RESOLVING THE LEDGER
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0 Share Newsweek is a Trust Project member See more of our trusted coverage when you search. Prefer Newsweek on Google to see more of our trusted coverage when you search. Flight attendants and pilots have the highest and second-highest proportions of radiation-related cancer deaths among more than 500 occupations in the United States, according to a new study.
The study, published this week in JAMA Internal Medicine , analyzed all U.S. death certificates recorded between 2020 and 2024 through the National Vital Statistics System.
Led by Dr. Vishal Patel, a Harvard Medical School clinical fellow in surgery at Brigham and Women's Hospital, the research examined nearly 13 million deaths spanning 503 occupations, including about 14,000 pilots and 7,000 flight attendants.
The study found that pilots and flight attendants had the highest percentages of deaths from cancers linked to radiation, including breast, prostate, central nervous system cancers, and melanoma, while pilots also had a higher rate of leukemia deaths.
“Aircrew members receive the largest mean annual effective dose of ionizing radiation of any occupational group in the US, primarily due to cosmic rays encountered at commercial flight altitudes,” the study's authors wrote. “Potential health consequences of this exposure, including cancer risk, have become a priority for public health experts and federal agencies.”
The recent research comes as the pilot profession was ranked 10 th among the "100 Best Jobs" in America in this year’s edition of the annual listing by U.S. News & World Report, while flight attendants ranked 39th.
Dr. Nathan Goodyear, co-founder of the Williams Cancer Institute, said the findings stand out because of how consistently flight crews ranked above other occupations.
Goodyear told Newsweek : "Compared to the other 503 occupations, there were an overall 50 percent higher adjusted odds of radiation-related cancer deaths in flight attendants. In pilots, the higher adjusted odds of radiation-related cancer deaths were 36 percent."
Goodyear said the increased odds were observed across most of the radiation-related cancers examined, although the strength of the associations varied by cancer type and occupation. He added that one of the most compelling aspects of the findings was that ground-based aviation workers did not show the same pattern.
Experts emphasized that the findings do not establish that cosmic radiation directly caused the deaths.
Goodyear noted that several potentially important factors were unavailable in the data, including cumulative flight hours, years spent working as aircrew, radiation dose measurements, flight routes, altitude, solar particle events, sleep disruption, ultraviolet exposure, body weight, and lifestyle habits.
“Without the inclusion of these additional variables, we cannot extrapolate association to cause and effect,” Goodyear said.
Dr. Brian Honeyman, a board-certified physician specializing in hospice and palliative medicine and internal medicine, similarly urged caution when interpreting the results.
“What jumps out to me is that this is a study regarding cancer death, not just detecting more cancers in pilots and flight attendants,” Honeyman told Newsweek .
He noted that aircrew members generally have regular health screenings and tend to be healthier overall, factors that can complicate mortality analyses. While ionizing radiation is a known human carcinogen and flight crews are exposed to higher levels at altitude, Honeyman stressed that biological plausibility alone does not prove causation.
“Dose [of ironizing radiation] varies based on altitude, duration of flight, flight route, and solar activity,” Honeyman added. “Biological plausibility does not equate to establishing causality in this data set.”
Dr. Ayesha Bryant, a physician, clinical scientist, and clinical advisor at Alpas Wellness, described the findings as an important occupational health signal.
“The most important finding of this study is that a valid occupational health warning exists for pilots and flight attendants,” Bryant told Newsweek .
She noted that flight attendants were approximately 1.5 times more likely to die from radiation-induced cancers than workers overall, while pilots were approximately 1.36 times more likely, according to the study.
However, Bryant said cosmic radiation may be only one piece of a more complex picture. Along with occupational radiation exposure, both groups experience significant circadian disruption, and pilots may also encounter ultraviolet A exposure through cockpit windows.
“Radiation is one, but certainly not the only possible contributing factor,” she said.
Bryant also identified a major limitation of the study—the absence of individual radiation absorption measurements. Without this data, researchers could not determine whether higher radiation doses corresponded with greater cancer risk.
Several experts said the findings support improved monitoring of occupational exposure rather than immediate changes to cancer screening recommendations.
Bryant said the results should not be interpreted as justification for additional screening beyond existing age- and risk-based guidelines. Instead, she said they support more comprehensive tracking of cumulative radiation exposure and stronger long-term studies examining flight history and cancer outcomes.
Honeyman agreed, suggesting that reducing and measuring exposures should take priority. He pointed to U.S. Centers for Disease Control and Prevention (CDC) information indicating that long-duration flights and routes over polar regions are associated with increased cosmic radiation exposure and noted that the Federal Aviation Administration (FAA) already provides flight-dose estimates.
He said employers and regulators should consider tracking cumulative occupational radiation doses over entire careers, particularly for crew members flying long-haul or polar routes.
Patel, V. R., Liu, M., & Jena,...
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