Screening and early detection
Prepared by the AVMA Group Health and Life Insurance Trust
Veterinarians encourage pet owners to get preventive care for their pets, yet may often be guilty of not taking the same good care of themselves. It's a problem common to many physicians; a study from Johns Hopkins School of Medicine indicated that a third of physicians do not have a doctor whom they see on a regular basis. This translates to a host of problems, including a lower rate of preventive screenings for cancer.
How do veterinarians and physicians fare when compared with the general population and the American Cancer Society recommendations for screenings?
Consider breast cancer, the most-often-diagnosed type of cancer among American women. The American Cancer Society recommends an annual mammogram for women over age 40. Of the Johns Hopkins study participants, 84 percent of the female physicians with a regular source of care had undergone mammography, whereas only about 47 percent of female physicians without a source for regular examinations had. The cancer society says that in the year 2000, more than 55 percent of American women 40 and older said they had mammography performed within the past year, and more than 70 percent reported having undergone the procedure within the past two years.
Consider colorectal cancer, for which early diagnosis and treatment result in survival rates exceeding 90 percent. The American Cancer Society's recommended schedule for colorectal cancer screening includes an annual fecal occult blood test beginning at age 50. In the Johns Hopkins survey, about 75 percent of the physicians had been screened. Among physicians who did not have a regular physician, however, the rate decreased to 55 percent. The screening rate among Americans 50 and older is not high; in the year 2000, just a little more than 17 percent reported having a fecal occult blood test performed, although 30 percent did report having an endoscopy, which is another of the cancer society's recommended screening options.
AVMA Group Health and Life Insurance Trust statistics suggest veterinarians could take a more active role in their own health care. Among AVMA GHLIT members, approximately a third of female veterinarians between the ages of 35 and 60 had mammography performed last year. Among both males and females, fewer than 10 percent of AVMA GHLIT members between the ages of 45 and 65 (the age group for which data are available) had colorectal examinations in 2004.
The good news is there are no definitive studies to indicate veterinarians have a higher cancer mortality rate than the general population does. This is despite the fact that veterinarians may have many exposures to potential carcinogens during the course of their career.
Workplace carcinogens include radiation and pesticides
On Jan. 31, 2005, the Department of Health and Human Services released its 11th edition of the Report on Carcinogens, adding 17 substances to the growing list of cancer-causing agents, bringing the total to 246. Of particular interest to veterinarians is the addition of x-radiation and gammaradiation.
Radiation is linked to skin cancer, thyroid cancer, and leukemia. Fortunately, the doses received in veterinary practice are generally insufficient to cause a major increase in risk, unless there are problems with equipment or procedures.
Workplace chemicals may pose the greatest risk for veterinarians. Some laboratory and hospital chemicals suspected as carcinogens are ethylene oxide gas, anesthetic gases, formalin, iron dextran complex, and some chemotherapy drugs, including azathioprine, chlorambucil, cyclosporin A, and cyclophosphamide. Pesticides are another area of concern, especially organophosphate insecticides and carbamates. A correlation has been shown between pesticides and non-Hodgkin's lymphoma, leukemia and multiple myeloma.
Veterinarians concerned about exposure in the workplace can access the Department of Health and Human Services' searchable database of substances known or reasonably anticipated to be human carcinogens, at http://ntp.niehs.nih.gov. An individual may look up a particular substance and find a wealth of information about its properties, uses, and carcinogenicity, as well as information on exposure, regulations, and guidelines.
Being aware of potential carcinogens in the workplace and scrupulously adhering to safety regulations are two important, proactive steps every veterinarian should take. A third important step is availing oneself of preventive health care, including cancer screenings. The AVMA GHLIT has recently upgraded the Wellness Benefit on many plans to encourage veterinarians to be more proactive about their health.
In summary, while the veterinary workplace—like many workplaces today—does present a risk of exposure to potential carcinogens, veterinarians can protect their health by being aware of substances in their environment that may pose risk and by following safety guidelines. A commitment to getting regular health examinations, including cancer screenings, is also vital to the health of every veterinarian.
For more information on the AVMA GHLIT, call (800) 621-6360 or visit www.avmaghlit.org.