Case Control Study
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World J Gastroenterol. Jul 21, 2014; 20(27): 9116-9120
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9116
Incidence of colorectal neoplasms among male pilots
Menachem Moshkowitz, Ohad Toledano, Lior Galazan, Aharon Hallak, Nadir Arber, Erwin Santo
Menachem Moshkowitz, Lior Galazan, Aharon Hallak, Nadir Arber, Erwin Santo, Ohad Toledafno, Integrated Cancer Prevention Center and Department of Gastroenterology, Tel- Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 64239, Israel
Author contributions: Moshkowitz M, Arber N and Santo E designed research; Toledano O, Galazan L, Hallak A and Arber N performed research and analyzed data; Moshkowitz M and Arber N wrote the paper.
Correspondence to: Nadir Arber, MD, MSc, MHA, Head, Integrated Cancer Prevention Center and Department of Gastroenterology, Tel- Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann St. Tel Aviv 64239, Israel. nadira@tlvmc.gov.il
Telephone: +972-3-6974968 Fax: +972-3-6974867
Received: October 21, 2013
Revised: December 11, 2013
Accepted: March 8, 2014
Published online: July 21, 2014
Processing time: 273 Days and 0.2 Hours
Abstract

AIM: To assess the prevalence of colorectal neoplasms (adenomas, advanced adenomas and colorectal cancers) among Israeli military and commercial airline pilots.

METHODS: Initial screening colonoscopy was performed on average-risk (no symptoms and no family history) airline pilots at the Integrated Cancer Prevention Center (ICPC) in the Tel-Aviv Medical Center. Visualized polyps were excised and sent for pathological examination. Advanced adenoma was defined as a lesion >10 mm in diameter, with high-grade dysplasia or villous histology. The results were compared with those of an age- and gender-matched random sample of healthy adults undergoing routine screening at the ICPC.

RESULTS: There were 270 pilots (mean age 55.2 ± 7.4 years) and 1150 controls (mean age 55.7 ± 7.8 years). The prevalence of colorectal neoplasms was 15.9% among the pilots and 20.6% among the controls (P = 0.097, χ2 test). There were significantly more hyperplastic polyps among pilots (15.5% vs 9.4%, P = 0.004) and a trend towards fewer adenomas (14.8% vs 20.3% P = 0.06). The prevalence of advanced lesions among pilots and control groups was 5.9% and 4.7%, respectively (P = 0.49), and the prevalence of cancer was 0.7% and 0.69%, respectively (P = 0.93).

CONCLUSION: There tends to be a lower colorectal adenoma, advanced adenoma and cancer prevalence but a higher hyperplastic polyp prevalence among pilots than the general population.

Keywords: Colorectal cancer; Adenomatous polyps; Colon neoplasms; Hyperplastic polyps

Core tip: Military and commercial airline pilots are exposed to cosmic radiation and other specific occupational factors. Several epidemiological studies on a possible elevated cancer risk, including colorectal cancer, among flight personnel have yielded contradictory results. We aimed to evaluate the incidence of colorectal neoplasms among Israeli military and commercial pilots and to compare it with the incidence of colorectal neoplasms among the general population. We found that the prevalence of colorectal adenomas, advanced adenoma and cancer is not higher, and tends to be even lower, among aircrew than that of the general population. It seems that ionizing radiation does not constitute a risk factor for colorectal cancer among air crew personal.