Cancer Incidence and Cause-Specific Mortality in Male and Female Physicians

Institute of Experimental and Clinical Medicine, Tallinn, Estonia.
Scandinavian Journal of Public Health (Impact Factor: 1.83). 02/2002; 30(2):133-40. DOI: 10.1080/14034940210133735
Source: PubMed

ABSTRACT To evaluate whether the presumed knowledge of physicians about healthier lifestyle decreases their risk of cancer and mortality, a retrospective cohort study of male and female physicians was conducted in Estonia.
The cancer incidence and cause-specific mortality of 3,673 physicians (870 M, 2,803 F) in Estonia was compared with the rates of the general population. Information on cancer cases and deaths in the cohort between 1983 and 1998 was obtained from the Estonian Cancer Registry and the mortality database of Estonia.
The standardized incidence ratio (SIR) for all cancers was 1.32 (95% confidence interval (CI) 1.15-1.48) in women and 0.92 (95% CI 0.73-1.13) in men. Female physicians had an elevated risk for breast cancer (SIR 2.03, 95% CI 1.62-2.51) and myeloid leukaemia (SIR 3.69, 95% CI 1.35-8.02). Male physicians had an excess of skin melanoma (SIR 4.88, 95% CI 1.58-11.38). A large deficit of lung cancer was observed (SIR 0.24, 95% CI 0.11-0.48). The very low all-cause mortality in the cohort (standardized mortality ratio 0.55, 95% CI 0.50-0.61) was mainly due to large deficits in deaths from lung cancer, cardiovascular diseases and external causes. The suicide rate in the cohort was lower than in the general population.
No health risks were observed in the cohort that could be linked to the occupational exposures of physicians. The pattern of cancer incidence and mortality seen in physicians in Estonia is similar to the pattern seen among professional classes in other countries.

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Available from: Mati Rahu, Sep 26, 2015
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    • "Hawton et al. [11] found a significantly lower standardized suicide mortality ratio of 0.67 for male physicians and a ratio of 2.02 for female physicians in the UK. More recent research [10] suggests that the disparity between physician and nonphysician suicide rates may be smaller. It has become evident that age and gender are major confounding factors in this area, which could partly explain the varied conclusions in the literature. "
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    ABSTRACT: Objective. To describe a psychiatric profile and characteristics of physicians who killed themselves in Quebec between 1992 and 2009. Method. The cases of 36 physicians (7 females and 29 males) and 36 nonphysicians who committed suicide were matched for age and gender and examined in a nested case control design. All subjects were judged as definite suicide by the Quebec Coroner Head Office. Consensus regarding DSM-IV diagnoses was established by two forensic psychiatrists. Results. Rates of all Axis I diagnoses were 83% for physicians and 91% for nonphysicians at the time of suicide. Major depressive disorders were the most frequently observed pathology in both groups (61% and 56%, resp.). Conclusions. Physicians and nonphysicians who committed suicide in Quebec suffered from the same type of psychiatric disorder at the time of killing themselves. The findings advocate strongly for more efficient suicide prevention measures including early detection and treatment of mood disorders for the physicians.
    Depression research and treatment 07/2011; 2011(2):936327. DOI:10.1155/2011/936327
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    • "It seems that doctors in western industrialized countries had a higher mortality rate than the general population until about 1950 [3,4]. More recently, however, doctors have enjoyed a lower mortality rate than the rate in the general population [4,5], with the notable exception of death from suicide [4,6-11] and violent deaths [4]. Most studies have compared mortality rates for doctors with those of the general population or within the medical profession, but not with comparable socio-economic groups. "
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    ABSTRACT: To study the mortality pattern of Norwegian doctors, people in human service occupations, other graduates and the general population during the period 1960-2000 by decade, gender and age. The total number of deaths in the study population was 1 583 559. Census data from 1960, 1970, 1980 and 1990 relating to education were linked to data on 14 main causes of death from Statistics Norway, followed up for two five-year periods after census, and analyzed as stratified incidence-rate data. Mortality rate ratios were computed as combined Mantel-Haenzel estimates for each sex, adjusting for both age and period when appropriate. The doctors had a lower mortality rate than the general population for all causes of death except suicide. The mortality rate ratios for other graduates and human service occupations were 0.7-0.8 compared with the general population. However, doctors have a higher mortality than other graduates. The lowest estimates of mortality for doctors were for endocrine, nutritional and metabolic diseases, diseases in the urogenital tract or genitalia, digestive diseases and sudden death, for which the numbers were nearly half of those for the general population. The differences in mortality between doctors and the general population increased during the periods. Between 1960 and 2000 mortality for doctors converged towards the mortality for other university graduates and for people in human service occupations. However, there was a parallel increase in the gap between these groups and the rest of the population. The slightly higher mortality for doctors compared with mortality for other university graduates may be explained by the higher suicide rate for doctors.
    BMC Public Health 03/2011; 11(1):173. DOI:10.1186/1471-2458-11-173 · 2.26 Impact Factor
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    • "It has been shown that physicians may use their own professional knowledge and skills and may engage healthier lifestyles in ways that reduce their own risks of adverse health outcomes (Innos et al. 2002). There is no information regarding the lifestyles of health personnel in Taiwan, and so we were unable to confirm or refute the above speculation. "
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    ABSTRACT: To assess the causes and cause-specific risks of hospitalization among physicians in Taiwan. The data used in this study were retrieved from filed claims and registries of the National Health Insurance Research Database. A cohort of 33,380 physicians contracted with the national insurance program between 1997 and 2002 were linked to the information on the inpatient claim data for hospitalization. The physicians' incidence density of hospitalization was compared with that of the general population, other health personnel, and nurses to compute the calendar year-, age-, and gender-standardized hospitalization ratios (SHRs). A multivariate log-linear model was also used to assess the effects of gender, age, type of contract, and specialty on the risks of hospitalization. Compared with the general population, physicians experienced significantly reduced risks of all causes (SHR=54.5, 95 percent confidence interval [CI] 53.4-55.5) and all major cause-specific hospitalizations, especially mental disorders (SHR=6.9, 95 percent CI 5.8-8.4). On the other hand, compared with other health personnel, physicians had a small but significantly higher risk of all causes of hospitalization (SHR=107.8, 95 percent CI 105.1-110.6). Higher risks of hospitalization were also noted for neoplasms (SHR=108.9, 95 percent CI 102.0-116.3) and diseases of the respiratory system (SHR=114.2, 95 percent CI 107.3-121.5). In addition to the above diagnoses, physicians also had significantly higher risks for genitourinary and musculoskeletal system and connective tissue problems than nurses. Compared with their physician colleagues, female physicians, young (<30 years) and older (> or =60 years) physicians, and those working with the health institutions and programs were at elevated risks of hospitalization for all causes as well as for certain specific diseases. Physicians in Taiwan are at higher risks of developing specific diseases compared with their allied health colleagues. As the health of physicians is vital to the quality of care, Taiwanese health policy analysts should recognize that increased patient volume and satisfaction with public health care should not be achieved at the expense of physicians' health.
    Health Services Research 04/2008; 43(2):675-92. DOI:10.1111/j.1475-6773.2007.00776.x · 2.78 Impact Factor
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