{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T03:20:16Z","timestamp":1787628016265,"version":"build-2736575974"},"reference-count":26,"publisher":"BMJ","issue":"10","funder":[{"name":"Intramural Research Program of the National Institutes of Health","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"National Cancer Institute (NCI) Interdisciplinary Training Grant in Cancer Epidemiology","award":["R25CA113951"],"award-info":[{"award-number":["R25CA113951"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2025,10,25]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We evaluated the relationship between cumulative occupational ionising radiation exposure and gastrointestinal cancer mortality in a cohort of US radiologic technologists (USRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 106\u2009072 USRT cohort participants who were cancer-free at completion of the baseline questionnaire (1983\u20131998, representing completion of the first (1983\u20131989) or second questionnaire (1994\u20131998) as baseline), protracted low- to moderate-dose occupational ionising radiation exposure was evaluated in relation to gastrointestinal cancer mortality over the follow-up period (through 2021). Poisson regression was used to calculate linear excess relative rates (ERR) of gastrointestinal cancer mortality per 100 mGy colon-absorbed dose (mean=15\u2009mGy; range 0\u2013754 mGy), lagged 10 years, adjusting the baseline mortality rate for attained age, sex, birth cohort, race and other potential confounders (alcohol consumption, smoking, body mass index, non-steroidal anti-inflammatory drug (NSAID) use).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over follow-up (mean=31.4 years), 570 pancreatic, 504 colon, 171 liver, 131 oesophageal, 106 stomach and 73 rectal cancer deaths were identified. In the full cohort, no significant dose-response relationships were observed for pancreatic, colon, liver, oesophageal or rectal cancer mortality. A non-significant positive association for stomach cancer mortality was observed in a model minimally adjusted for attained age, sex and birth cohort; however, this association was attenuated after additionally adjusting for race and NSAID use (ERR\/100mGy=1.56; 95% CI &lt;0 to 159). Evidence for effect modification for stomach cancer mortality was observed by birth year (\n                      <jats:italic>P<\/jats:italic>\n                      -interaction=0.002) and year first worked (0.004), although based on small number of deaths, most positive associations within categories were not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this nationwide cohort of radiologic technologists, cumulative occupational ionising radiation exposure was not clearly associated with mortality from specific gastrointestinal cancers. Studies with cancer incidence follow-up and pooled analyses of ionising radiation-exposed populations may provide more comprehensive and robust dose-response estimates for specific gastrointestinal cancers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2025-110223","type":"journal-article","created":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T18:20:14Z","timestamp":1763922014000},"page":"485-493","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Low-dose occupational ionising radiation exposure and gastrointestinal cancer mortality among US radiologic technologists, 1983\u20132021"],"prefix":"10.1136","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9772-0669","authenticated-orcid":false,"given":"Jim Z","family":"Mai","sequence":"first","affiliation":[{"name":"Radiation Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Velazquez-Kronen","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA"},{"name":"University at Buffalo School of Public Health and Health Professions, Buffalo, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha S","family":"Linet","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo L","family":"Freudenheim","sequence":"additional","affiliation":[{"name":"University at Buffalo School of Public Health and Health Professions, Buffalo, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Wactawski-Wende","sequence":"additional","affiliation":[{"name":"University at Buffalo School of Public Health and Health Professions, Buffalo, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeeun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choonsik","family":"Lee","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale L","family":"Preston","sequence":"additional","affiliation":[{"name":"Hirosoft International, Eureka, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9523-1914","authenticated-orcid":false,"given":"Bruce H","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth K","family":"Cahoon","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cari M","family":"Kitahara","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"2025120301301088000_82.10.485.1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.02.068"},{"key":"2025120301301088000_82.10.485.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-024-21192-3","article-title":"Epidemiological trends in gastrointestinal cancers and risk factors across U.S. states from 2000 to 2021: a systematic analysis for the global burden of disease study 2021","volume":"25","author":"Jiang","year":"2025","journal-title":"BMC Public Health"},{"key":"2025120301301088000_82.10.485.3","unstructured":"Radiation IARC monographs on the evaluation of carcinogenic risks to humans. 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