Abstract P3-06-01: Occupational exposure to ionizing radiation in female physicians and risk of breast cancer: a systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Background: Recent advancements in health technologies have enabled minimally invasive procedures with the increasing use of ionizing radiation for radioscopy and fluoroscopy by orthopedic surgeons, radiologists, urologists, cardiologists, vascular surgeons, and plastic surgeons. Concurrently, there appears to be an increased incidence of breast cancer among these professionals. In addition to various other risk factors to which they are exposed, it is likely that ionizing radiation also plays a role in carcinogenesis. This study is a systematic review and meta-analysis conducted to evaluate the prevalence of breast cancer in female physicians exposed to ionizing radiation in the workplace. Methods: This systematic review was conducted following the PRISMA protocol and was registered in PROSPERO (ID: CRD42024553635). PubMed, Embase, and LILACS databases were searched. Also, reference lists from other articles were searched. Mesh terms used were: breast neoplasms, physicians and prevalence. Articles that described the prevalence of breast cancer among female physicians exposed to ionizing radiation in the workplace were included. We restricted the publication languages to English, Spanish, or Portuguese. Article screening was performed independently by two evaluators (MM and YR) using the Rayyan platform. Methodological quality assessment and biases of included studies were assesed using the Newcastle-Ottawa Scale (NOS) for cohort studies. All statistical analyses were performed using the Review Manager (RevMan) Web v. 8.0.0 (The Cochrane Collaboration). Results: As of January 2024, 2597 studies were retrieved, with seven studies meeting the inclusion criteria. One study was excluded due to duplicate data. Six cohort studies were included, evaluating a total of 34,744 female participants, including 8,103 female physicians exposed to ionizing radiation, and 26,641 participants in the control group, with a minimum follow-up of 10 years (ranging from 10 to 30 years). According to the NOS instrument, five studies were rated as good and one as fair. Meta-analysis assessment revealed an increased risk among female physicians exposed to ionizing radiation in the workplace, with an odds ratio (OR) of 1.84 (95% CI 1.11 to 3.06; p = 0.02; I2 = 71%; six studies; 34,744 participants). A sensitivity analysis excluding the study rated as fair showed that the risk of breast cancer in the exposed group still increased, with an OR of 1.42 (95% CI 1.06 to 1.89; p = 0.02; I2 = 0%; five studies; 23,854 participants). Conclusions: Female physicians exposed to ionizing radiation during procedures such as radioscopy or fluoroscopy, appear to have an increased risk for breast cancer compared to female physicians not exposed to radiation. However, currently, there are no mandatory regulations for measuring radiation exposure, recommendations for the use of protective equipment according to the physician's body type, or specific screening policies for these professionals. Therefore, the assessment of this exposure and the associated increased risk of breast cancer should be further investigated to enhance worker safety measures and to guide specific screening strategies. Citation Format: Milena Martello Cristófalo, Yedda Nunes Reis, Jonathan Yugo Maesaka, Bruna Salani Mota, José Maria Soares-Jr, Edmund Chada Baracat, Michail Ignatiadis. Occupational exposure to ionizing radiation in female physicians and risk of breast cancer: a systematic review and meta-analysis [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P3-06-01.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.040 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.035 |
| Bibliometrics | 0.007 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".