Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis
Commercial airline cockpit crew (CCC) are potentially exposed to occupational risk factors that may have detrimental health effects. However, available literature on prostate cancer (PCa) as a health outcome is conflicted. Therefore, this review of cohort studies aims to evaluate the incidence of an...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Société Internationale d’Urologie (SIU)
2022-05-01
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| Series: | Société Internationale d’Urologie Journal |
| Subjects: | |
| Online Access: | https://siuj.org/index.php/siuj/article/view/184/116 |
| _version_ | 1797371074296414208 |
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| author | Hadia Khanani George McClintock Hilary Fernando Gillian Heller Rebecca Asher Cindy Garcia David P. Smith Ian Getley Nariman Ahmadi Norbert Doeuk Scott Leslie Niruban Thanigasalam Henry H. Woo |
| author_facet | Hadia Khanani George McClintock Hilary Fernando Gillian Heller Rebecca Asher Cindy Garcia David P. Smith Ian Getley Nariman Ahmadi Norbert Doeuk Scott Leslie Niruban Thanigasalam Henry H. Woo |
| author_sort | Hadia Khanani |
| collection | DOAJ |
| description | Commercial airline cockpit crew (CCC) are potentially exposed to occupational risk factors that may have detrimental health effects. However, available literature on prostate cancer (PCa) as a health outcome is conflicted. Therefore, this review of cohort studies aims to evaluate the incidence of and mortality from PCa in CCC based on studies published to date. PubMed, Medline, EMBASE and SCOPUS were searched from 1946 to April 2021. Cohort studies reporting standardized incidence ratios (SIR) and/or standardized mortality ratios (SMR) of PCa in CCC were included. Military, cabin crew and service personnel data were excluded. Independent data extraction was conducted, and study quality assessed. Standardized ratios were pooled using a fixed effects model and expressed with 95% confidence intervals. 75 studies were assessed for eligibility from which 6 involving 129 374 licensed CCC were included in the final analysis: Two reported incidence only, 1 incidence and mortality and 3 reported mortalities only. The pooled SIR for PCa in CCC was 1.41 (95% CI 1.17 to 1.71) with moderate heterogeneity (I2 = 53%) however, the pooled SMR was not statistically significant (1.08; 95% CI 0.94 to 1.24) also with moderate heterogeneity (I2 = 70%). The available evidence shows that CCC are at a higher risk of developing PCa but there is no evidence to suggest a similarly higher risk of death from the disease. The effect of early detection through PSA testing in this cohort is unclear. Occupational exposure to radiation and sleep disturbance may play a role, but clear evidence of additional risk is lacking. Our review indicates that most evidence is dated and to confidently assess contemporary health outcomes of CCC, further research is required. |
| first_indexed | 2024-03-08T18:13:39Z |
| format | Article |
| id | doaj.art-5796e312f4a547e78c588d7e1ee9f7aa |
| institution | Directory Open Access Journal |
| issn | 2563-6499 |
| language | English |
| last_indexed | 2024-03-08T18:13:39Z |
| publishDate | 2022-05-01 |
| publisher | The Société Internationale d’Urologie (SIU) |
| record_format | Article |
| series | Société Internationale d’Urologie Journal |
| spelling | doaj.art-5796e312f4a547e78c588d7e1ee9f7aa2023-12-31T18:13:12ZengThe Société Internationale d’Urologie (SIU)Société Internationale d’Urologie Journal2563-64992022-05-013314516210.48083/PDKF1241Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-AnalysisHadia Khananihttps://orcid.org/0000-0003-2101-8261George McClintockhttps://orcid.org/0000-0002-6992-8013Hilary Fernandohttps://orcid.org/0000-0003-3647-8658Gillian Hellerhttps://orcid.org/0000-0003-1270-1499Rebecca Asherhttps://orcid.org/0000-0003-2502-4693 Cindy Garciahttps://orcid.org/0000-0002-5787-2964David P. Smithhttps://orcid.org/0000-0002-1474-3214Ian Getleyhttps://orcid.org/0000-0001-5864-1044Nariman Ahmadihttps://orcid.org/0000-0001-8727-5952Norbert Doeukhttps://orcid.org/0000-0003-4322-2984Scott Lesliehttps://orcid.org/0000-0001-9848-969XNiruban Thanigasalamhttps://orcid.org/0000-0002-6438-8732Henry H. Woohttps://orcid.org/0000-0003-4099-0339Commercial airline cockpit crew (CCC) are potentially exposed to occupational risk factors that may have detrimental health effects. However, available literature on prostate cancer (PCa) as a health outcome is conflicted. Therefore, this review of cohort studies aims to evaluate the incidence of and mortality from PCa in CCC based on studies published to date. PubMed, Medline, EMBASE and SCOPUS were searched from 1946 to April 2021. Cohort studies reporting standardized incidence ratios (SIR) and/or standardized mortality ratios (SMR) of PCa in CCC were included. Military, cabin crew and service personnel data were excluded. Independent data extraction was conducted, and study quality assessed. Standardized ratios were pooled using a fixed effects model and expressed with 95% confidence intervals. 75 studies were assessed for eligibility from which 6 involving 129 374 licensed CCC were included in the final analysis: Two reported incidence only, 1 incidence and mortality and 3 reported mortalities only. The pooled SIR for PCa in CCC was 1.41 (95% CI 1.17 to 1.71) with moderate heterogeneity (I2 = 53%) however, the pooled SMR was not statistically significant (1.08; 95% CI 0.94 to 1.24) also with moderate heterogeneity (I2 = 70%). The available evidence shows that CCC are at a higher risk of developing PCa but there is no evidence to suggest a similarly higher risk of death from the disease. The effect of early detection through PSA testing in this cohort is unclear. Occupational exposure to radiation and sleep disturbance may play a role, but clear evidence of additional risk is lacking. Our review indicates that most evidence is dated and to confidently assess contemporary health outcomes of CCC, further research is required.https://siuj.org/index.php/siuj/article/view/184/116prostate cancercommercial airline pilotsincidencemortality |
| spellingShingle | Hadia Khanani George McClintock Hilary Fernando Gillian Heller Rebecca Asher Cindy Garcia David P. Smith Ian Getley Nariman Ahmadi Norbert Doeuk Scott Leslie Niruban Thanigasalam Henry H. Woo Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis Société Internationale d’Urologie Journal prostate cancer commercial airline pilots incidence mortality |
| title | Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis |
| title_full | Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis |
| title_fullStr | Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis |
| title_short | Incidence and Mortality of Prostate Cancer in Commercial Airline Cockpit Crew: Systematic Review and Meta-Analysis |
| title_sort | incidence and mortality of prostate cancer in commercial airline cockpit crew systematic review and meta analysis |
| topic | prostate cancer commercial airline pilots incidence mortality |
| url | https://siuj.org/index.php/siuj/article/view/184/116 |
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