Prevalence of All-Cause and Breast Cancer in Female Neurosurgeons

Introduction: Previous studies have shown an increased prevalence of breast and all-cause cancer amongst female orthopedic surgeons. This study aimed to assess cancer burden in female neurosurgeons.

Methods: This study received exempt approval from the local institutional IRB office for human subjects research. A RedCap survey was designed with multiple-choice questions regarding social determinants of health, medical history, stage of neurosurgical training, radiation exposure, and safety training, and an optional free-response section. The survey was distributed to AANS members registered with a female gender at all stages of training, and publicized on social media. Standardized prevalence ratios for cancer prevalence were calculated using age-, gender-, and race/ethnicity-specific controls from the SEER cancer registry. Respondents with and without a self-reported history of cancer were compared based on occupational radiation exposure, protective shielding use, and radiation training. Statistical significance between these groups was calculated with chi-squared analysis.

Results: Out of 120 respondents, 13 (10.8%) reported a previous cancer diagnosis. The prevalence of cancer was 199% higher among respondents compared with that of the age and race/ethnicity-adjusted general US female population (SPR = 2.99, 95% CI = 1.58-4.83). The majority of respondents reported exposure to radiation in their practice (88.4%), use of radiation at least three times per week (73.3%), and use of shielding at all times during radiation exposure (68.5%). There were no significant differences in radiation use, radiation frequency, or specific types of radiation procedures between respondents with and without a history of cancer. Free text response highlighted that respondents experience limited access to protective shields, poor fit of lead aprons, and discomfort when wearing aprons.

Conclusion : All-cause cancer had a higher prevalence in female neurosurgeons in this study compared to age-, gender-, and race/ethnicity-matched controls, independent of radiation use, exposure, and safety training by self report.