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Prevalence of Cancer in Female Urologists
Ashley Brandon, MD1, Brooke Harnisch, MD2, Alex Sox-Harris, PhD3, Loretta Chou, MD3, Lori Lerner, MD2.
1Boston Univeristy/ Boston Medical Center, Boston, MA, USA, 2Boston University/ Boston VAMC, Boston, MA, USA, 3Stanford University, Stanford, CA, USA.

Prevalence of Cancer in Female Urologists
Background:
Recent studies suggest that female orthopedic surgeons are at increased risk from the general population of developing breast cancer. One hypothesis is that they are exposed to low dose ionizing radiation during clinical practice. Urologists are also exposed to radiation throughout their careers through x-ray and fluoroscopy, and have other similar risk factors such as delayed childbirth, older age at first birth, low parity, nulliparity, and high socioeconomic status. The purpose of this study was to determine the prevalence of overall malignancy and breast cancer among female urologists.
Methods:
An Institutional Review Board approved survey was sent to all 487 American board certified urologists between June and October 2012. Data including demographics, practice environment, type and quantity of radiation used in practice, radiation protection, type of cancer, age at diagnosis and breast cancer risk factors were analyzed. Standardized prevalence ratios (SPRs) and 95% confidence intervals (CIs) were calculated by dividing the observed number of cancers among female urologists by expected number, based on the gender, age, and race-specific cancer prevalence statistics within the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program.
Results:
Of the women surveyed, 70% responded (n=341). The mean age of participants was 45.7 ± 7.5 years. The majority of female urologists practiced in either an academic or private setting. The most common subspecialties were general urology and female/reconstruction (Table 1). Of the female urologists currently working, 12 malignancies were identified including breast cancer (n=7), melanoma (n=2), thyroid (n=2) and cervical (n=1). The mean age at diagnosis was 41.5 ± 9.3 years. Twenty-five percent of women diagnosed with cancer had a family history of malignancy. Female urologists did not have a higher cancer prevalence for all malignancies compared to women in the general population (SPR 0.79, 95% CI 0.32-1.63). There was also no difference in breast cancer prevalence between these two groups (SPR 1.28, 95% CI 0.41-2.99).
Conclusion:
The prevalence for all malignancies and breast cancer in female urologists was not elevated as compared to the general population. While female urologists have similar risk factors to female orthopedic surgeons, the cancer prevalence is not affected. Further research is needed to determine factors that could explain this difference including breast cancer risk and protective factors such as radiation shielding.
Table 1.Demographics and practice patterns of female urologists
Mean age (years)45.7 ± 7.51
Mean years since starting residency training17.5 ± 6.65
Current employment
Full time
Part time
Not working
Unknown

300 (88%)
35 (10.3%)
3 (0.88%)
3 (0.88%)
Setting
Academic
Health maintenance organization
Hospital
Private Practice
Unknown

92 (30%)
20 (5.9%)
44 (12.9%)
173 (50.7%)
12 (3.5%)
Subspecialty
Andrology
Female/Reconstruction
General
Pediatrics
Laparoscopic/endourology
Oncology
Unknown

4 (1.2%)
94 (27.6%)
173 (50.7%)
27 (7.9%)
9 (2.6%)
13 (3.8%)
21 (6.2%)
Standard fluoroscopy use
Unknown
< 6 times per year
1-2 times/month
>1 time/week
Use of protective shielding

7 (2%)
21 (6.2%)
126 (37%)
187 (55%)
322 (94%)


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