Breast Cancer Rate and Mortality in Flight Attendants

Abstract

Background: Previous reports have suggested that breast cancer is more common among flight attendants than that in the general population. Constant exposure to cosmic radiation and circadian disruption are postulated to be the culprits to the problem. Methods: A comprehensive review was performed on Medline, EMBASE, CINAHL, and Cochrane databases using predefined strategy. Retrieved studies were independently screened and rated for relevance. Data were extracted and analyzed by two researchers according to PRISMA protocol for systematic review and meta-analysis. Result: Forty three studies were identified using the preset keywords defined in the study protocol. After excluding irrelevant papers, 12 studies were included for pooled analysis. Ten studies (4 American, 6 European) evaluated the breast cancer prevalence in flight attendants, Pooled analysis found that, 1,061 (2.35%) out of the 45,111 flight attendants censored had breast cancer. The standardized prevalence ratio (SPR) was 1.08 (90% CI, 0.30-2.58), when compared to the Surveillance, Epidemiology, and End Results (SEER) data in 2015. Two European studies evaluated breast cancer mortality among flight attendants, pooled analysis found that, out of the 34,898 flight attendants censored, 61 (0.17%) had breast-cancer related mortality. None of the 12 studies were able to demonstrate an association between cosmic irradiation, circadian disruption and breast cancer in flight attendants. Conclusions: Overall breast cancer prevalence was 235/100,000 female flight attendants, with SPR of 1.08. The current evidence is insufficient to associate breast cancer with workplace risks like cosmic radiation and circadian disruption.