots had a modestly raised risk of in-situ melanoma (SIR 1.39 [95% CI 1.08-1.78]) but no elevation in invasive melanoma compared with the general Australian population. (12) Given the high background rates of melanoma in Australia however, it is possible that this finding reflects a lower contribution of occupational exposure to total UV exposure in Australian certified commercial pilots. In the northern hemisphere, both ambient UV levels and melanoma incident rates are lower compared to Australia.…”