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Updated: Mar 7, 2026
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Mortality in U.S. Physicians Likely to Perform Fluoroscopy-guided Interventional Procedures Compared with
Martha S Linet1, Cari M Kitahara1, Estelle Ntowe1
1From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
Abstract:
Purpose To compare total and cause-specific mortality rates between physicians likely to have performed fluoroscopy-guided interventional (FGI) procedures (referred to as FGI MDs) and psychiatrists to determine if any differences are consistent with known radiation risks. Materials and Methods Mortality risks were compared in nationwide cohorts of 45 634 FGI MDs and 64 401 psychiatrists. Cause of death was ascertained from the National Death Index. Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for FGI MDs versus psychiatrists, with adjustment (via stratification) for year of birth and attained age. Results During follow-up (1979-2008), 3506 FGI MDs (86 women) and 7814 psychiatrists (507 women) died. Compared with psychiatrists, FGI MDs had lower total (men: RR, 0.80 [95% CI: 0.77, 0.83]; women: RR, 0.80 [95% CI: 0.63, 1.00]) and cancer (men: RR, 0.92 [95% CI: 0.85, 0.99]; women: RR, 0.83 [95% CI: 0.58, 1.18]) mortality. Mortality because of specific types of cancer, total and specific types of circulatory diseases, and other causes were not elevated in FGI MDs compared with psychiatrists. On the basis of small numbers, leukemia mortality was elevated among male FGI MDs who graduated from medical school before 1940 (RR, 3.86; 95% CI: 1.21, 12.3). Conclusion Overall, total deaths and deaths from specific causes were not elevated in FGI MDs compared with psychiatrists. These findings require confirmation in large cohort studies with individual doses, detailed work histories, and extended follow-up of the subjects to substantially older median age at exit. © RSNA, 2017 Online supplemental material is available for this article.
Insights
Physicians performing fluoroscopy-guided interventional procedures showed lower total and cancer mortality than psychiatrists. However, a small elevated risk for leukemia was noted in early-graduating male physicians, warranting further study.
Area of Science:
- Medical Physics
- Epidemiology
- Occupational Health
Background:
- Fluoroscopy-guided interventional (FGI) procedures involve radiation exposure.
- Assessing long-term health risks for physicians performing these procedures is crucial.
Purpose of the Study:
- To compare total and cause-specific mortality rates between physicians performing FGI procedures and psychiatrists.
- To investigate if mortality differences align with known radiation risks.
Main Methods:
- Nationwide cohorts of 45,634 FGI physicians and 64,401 psychiatrists were analyzed.
- Cause of death was determined using the National Death Index.
- Poisson regression adjusted for birth year and age was used to estimate relative risks.
Main Results:
- FGI physicians had lower total mortality (RR 0.80) and cancer mortality (men RR 0.92, women RR 0.83) compared to psychiatrists.
- No elevated mortality was observed for specific cancers, circulatory diseases, or other causes.
- A small, elevated leukemia mortality risk (RR 3.86) was found in male FGI physicians graduating before 1940.
Conclusions:
- Overall mortality and cause-specific deaths were not elevated in FGI physicians compared to psychiatrists.
- Findings suggest FGI procedures may not increase overall mortality risk.
- Further large cohort studies with individual dosimetry and detailed work histories are needed for confirmation.
