EUH Morning Report: Should physicians consider patients in or formerly in the military with occupational exposure to radar higher risk for hemolymphatic cancers?

The Bottom Line: Though there is a possible connection supported by some case reports and a few retrospective cohort studies, a definitive causation of military occupational exposure to radar with hemolymphatic and other cancers has not been established. However, physicians can still consider hemolymphatic cancer in their differential diagnosis if they know their patient has had occupational exposure to radar.

In their retrospective cohort study of a previously published case series of 47 patients diagnosed with cancer following years of occupational exposure to radiofrequency radiation (RFR), Peleg (2018) found “the consistent association of RFR and highly elevated HL cancer risk in the four groups spread over three countries, operating different RFR equipment types and analyzed by different research protocols, suggests a cause-effect relationship between RFR and HL cancers in military/occupational settings.”

In 2023, Peleg et. al published a second study analyzing data from a new case series of 46 patients diagnosed with cancer that had exposure to radar in a military setting and comparing them with similar groups from other studies, finding “a consistent, statistically significant, and well-documented atypically high HL PF, distinctly higher than expected in the community (Cancer Registry) or computed from unexposed comparison groups.”

(Peleg)

EUH Morning Report: What is the risk of cancer from diagnostic imaging?

The Bottom Line: “Neither physicians nor patients are generally aware of the radiation associated with CT, its risk of carcinogenesis, or the importance of limiting exposure among younger patients.” (Smith-Bindman et al)

“Radiation doses from commonly performed diagnostic CT examinations are higher and more variable than generally quoted, highlighting the need for greater standardization across institutions.” (Smith-Bindman et al)

“CT delivers much higher radiation doses than do conventional diagnostic x-rays. For example, a chest CT scan typically delivers more than 100 times the radiation dose of a routine frontal and lateral chest radiograph.” (Smith-Bindman et al)

EUH Morning Report: What cancers are associated with Dermatomyositis?

The Bottom Line: “The types of malignancy that are significantly associated with Dermatomyositis/Polymyositis (DM/PM) remain somewhat controversial. A large multinational population-based study observed significantly elevated risks for lung, ovarian, pancreatic, gastric, colorectal malignancies, and non-Hodgkin lymphoma in patients with DM and for non-Hodgkin lymphoma, lung, and bladder malignancies in patients with PM. On the other hand, the most commonly observed malignancy was nasopharyngeal malignancy in a study based in Taiwan. This suggests that significant heterogeneity may exist in the types of malignancy associated with DM/PM but may also reflect differences in malignancy risk across different populations.” (Hill)

(Hill)