Childhood thyroid cancer since accident at Chernobyl

Stsjazhko, V A; Цыб, А Ф; Тronko, М.D.; Souchkevitch, G.; Baverstock, Keith

doi:10.1136/bmj.310.6982.801

Cited by 113 publications

(88 citation statements)

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“…Examinations include palpation of the neck, ultrasound imaging and thyroid hormone testing. In Belarus, 62% of the thyroid cancer cases among children were found in the period 1986-1994 by this programme (Stsjazhko et al, 1995). A main effect of this intense thyroid surveillance of children might be an early diagnosis, contributing to the considerably higher thyroid cancer incidence in Belarus for ages 7-15, if compared to ages 16-22.…”

Section: Thyroid Surveillance and Background Incidence Rate Of Cancermentioning

confidence: 99%

Childhood exposure due to the Chernobyl accident and thyroid cancer risk in contaminated areas of Belarus and Russia

Kenigsberg²,

et al. 1999

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The thyroid dose due to 131 I releases during the Chernobyl accident was reconstructed for children and adolescents in two cities and 2122 settlements in Belarus, and in one city and 607 settlements in the Bryansk district of the Russian Federation. In this area, which covers the two high contamination spots in the two countries following the accident, data on thyroid cancer incidence during the period 1991–1995 were analysed in the light of possible increased thyroid surveillance. Two methods of risk analysis were applied: Poisson regression with results for the single settlements and Monte Carlo (MC) calculations for results in larger areas or sub-populations. Best estimates of both methods agreed well. Poisson regression estimates of 95% confidence intervals (CIs) were considerably smaller than the MC results, which allow for extra-Poisson uncertainties due to reconstructed doses and the background thyroid cancer incidence. The excess absolute risk per unit thyroid dose (EARPD) for the birth cohort 1971–1985 by the MC analysis was 2.1 (95% CI 1.0–4.5) cases per 10 4 person-year Gy. The point estimate is lower by a factor of two than that observed in a pooled study of thyroid cancer risk after external exposures. The excess relative risk per unit thyroid dose was 23 (95% CI 8.6–82) Gy −1 . No significant differences between countries or cities and rural areas were found. In the lowest dose group of the settlements with an average thyroid dose of 0.05 Gy the risk was statistically significantly elevated. Dependencies of risks on age-at-exposure and on gender are consistent with findings after external exposures. © 1999 Cancer Research Campaign

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Section: Thyroid Surveillance and Background Incidence Rate Of Cancermentioning

confidence: 99%

Childhood exposure due to the Chernobyl accident and thyroid cancer risk in contaminated areas of Belarus and Russia

Kenigsberg²,

et al. 1999

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“…Several years after the accident, a dramatic increase in thyroid cancer in persons exposed in childhood and adolescence was reported. [1][2][3] This increase has been clearly linked to radiation exposure from the Chernobyl accident. 4,5 In recent years, an increase in breast cancer incidence has also been reported in regions of Belarus and Ukraine contaminated by the Chernobyl accident.…”

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confidence: 99%

Breast cancer in Belarus and Ukraine after the Chernobyl accident

Pukkala

Kesminiene

Поляков³

et al. 2006

Intl Journal of Cancer

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An increase in breast cancer incidence has been reported in areas of Belarus and Ukraine contaminated by the Chernobyl accident and has become an issue of public concern. The authors carried out an ecological epidemiological study to describe the spatial and temporal trends in breast cancer incidence in the most contaminated regions of Belarus and Ukraine, and to evaluate whether increases seen since 1986 correlate to radiation exposure from the Chernobyl accident. The authors investigated the trends through age-cohort-period-region analyses of district-specific incidence rates of breast cancer for Gomel and Mogilev regions of Belarus and Chernigiv, Kyiv and Zhytomir regions of Ukraine. Doseresponse analyses were based on Poisson regression, using average district-specific whole body doses accumulated since the accident from external exposure and ingestion of long-lived radionuclides. The study demonstrated increases in breast cancer incidence in all areas following the Chernobyl accident, reflecting improvements in cancer diagnosis and registration. In addition, a significant 2-fold increase in risk was observed, during the period 1997-2001, in the most contaminated districts (average cumulative dose of 40.0 mSv or more) compared with the least contaminated districts (relative risk [RR] in Belarus 2.24, 95% confidence interval [CI] 1.51-3.32 and in Ukraine 1.78, 95% CI 5 1.08-2.93). The increase, though based on a relatively small number of cases, appeared approximately 10 years after the accident, was highest among women who were younger at the time of exposure and was observed for both localised and metastatic diseases. It is unlikely that this excess could be entirely due to the increased diagnostic activity in these areas. ' 2006 Wiley-Liss, Inc.

