Cosmic radiation exposure and cancer risk among flight crew.

Nearly 20 epidemiologic or related studies of cancer incidence and mortality have been published during or since 2000, with several reporting increased risks of female breast cancer among flight attendants and melanoma among both pilots and cabin crew. Occasionally, excesses of other cancers have been observed, but not consistently. Although the real causes of these excess cancer risks are not known, there is concern that they may be related to occupational exposures to ionizing radiation of cosmic origin. It is possible that confounding risk factors may partially or totally explain the observed relationships, but several investigations are beginning to address lack of past adjustment for reproductive factors and sun exposure with improved study designs. With progress in aviation technology, planes will fly longer and at higher altitudes, and presumably the number of flights and passengers will increase. To respond responsibly to the real and perceived risks associated with flying, more extensive data are needed, but special efforts should be considered to ensure new projects can genuinely add to our current knowledge.