Melanoma risk may be elevated in flight-based occupations

1. Both airline pilots and cabin crew had higher incidences of developing melanoma than the general population.

2. Flight-based occupations were also associated with increased risk of mortality due to melanoma.

Evidence Rating Level: 2 (Good)

Study Rundown: Melanoma is one of the most common cancers in the United States and is associated with UV and cosmic radiation exposure. Various cohort studies have observed higher incidences of melanoma in flight-based workers, but a complete review of the literature has not been undertaken. Thus, this meta-analysis sought to establish the significance of these correlations amongst flight-based pilots and cabin crew. Overall standardized incidence ratios (SIR) for pilots and cabin crew indicated an over two-fold increase in melanoma when compared to the general population. Additionally, the standard mortality ratio (SMR) showed a 1.42-fold increase for both flight-based occupations. Strengths of this study include its clear inclusion/exclusion criteria for reviewed literature. However, due to the wide heterogeneity of reviewed studies, such as undefined time spent in air for each participant, the significance may be affected.

Click to read the study in JAMA Dermatology

Relevant Reading: Cosmic Radiation Exposure and Cancer Risk Among Flight Crew

In-Depth [meta-analysis]: This systematic review included 19 studies that analyzed melanoma risk in flight-based workers. Melanoma risks were categorized in SIR and SMR for pilots and cabin crew when compared to the general population. Study heterogeneities were addressed using χ² and Ι² testing. The Bregg rank correlation test, Egger weighted linear regression test, and funnel plots were used to account for small cohort studies’ biases. Results showed a 2.22- and 2.09-fold increase in the incidence of melanoma in pilots and cabin crew (95% CI, 1.67-2.93, p=0.001 and 1.67-2.62, p=0.45 respectively). A 1.83-fold increase in melanoma mortality rate was also observed for pilots (95% CI, 1.27-2.63, p=0.33).

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