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Original article
Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures
  1. Marie Odile Bernier1,2,
  2. Michele M Doody1,
  3. Miriam E Van Dyke3,
  4. Daphné Villoing1,
  5. Bruce H Alexander4,
  6. Martha S Linet1,
  7. Cari M Kitahara1
  1. 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
  2. 2Laboratory of Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
  3. 3Department of Epidemiology, Emory University, Atlanta, Georgia, USA
  4. 4Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Marie Odile Bernier, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA; mo.bernier{at}


Introduction Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices.

Methods From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003–2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012–2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade.

Results During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers.

Conclusion Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed.

  • cohort study
  • ionising radiation
  • nuclear medicine
  • cancer

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  • Contributors All authors (MOB, MMD, DV, BHA, MSL, CMK) contributed to the design and conduct of the study, critically reviewed manuscript drafts and approved the final version. MOB, CMK and MSL had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding The research was funded by the intramural programme of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, USA.

  • Competing interests None declred.

  • Patient consent Not required.

  • Ethics approval The Institutional Review Boards of the National Cancer Institute and the University of Minnesota.

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

  • Data sharing statement Data from the USRT study may be made available on request from the principal investigator, CMK.