Occupational Exposure to Ionizing Radiation in Female Physicians and Breast Cancer Risk: A Systematic Review and Meta-analysis.

Introduction: Advancements in health technologies have enabled the performance of minimally invasive procedures using ionizing radiation for radioscopy and fluoroscopy by various physicians including orthopedic surgeons, radiologists, urologists, cardiologists, vascular surgeons, and plastic surgeons. Simultaneously, there appears to be an increasing frequency of breast cancer among these professionals. In addition to other risk factors to which they are exposed, ionizing radiation plays a role in carcinogenesis. This study is a systematic review and meta-analysis conducted to summarize the available literature on breast cancer risk among female physicians occupationally exposed to ionizing radiation.

Methods: A systematic search was conducted in the PubMed, Embase, and LILACS databases, as well as reference lists based on PRISMA checklist (PROSPERO CRD42024553635). The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed at Review Manager.

Results: Six observational studies were included, evaluating 34,744 participants: 8103 exposed to ionizing radiation and 26,641 controls, with a minimum 10-year follow-up. According to the NOS, 5 studies were classified as high quality and one as moderate. The meta-analysis revealed an increased breast cancer risk among female physicians exposed to ionizing radiation, with an odds ratio (OR) 1.84 (95% CI 1.11-3.06). A sensitivity analysis excluding the study classified as moderate quality showed a breast cancer risk in the exposed group with an OR 1.42 (95% CI 1.06-1.89).

Conclusions: Based on the results of this meta-analysis, female physicians occupationally exposed to ionizing radiation have an increased risk of breast cancer compared to those who are not exposed.