Leukaemia and myeloid malignancy among people exposed to low doses (&lt;100 mSv) of ionising radiation during childhood: a pooled analysis of nine historical cohort studies

Little, Mark P.; Wakeford, Richard; Borrego, David; French, Benjamin; Zablotska, Lydia B.; Adams, Michael; Allodji, Rodrigue S.; Vathaire, Florent de; Lee, Choonsik; Brenner, Alina V.; Miller, Jeremy S.; Campbell, D. S.; Pearce, Mark S.; Doody, Michele M.; Holmberg, Erik; Lundell, Marie; Sadetzki, Siegal; Linet, Martha S.; González, Amy Berrington de

doi:10.1016/s2352-3026(18)30092-9

Cited by 123 publications

(103 citation statements)

References 31 publications

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“…Our study shows that compared with women in the general population of Israel, women with alopecia resulting from irradiation treatment for tinea capitis are at increased risk for serious physical conditions, with an especially high risk of developing migraines and cancer. Cancer prevalence has already been strongly associated with a history of childhood irradiation for tinea capitis [ 6 , 9 , 10 , 11 , 12 , 13 ]. Although studies have not specifically addressed the association of this childhood exposure with migraines, migraines are associated with early childhood trauma and adult stressful life events [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

“…Until the introduction of the antifungal griseofulvin in 1958, about 200,000 children worldwide [ 6 ], mainly in the United States, Europe, and the Middle East [ 7 , 8 ], had been treated for tinea capitis by irradiation to induce epilation. Long-term follow-up studies have demonstrated the detrimental health effects of this treatment, including meningioma, leukemia, and tumors of the brain, salivary glands, thyroid, and skin, including melanomas in the head and neck area [ 6 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood

Segal‐Engelchin

Shvarts

2020

IJERPH

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Hair loss resulting from childhood irradiation for tinea capitis has been linked to mental health effects in women. However, the association of hair loss severity with mental health in this population is unknown. To address this gap, this study examined the association between hair loss severity and mental health outcomes in women irradiated for tinea capitis in childhood as well as the factors that contribute to these outcomes. Medical records, held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims, were retrospectively reviewed for 2509 women who received compensation for full or partial alopecia resulting from irradiation for tinea capitis. Mental health outcomes were determined by the number of mental health conditions reported. The results show that among women with more hair loss, risk was increased for a range of mental health problems, especially social anxiety (RR 2.44, 95% CI 2.09–2.87). Hair loss severity emerged as a significant predictor of mental health, adding to the effects of other predictors such as family, social and physical health problems (β = 0.13, 95% CI 0.27, 0.56). The effects of hair loss severity on mental health outcomes were mediated by women’s negative social experiences (indirect = 0.72, 95% bias-corrected confidence interval, 0.53–1.08). Healthcare professionals supporting women with hair loss after irradiation for childhood tinea capitis should be alert to a history of severe levels of hair loss.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood

Segal‐Engelchin

Shvarts

2020

IJERPH

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“…Hematologic cancers are of concern to space exploration because these malignancies are known to be among the most radio-sensitive both in childhood and in adulthood. [18][19][20] We observed 4 hematologic cancers in the astronaut cohort when fewer than 2 were expected, for an SIR of approximately 200. While the 2 observed deaths from this cancer type represented an insigni cant reduction in the mortality rate, the expected number of deaths from this cancer exceeded the expected number of cases, making interpretation of the SMR di cult.…”

