Pilots and flight attendants have the highest and second-highest rates of death from radiation-related cancers among more than 500 occupations, according to a new study published in JAMA Internal Medicine.
The research examined U.S. death records from 2020 through 2024 and included nearly 13 million people across 503 occupations. Researchers identified about 14,000 pilots and 7,000 flight attendants in the data and compared their cancer mortality with that of workers in other professions.
The researchers found that 6.9% of deaths among flight attendants were attributed to cancers associated with radiation exposure. The figure was 6.7% among pilots, compared with 5% for the overall working population.
After accounting for factors including age, sex, race and ethnicity, education and marital status, flight attendants had approximately 50% greater odds of dying from a radiation-related cancer than the general working population. Pilots had about 36% greater odds.
The cancers examined included leukemia, lymphoma, multiple myeloma, thyroid, prostate, breast, central nervous system, melanoma and non-melanoma skin cancers.
Cosmic radiation is a longstanding occupational concern for aircrew. At cruising altitudes, the atmosphere provides less protection from high-energy particles originating in space, increasing radiation exposure compared with people at ground level. Aircrew are considered among the most highly exposed occupational groups to ionizing radiation in the U.S.
The latest study is notable because previous research has largely focused on whether pilots and flight attendants are diagnosed with cancer at higher rates. Harvard researchers, for example, found elevated rates of several cancers among flight attendants in a 2018 study, including breast, thyroid, gastrointestinal and skin cancers. That research also pointed to disrupted sleep and circadian rhythms as possible contributing factors.
The new research, however, specifically examined cancer deaths rather than diagnoses.
The findings do not establish that cosmic radiation caused the additional deaths. Researchers could not determine how much radiation individual pilots or flight attendants had received during their careers, nor could they account completely for other occupational factors.
Irregular schedules and repeated disruption of circadian rhythms may also influence cancer risk. The researchers noted that jet lag, overnight work and frequent time-zone changes could contribute independently of radiation exposure.
Researchers and outside experts said the findings warrant greater attention to cancer prevention and screening among flight crews. Recommendations include regular skin examinations and potentially earlier or more frequent mammography for women working on high-altitude flights.
