Study Finds Pilots and Flight Attendants Have Higher Rates Of Radiation-Linked Cancer Deaths

A new analysis of U.S. death records finds that pilots and flight attendants have the largest proportions of deaths from cancers associated with ionizing radiation among more than 500 occupations. The peer-reviewed study, published in JAMA Internal Medicine, used National Vital Statistics System data for deaths recorded from 2020 through 2024.

Stock image: a view of a pilot in the cockpit of an A320 aircraft, with sun rays shining through the window.

Study Design And Key Findings

Led by Dr. Vishal Patel of Harvard Medical School and Brigham and Women's Hospital, researchers examined nearly 13 million death certificates across 503 occupations, including about 14,000 pilots and 7,000 flight attendants. The analysis identified higher proportions of deaths from cancers linked to ionizing radiation — notably breast, prostate, central nervous system cancers and melanoma — with pilots also showing an elevated proportion of leukemia deaths.

Stock image: a plane taking off at sunset.

"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 authors wrote, noting this exposure is a public health concern.

Expert Reactions And Cautions

Multiple clinicians and researchers highlighted the consistency of the signal while urging caution about causal interpretation. Dr. Nathan Goodyear, co-founder of the Williams Cancer Institute, said the study found about a 50% higher adjusted odds of radiation-related cancer death in flight attendants and about 36% higher adjusted odds in pilots compared with workers overall.

Stock image: a flight attendant is shown seated on a plane, while facing passengers.

Experts stressed that the analysis cannot prove that cosmic radiation directly caused these deaths because important individual-level data were not available in death certificates. Missing factors include cumulative flight hours, years employed as aircrew, direct radiation dose measurements, specific flight routes and altitudes, effects of solar particle events, sleep disruption, UV exposure, body weight and other lifestyle factors.

Major Limitations

• No individual radiation dose or cumulative exposure data.
• Death-certificate data do not capture work history, flight routes or personal risk factors.
• The study assessed cancer mortality (deaths), not cancer incidence (new diagnoses), which can be influenced by access to care and baseline health.

What This Means And Next Steps

While ionizing radiation is a known carcinogen and aircrew are exposed to higher average occupational doses from cosmic radiation at altitude, biological plausibility alone does not establish causation. Many experts recommended improved occupational monitoring and long-term, longitudinal studies linking individual flight histories, measured doses, and cancer outcomes before changing screening recommendations.

The U.S. Federal Aviation Administration already provides flight-dose estimates for aircrew, and public health agencies such as the CDC note that long-duration flights and routes over polar regions increase exposure. Several commentators suggested employers, regulators and regulators consider tracking cumulative radiation doses across careers — especially for crew on long-haul or polar routes — and investing in prospective studies.

Reference: Patel VR, Liu M, Jena AB. Cancer-Related Mortality Among US Pilots and Flight Attendants. JAMA Internal Medicine. 2026. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2852504