Grayson J K, Lyons T J
Armstrong Laboratory, Occupational and Environmental Health Directorate, Brooks AFB, TX, USA.
Aviat Space Environ Med. 1996 Feb;67(2):101-4.
We compared the cancer incidence of male United States Air Force (USAF) aircrew (342 cancers, 532,980.97 man-years) with non-flying Air Force officers (827 cancers, 1,084,370.08 man-years) between 1975-89.
Incident cancer cases for both aviators and non-flying officers were obtained from USAF hospitalization records. Age-adjusted standardized incidence ratios (SIR's) were calculated for aircrew using data from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program. Aviator age-adjusted cancer rate ratios were also obtained using non-flying officers as an internal comparison group.
We observed statistically significant excesses of aircrew cancers for all sites, testis, and urinary bladder. All other aviator cancer classifications were not significantly different from the comparison cohort; most notably, cancers of the colon and rectum, skin (both malignant melanoma and non-epithelial), brain and nervous system, Hodgkin's Disease and leukemias.
Previous studies of commercial pilots that demonstrated excesses of these cancers may have been biased by the use of external comparison groups. We used an internal comparison population to reduce selection bias, information bias and confounding. From these data we detected notable excess aircrew cancer risk for cancers of the testis, urinary bladder, and all sites combined.
我们比较了1975年至1989年间美国空军男性机组人员（342例癌症，532,980.97人年）与非飞行空军军官（827例癌症，1,084,370.08人年）的癌症发病率。
飞行员和非飞行军官的癌症发病病例均来自美国空军住院记录。使用美国国家癌症研究所监测、流行病学和最终结果（SEER）项目的数据，计算机组人员的年龄调整标准化发病率（SIR）。还以非飞行军官作为内部比较组，得出飞行员年龄调整后的癌症发病率比值。
我们观察到机组人员在所有部位、睾丸和膀胱的癌症发病率有统计学意义的过量。所有其他飞行员癌症分类与比较队列无显著差异；最显著的是，结肠和直肠癌、皮肤癌（恶性黑色素瘤和非上皮性）、脑和神经系统癌症、霍奇金病和白血病。
先前对商业飞行员的研究表明这些癌症发病率过高，可能因使用外部比较组而存在偏差。我们使用内部比较人群以减少选择偏倚、信息偏倚和混杂因素。从这些数据中，我们检测到机组人员在睾丸癌、膀胱癌以及所有部位综合起来的癌症风险有显著过量。
