Abstract

The oral report of eight cases of cancer over a period of 3 years among physicians working in a French University Hospital led us to conduct a retrospective cohort study to compare the incidence of cancer in these physicians with that of the general population living in the same area. The cohort consisted of 940 physicians (72% male, 28% female) who had worked for at least 1 year in this hospital between 1945 and 1994 (a total of 10,693 person-years). The incidence of cancer among physicians was compared with that of the general population using a local cancer registry which has recorded all cancer cases occurring in the Department between 1979 and 1994. Standardised incidence ratio (SIR) was calculated for all causes of cancer and site by site. Although the global incidence of cancer did not differ from that of the general population (SIR=0.97; 95% confidence interval (CI) 0.59-1.5), a significantly increased incidence of haematological malignancy was found among physicians (SIR=5.45; 95% CI 2-11.9). These findings pointed out the risk of lymphatic and haematopoietic cancer among physicians who started working after 1945 when the first rules pertaining to protection from ionising radiation came into effect. However, limitations of this study such as limited statistical power and lack of individual exposure data should be considered in the interpretation of these findings. Possible aetiological factors responsible for these risks are discussed. Education about general safety protection programmes against carcinogenic risk factors including physical, biological and chemical agents still remains a priority among physicians.

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