Section: Discussionmentioning

confidence: 90%

Cancer Incidence and Mortality in the U.S. Astronaut Corps, 1959-2017

Reynolds¹,

Little²,

Day³

et al. 2020

Preprint

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Background: Cancer incidence and mortality are important outcomes in the surveillance of long-term astronaut health. In this research, we compare cancer incidence rates, cancer-specific mortality rates, and cancer case fatality ratios in US astronauts with those in the US general population.Methods: We use standardized incidence ratios and standardized mortality ratios to index the incidence and mortality of various cancers against rates in the US general population, from the US astronaut cohort inception in April 1959 through 31 December 2017. We also compare the lethality of these cancers in astronauts and the general population using the relative case fatality ratio.Results: The astronaut cohort included 338 individuals and over 9600 person-years of follow-up time. The counts of most cancers were under 3, though there were 11 cases of melanoma and 30 cases of prostate cancer. Both prostate and melanoma had statistically significant increases in incidence, though only melanoma had a significant increase in mortality. Lung cancer had a statistically significant deficit of both cases and deaths, while colon cancer had sizable (but not statistically significant) reductions in incidence and mortality. Three cancers showed evidence of detection bias (colon, hematologic, prostate), possibly a result of astronaut health screening protocols. For all cancers combined, astronauts showed a non-significant reduction in incidence and mortality, and a significant reduction in case fatality ratio.Conclusions: Though there were observed increases in both incidence and mortality from melanoma among astronauts, these increases are consistent with those observed repeatedly among aircraft pilots, suggesting this may be associated with ultraviolet radiation or lifestyle factors rather than any astronaut-specific exposure. The increase in prostate cancer incidence is likely explained by detection bias, and the same may be true for hematologic cancers. The lack of statistical significance in the reduction of incidence and mortality for colon cancer may be attributable to relaxed screening practices for astronauts in recent years. As astronaut health surveillance continues and evolves, the growing database will lead to a clearer picture over time. The methods employed here provide a useful structure for ongoing analysis of this unique occupational cohort.

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“…childhood leukaemia and central nervous system (CNS) tumours [1,2]. A number of environmental factors have been suggested that could partially explain cancer risks in the general population, including traffic-related air pollution [3], background radiation [2,4] and agricultural pesticides [5]. These risk factors vary in space and it is thus natural to expect spatial variation in childhood cancer incidence.…”

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confidence: 99%

Bayesian spatial modelling of childhood cancer incidence in Switzerland using exact point data: a nationwide study during 1985–2015

et al. 2020

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Background: The aetiology of most childhood cancers is largely unknown. Spatially varying environmental factors such as traffic-related air pollution, background radiation and agricultural pesticides might contribute to the development of childhood cancer. This study is the first investigation of the spatial disease mapping of childhood cancers using exact geocodes of place of residence. Methods: We included 5947 children diagnosed with cancer in Switzerland during 1985-2015 at 0-15 years of age from the Swiss Childhood Cancer Registry. We modelled cancer risk using log-Gaussian Cox processes and indirect standardisation to adjust for age and year of diagnosis. We examined whether the spatial variation of risk can be explained by modelled ambient air concentration of NO 2 , modelled exposure to background ionising radiation, areabased socioeconomic position (SEP), linguistic region, duration in years of general cancer registration in the canton or degree of urbanisation. Results: For all childhood cancers combined, the posterior median relative risk (RR), compared to the national level, varied by location from 0.83 to 1.13 (min to max). Corresponding ranges were 0.96 to 1.09 for leukaemia, 0.90 to 1.13 for lymphoma, and 0.82 to 1.23 for central nervous system (CNS) tumours. The covariates considered explained 72% of the observed spatial variation for all cancers, 81% for leukaemia, 82% for lymphoma and 64% for CNS tumours. There was weak evidence of an association of CNS tumour incidence with modelled exposure to background ionising radiation (RR per SD difference 1.17; 0.98-1.40) and with SEP (1.6; 1.00-1.13). Conclusion: Of the investigated diagnostic groups, childhood CNS tumours showed the largest spatial variation. The selected covariates only partially explained the observed variation of CNS tumours suggesting that other environmental factors also play a role.

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Leukaemia and myeloid malignancy among people exposed to low doses (<100 mSv) of ionising radiation during childhood: a pooled analysis of nine historical cohort studies

Abstract: National Cancer Institute Intramural Research Program, National Cancer Institute, and US National Institutes for Health.

Cited by 123 publications

References 31 publications

Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood

Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood

Cancer Incidence and Mortality in the U.S. Astronaut Corps, 1959-2017

Bayesian spatial modelling of childhood cancer incidence in Switzerland using exact point data: a nationwide study during 1985–2015

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