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Original research
Incident skin melanoma in Danish male military pilots: a nested case–control study
  1. Julie Elbaek Pedersen,
  2. Johnni Hansen
  1. Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
  1. Correspondence to Julie Elbaek Pedersen, Danish Cancer Society Research Center, Danish Cancer Society, 2100 Copenhagen, Denmark; juliep{at}


Objectives A growing body of research has reported that pilots have an increased risk of skin melanoma, which may be caused by occupational exposure to cosmic and solar ultraviolet A radiation in aircraft cockpits. However, the existing literature cannot rule out confounding, for example, that pilots may spend more leisure time in the sun compared with the general population, which therefore leaves the current evidence inconclusive. The present study aimed to provide more knowledge regarding this association.

Methods This nested case–control study included 199 male cases of skin melanoma diagnosed between 1990 and 2003, and 1126 male cancer-free controls identified from a large Danish military population. Among these individuals, 10 cases had ever worked as a pilot.

Detailed information on military service and other held jobs together with socioeconomic and lifestyle characteristics, for example, leisure-time sun exposure habits, had been obtained from a structured questionnaire.

Results Adjusted results showed a positive association between work onboard aircraft and skin melanoma (OR=2.30, 95% CI: 1.06–4.97) and the risk was indicated only to be increased in pilots (OR=7.08, 95% CI: 2.51–19.93). A positive association between longer duration of employment as a pilot and skin melanoma was also observed (ORper year=1.07, 95% CI: 1.01–1.14).

Conclusions The findings from this study conducted among Danish military personnel suggest that pilots have an increased risk of skin melanoma after accounting for leisure-time sun exposure and socioeconomic status. Future large-scale studies focusing on the risk of skin melanoma in pilots, including detailed objective information on dimensions of exposure and potential confounders, are warranted.

  • Occupational Health
  • Public health
  • Radiation
  • Melanoma

Data availability statement

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  • Contributors JEP performed the analyses, interpreted the results and wrote the manuscript. JH is responsible for the overall content and was a key contributor to the design process of the study, data collection, cleaning and linkage, and the analyses that were undertaken, and revised the manuscript critically for important intellectual content. Both authors have approved the final version to be published and are accountable for all aspects of the work.

  • Funding This study was supported by a grant from the Danish Ministry of Defence.

  • Disclaimer The funding source had no role in the design or analysis of the study or in the decision to submit the manuscript for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.