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No increased risk of death among U.S. physicians who perform fluoroscopy-guided interventional procedures compared to psychiatrists

Posted on March 01, 2017

The latest results from a prospective cohort study of U.S. physicians who performed fluoroscopy-guided interventional procedures (FGI MDs) found no increased risk of death (total and cause-specific), compared to physicians who did not perform these types of tests (psychiatrists), according to a new study by researchers at the National Cancer Institute (NCI). The results of the study were reported online February 23, 2016, in Radiology.

Fluoroscopy-guided interventional (FGI) procedures are often an alternative to more invasive surgeries, resulting in both clinical benefits and lower cost to patients. The use of these procedures has surged since their introduction in the 1960s. Some concerns have been raised regarding the potential for occupational exposure to ionizing radiation from repeated administering of these procedures.

Epidemiologists at the NCI compared risk of death among 45,634 physicians who perform these procedures and 64,401 psychiatrists. The team chose psychiatrists as a comparison group because they are a class of physicians unlikely to have any occupational exposure to fluoroscopy. During the follow-up period (1979-2008), researchers found that doctors who performed these procedures had lower death rates than psychiatrists for all-cause and many specific causes of death. This disparity increased with later year of medical school graduation. A notable exception was an almost 4-fold increased risk of leukemia, which has previously been associated with radiation exposure, among male FGI MDs who graduated from medical school before 1940, but this was based on a small number of physicians.

Although larger and longer-term follow-up studies must be done to confirm these results, this study suggests that modern safety measures protecting physicians who perform FGI procedures have been effective in preventing radiation-related deaths.

Reference: Linet MS et al., Mortality in U.S. physicians likely to perform fluoroscopy-guided interventional procedures compared with psychiatrists, 1979 to 2008. Radiology. February 23, 2017. DOI: 10.1148/radiol.2017161306