Is there an Increased Incidence of Surgically Removed Thyroid Carcinoma in Belgium Ten Years After Chernobyl ? A Study of Hospital Discharge Data

Abstract

In order to provide some answers to the much debated subject of the consequences of the Chernobyl accident, this study attempts to measure the incidence of surgically removed thyroid cancers in Belgium ten years following the explosion. The analysis was made from the hospital discharge data between 1993 and 1998. It offers the advantage of national coverage in spite of certain validity limits. The results show an increase in surgically removed thyroid cancers, which is not, however, evident in the more susceptible younger generation who were involved at the time of the accident. Furthermore, the geographic distribution of the incidence is more marked in the south of the country, unaffected by the radioactive iodine contamination of 1986, which was more prevalent in the east of the country. The study of the type of surgery involved shows a rise in the proportion of total thyroidectomies. These findings are in favour of the hypothesis of a causal effect linking the increased incidence of thyroid cancers to medical practice and surgery in particular and not to the consequence of the possible contamination.

Thyroid cancer surgery in Germany

“…Despite an identical health care system all over Germany and the availability of guidelines for surgical treatment of thyroid cancer [16], regional analyses of the percentage of hospitalisations that included a total thyroidectomy showed considerable variation within Germany. This finding is in line with similar recent analyses conducted in the United States [4] and Belgium [5] that reported strong regional variability in approaches to treat thyroid cancer.…”

“…Similar nationwide percentages (two-thirds) were observed in Belgium from 1993 to 1998 [5] and in the United States in 2004 [4]. Despite an identical health care system all over Germany and the availability of guidelines for surgical treatment of thyroid cancer [16], regional analyses of the percentage of hospitalisations that included a total thyroidectomy showed considerable variation within Germany.…”

“…In fact, this central database represents a virtually complete collection of all hospitalisations in German hospitals that are reimbursed according to the DRG system. Hospital discharge data have been used previously in other countries to study epidemiological features of the treatment of thyroid cancer [3][4][5]. German DRG statistics have been recently used to provide data on patients with other diseases, including skin cancer, testicular cancer and diseases of the genital tract [6][7][8].…”