Evidence map›Paper›PMID 40112244›Full record

ArticleJournal of the National Cancer Institute2025

Sex-specific radiation-associated lung cancer mortality risks as impacted by smoking among US radiological technologists.

Cato M Milder, Elizabeth K Cahoon, Sara J Schonfeld, Dale L Preston, Bruce H Alexander, Martha S Linet, Cari M Kitahara

Abstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Cato M MilderRadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0002-9400-2095
Elizabeth K CahoonRadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0002-8028-0588
Sara J SchonfeldRadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0002-4368-4647
Dale L PrestonHirosoft International, Eureka, CA, United States.ORCID 0000-0002-0641-2925
Bruce H AlexanderDivision of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, United States.ORCID 0000-0002-9523-1914
Martha S LinetRadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0002-1687-5587
Cari M KitaharaRadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0001-6416-4432

Funding

Intramural Research ProgramNCI NIH HHS
6 · The paper itself

Abstract

backgroundThe Life Span Study of Japanese atomic bomb survivors estimated greater risks of radiation-associated lung cancer among females than males, with direct implications for occupational radiation safety policy. To evaluate replicability of these findings in radiation workers, we assessed sex-specific radiation-associated risks of lung cancer mortality in a large cohort of US radiological technologists.

methodsUsing data from 4 questionnaires (1983-2013), we reconstructed lifetime smoking history for 83 715 female and 26 650 male technologists. We estimated individual lung occupational radiation doses using badge dose and questionnaire data. We used Poisson regression to investigate joint radiation-smoking effects on sex-averaged and sex-specific lung cancer mortality risk.

resultsFor 1243 female and 607 male technologists who died from lung cancer, median cumulative lung dose was 16.2 mGy (non-cases: 7.7 mGy) and 24.5 mGy (non-cases: 10.1 mGy), respectively. Excess risk of lung cancer increased with increasing radiation dose. However, smoking modified this effect: the radiation effect at 100 mGy increased until 16 cigarettes/day, after which it declined. Excess relative risk (ERR) per 100 mGy was greater among males (never smoking additive ERR = 1.98; 95% CI = 0.34 to 6.25) than females (never smoking additive ERR = 0.40; 95% CI = -0.02 to 1.21); sex differences persisted up to ∼40 cigarettes/day.

conclusionsOur results indicated radiation-associated risks of lung cancer mortality were stronger in males than females, in contrast to the Life Span Study. However, both studies found radiation-associated risks were highest in workers with light-to-moderate smoking intensity. Altogether, these findings reinforce the importance of rigorous radiation protection measures for all radiation workers, regardless of sex, alongside interventions to support smoking cessation.

Indexed as

Lung NeoplasmsNeoplasms, Radiation-InducedOccupational DiseasesOccupational ExposureSmokingTechnology, RadiologicAdultAgedFemaleHumansMaleMiddle AgedRadiation DosageRisk FactorsSex FactorsSurveys and Questionnaires

Identifiers

PMID40112244
PMCPMC12229458

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.