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“…Moreover, the excess of SMN found in our series was observed in patients exposed to several GBq of '3'I, quantities which are much larger than those involved in the contamination resulting from the Chernobyl accident (Stsjazhko et al, 1995).…”

Section: Discussionmentioning

confidence: 82%

“…A substantial increase in thyroid cancer incidence has been observed in children living in the most heavily contaminated areas at the time of the accident (Stsjazhko et al 1995), but no increased incidence of other malignancies, including leukaemia, has been reported so far. More data are thus needed to predict future risks in populations that have been contaminated.…”

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confidence: 99%

Leukaemias and cancers following iodine-131 administration for thyroid cancer

Vathaire

Schlumberger²,

Delisle³

et al. 1997

Br J Cancer

125

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Summary We studied 1771 patients treated for a thyroid cancer in two institutions. None of these patients had been treated with external radiotherapy and 1497 had received 1311. The average 1311 cumulative activity administered was 7.2 GBq, and the estimated average dose was 0.34 Sv to the bone marrow and 0.80. Sv to the whole body. After a mean follow-up of 10 years, no case of leukaemia was observed, compared with 2.5 expected according to the coefficients derived from Japanese atomic bomb survivors (P = 0.1). A total of 80 patients developed a solid second malignant neoplasm (SMN), among whom 13 developed a colorectal cancer. The risk of colorectal cancer was found to be related to the total activity of 1311 administered 5 years or more before its diagnosis (excess relative risk = 0.5 per GBq, P = 0,02).These findings were probably caused by the accumulation of 1311 in the colon lumen. Hence, in the absence of laxative treatment, the dose to the colon as a result of 1311 administered for the treatment of thyroid cancer could be higher than expected from calculation of the International Commission on Radiological Protection (ICRP). When digestive tract cancers were excluded, the overall excess relative risk of second cancer per estimated effective sievert received to the whole body was -0.2 (P = 0.6).Keywords: radiocarcinogenesis; carcinogenic effects of 1311; protracted exposure to radiation; thyroid cancer On account of the small population dose involved, published studies (IARC, 1994) of nuclear industry workers do not have sufficient power to make reliable comparisons with the risks estimated from the Japanese atomic bomb survivors (UNSCEAR, 1994). Hence, studies of adult populations undergoing protracted exposure to radiation for medical reasons are still necessary. For this purpose, '3'I is a suitable model, because its physical halflife is 8 days. The risks of solid tumours and leukaemia after administration of '3'I have been studied in several cohorts of adults (Hall et al 1991(Hall et al , 1992 Dottorini et al, 1995); nevertheless, the statistical power of these studies is still insufficient to derive precise coefficients.Another reason for studying the carcinogenic effects of '3'I is the fact that considerable amounts of various radioisotopes of iodine, including '3'I, were released in the atmosphere during the Chernobyl accident. A substantial increase in thyroid cancer incidence has been observed in children living in the most heavily contaminated areas at the time of the accident (Stsjazhko et al. 1995), but no increased incidence of other malignancies, including leukaemia, has been reported so far. More data are thus needed to predict future risks in populations that have been contaminated.We report the results of a study of 1771 patients treated for a thyroid cancer, of whom 651 had received 1311 for diagnosis, and 846 for therapy. Among the 2479 patients, 173 patients were excluded because they had died or were lost to follow-up during the first two years after the diagnosis of thyroid cancer; ...

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Childhood thyroid cancer since accident at Chernobyl

Cited by 113 publications

References 0 publications

Childhood exposure due to the Chernobyl accident and thyroid cancer risk in contaminated areas of Belarus and Russia

Childhood exposure due to the Chernobyl accident and thyroid cancer risk in contaminated areas of Belarus and Russia

Breast cancer in Belarus and Ukraine after the Chernobyl accident

Leukaemias and cancers following iodine-131 administration for thyroid cancer

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