Transcript Heat Related Illnesses

Cancer and the Aviator
John T. Carmack, MD, MPH
Lt Col, PAANG, MC, SFS
193 Special Operations Squadron
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The Big Cancers
Other Cancers
Cancer and Aviation
Prevention and Screening Recommendations
The Big Cancers
• Breast Cancer
– 1/7 women
– #1 cancer in women
– 2nd leading cause cancer death
• Colorectal Cancer– #1 leading cause CA death
– 15-30 cases/100,000 population
• Lung Cancer
– Leading cause of cancer death men
– ~73 cases /100,000 population
The Big Cancers
• Gynecologic Cancers
• Prostate Cancer
– Most common cancer in men
– 80-200 cases/100,000
– Death rates ~ 12-60/100,000
• Skin Cancer
– Who is at risk?
– ~20 cases/100,000
Other Cancers
• Testicular Cancer
– Rare – most common ages 15-34
– Overall 5 year survival 95-99%
– 0.01-0.04 cases/100,000 population
• Pancreatic Cancer
– 1/76 people in the U.S.
• Brain Cancer—”doo-doo happens”
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Time trends (1998-2007) in brain cancer incidence rates in relation to mobile phone use in
England. Bioelectromagnetics. 2011 Jul;32(5):334-9. doi: 10.1002/bem.20648. Epub 2011
Jan 28. de Vocht F, Burstyn I, Cherrie JW.
These data do not indicate a pressing need to implement a precautionary principle by means of
population-wide interventions to reduce RF exposure from mobile phones.
Testicular Cancer in U.S. Air
Force Officers
• Lt Col Christopher Walker – June 2011
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Air Force Research Laboratory
Association between TC and aviators
Retrospective 1998-2008
63 cases in a population 632,323
• ~10 cases/100,000 population
• Aviators: 16.9/100,000
• Nonaviators: 7.8/100,000
– Did suggest an association however not
statistically significant
Cosmic Radiation
“Exposure to ionizing radiation in the aviation cohort has been examined
many times as a potential occupational hazard that can lead to
increased cancer rates. The results of these studies, when looking
specifically at testicular cancer, have not been consistent.”
Sigurdson AJ, Ron E. “Cosmic Radiation Exposure and Cancer Risk Among Flight Crew,”
Cancer Investigation, 22 (5), Jan 2004, pp. 743-61.
Cancer Incidence and Mortality
Among Flight Personnel
An excellent review article and synopsis of all scientific studies of cancer in aircrew
members to date [2000] (meta-analysis) concludes the following:
Male pilots:
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Slight increased incidence of cancers of the brain and melanoma
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Increase mortality from prostate and brain cancer
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Risk of other types of cancer was lower in pilots
Female flight attendants:
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Higher risk of melanoma and breast cancer
Cause and Effect:
“The cause for these findings is not clear since it is difficult to separate occupational exposures from
routine exposures such as potential for more sun with increased access to travel and potentially
increased leisure time.”
Aviation, Space and Environmental Medicine, 2000; 71:216-24 "Cancer Incidence and Mortality Among Flight
Personnel: A Meta-Analysis" Ballard et al.
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Cancer Summary
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Leading cause of death worldwide
Breast Cancer #1 in women (1/7)
Lung Cancer: leading cause cancer death men
Colon Cancer: leading cause cancer death in
cancer that affects both men/women
Cancer Summary
About 30% of cancer deaths are due to the
five leading behavioral and dietary risks:
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high body mass index,
low fruit and vegetable intake
lack of physical activity
tobacco use
alcohol use
Screening and Prevention
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Lung Cancer—stop smoking/second hand
Breast Cancer—screening mammograms
Prostate Cancer—annual prostate exam
Cervical Cancer—annual PAP smear
Skin Cancer—sun screen/reduce exposure
Colon Cancer—screening colonoscopy
"The ultimate determinant in the struggle
now going on for the world will not be
bombs and rockets but a test of wills and
ideas---a trial of spiritual resolve: the
values we hold, the beliefs we cherish and
the ideals to which we are dedicated."
Ronald Wilson Reagan
QUESTIONS
QUETIONS