Nested Case‐Control Study of Incident Prostate Cancer in Danish Male Military Pilots

OBJECTIVES: Pilots may have an increased risk of prostate cancer, potentially linked to circadian rhythm disruptions from crossing time zones, prolonged sedentary work, and ionizing radiation. However, existing research on associations presents inconsistent findings, likely attributable to methodological limitations, such as using the general population as a reference group and reliance on mortality as the primary outcome measure. This study aimed to contribute to understanding of the incidence of prostate cancer in pilots. METHODS: This nested case-control study included 54 male prostate cancer cases diagnosed between 1990 and 2003, along with 1126 cancer-free male controls, selected from a large Danish military population. Comprehensive data on military service, occupational history, exposures, and socioeconomic status (SES) were collected through a structured questionnaire. Among the cases, 7 individuals had previously worked onboard aircraft. RESULTS: Adjusted results indicated a positive association between working onboard aircraft and the risk of prostate cancer (OR = 3.42, 95% CI: 1.28-9.11). The risk was even more pronounced among individuals working as pilots. CONCLUSIONS: The findings from this study of Danish military personnel indicate that pilots may have an elevated risk of prostate cancer, even after adjusting for SES. Future large-scale studies are needed to investigate this association further, incorporating detailed, objective data on exposure factors such as circadian rhythm disruptions and potential confounders.