Do airline pilots and cabin crew have raised risks of melanoma and other skin cancers? Systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational cohort studies
PubMed 30585313 · doi:10.1111/bjd.17586
What was done
A systematic review and meta-analysis searched MEDLINE, ISI Science Citation Index, Embase, SCOPUS, and CINAHL up to June 2018. Studies reporting melanoma and keratinocyte cancer (KC) risk or mortality among airline pilots and cabin crew compared to the general population were identified. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) were pooled using random-effects models across 12 eligible studies selected from 5,866 retrieved records.
What was found
- Melanoma pooled SIR: 2.03 (95% CI 1.71-2.40) in pilots; 2.12 (95% CI 1.71-2.62) in cabin crew. - Melanoma pooled SMR: 1.99 (95% CI 1.17-3.40) in pilots; 1.18 (95% CI 0.73-1.89) in cabin crew. - Keratinocyte cancer pooled SIR: 1.86 (95% CI 1.54-2.25) in pilots; 1.97 (95% CI 1.25-2.96) in cabin crew. - There was no evidence of study heterogeneity.
Why it matters
This review shows flight crews experience approximately twice the expected population incidence of skin cancers, with pilots also showing an elevated risk of dying from melanoma.
Limits
The underlying studies were largely observational and collected data several decades ago (primarily between the 1970s and 1990s), limiting generalizability to contemporary flight conditions and exposures. The total number of individual participants was not reported in the abstract, and the included studies cannot fully control for non-occupational recreational ultraviolet radiation exposure.
Cited by
- partial Airline pilots have higher rates of cancer, in part due to elevated atmospheric cosmic radiation exposure.