Thyroid Nodularity and Chromosome Aberrations Among Women in Areas of High Background Radiation in China

Wang, Zuoyuan; Boice, John D.; Wei, Liang; Beebe, Gilbert W.; Zha, Yongru; Kaplan, Michael M.; Too, Zufan; Maxon, Harry R.; Zhang, Shouzhi; Schneider, Arthur B.; Tan, B.; Wesseler, Terrence A.; Chen, Deqing; Ershow, Abby G.; Kleinerman, Ruth A.; Littlefield, L. Gayle; Preston, Dale L.

doi:10.1093/jnci/82.6.478

Cited by 84 publications

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“…18,19 Data from ecologic studies around Chernobyl have been inconsistent, and clinical thyroid disease related to the presence of antithyroid antibody levels has not been observed. 4 Further, the moderate or severe iodine deficiency around Chernobyl may have moderated the effect of any thyroid disease process.…”

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confidence: 99%

Thyroid Disease 60 Years After Hiroshima and 20 Years After Chernobyl

Boice¹

2006

JAMA

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1 Subsequent surveys found a significant excess of papillary thyroid cancer but not of follicular, medullary, or anaplastic cancer.2,3 A straight line adequately describes the relationship between radiation dose and thyroid cancer incidence, relative risks are similar in males and females, and age at exposure substantively influences risk. Risk is highest for children exposed when younger than 10 years, and there is no significant increase in risk of thyroid cancer for those exposed after age 20 years. Radiation-induced thyroid cancers are rarely fatal, but the risk per unit dose following exposure in childhood is higher than for any other radiation-induced malignancy. 4 Radiation-induced thyroid cancer has been extensively studied in human populations other than atomic bomb survivors. These populations include patients treated with radiation for malignant and nonmalignant conditions, populations exposed to radioactive fallout from nuclear weapons tests, and populations living in the vicinity of nuclear installations such as Chernobyl in the former Soviet Union and Hanford in Washington State. 4,5 The latest research from the Adult Health Survey (AHS) in Japan reported in this issue of JAMA by Imaizumi and colleagues 6 derives from a cross-sectional study of 4091 survivors of the Hiroshima and Nagasaki atomic bombings in 1945 who were invited to a special thyroid examination more than 50 years later. The prevalences of thyroid cancer (n=87), benign nodules (n = 207), and cysts (n = 324) were significantly increased and directly related to radiation dose, and the risk decreased with increasing age at exposure; however, autoimmune thyroid diseases (positive antithyroid antibodies, antithyroid antibody-positive hypothyroidism, or Graves disease) were not linked to radiation exposure.There are several new findings of note. First, it is remarkable that a biological effect from a single brief environmental exposure nearly 60 years in the past is still present and can be detected. The radiation doses (mean, 45 cGy) were related to the distance from the hypocenters, and enormous effort was required to accurately estimate exposures for individuals. 7 The existence of dose-response relationships strongly supports the authors' assertion of a radiationrelated excess of thyroid neoplasms nearly 60 years after exposure. Second, using highly sensitive assays to detect serum levels of antithyroid antibodies and thyroid-stimulating hormone, this study was not able to confirm the findings of a smaller but similar investigation of Nagasaki atomic bomb survivors that purported to show an association between radiation and autoimmune thyroid disease. 8 The absence of a dose-response relationship for any measure of autoimmune disease in the study by Imaizumi et al is consistent with earlier studies of atomic bomb survivors 6 and a recent study of persons exposed as children to iodine 131 releases from the Hanford nuclear site. 9The study of atomic bomb survivors remains the single most important study of radiation effects in huma...

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confidence: 99%

Thyroid Disease 60 Years After Hiroshima and 20 Years After Chernobyl

Boice¹

2006

JAMA

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“…Overall, 50% of the practitioner-discovered male cases (6112) were detected at the Laboratory compared to 13% of the corresponding female cases (4/30). A total of 20 different health care practitioners were responsible for detecting 42 cancers in the LAC clinical case series. A review of the frequency at which individual practitioners at the LAMC or the Laboratory detected thyroid cancer among LAC residents failed to demonstrate any unusual temporal pattern or provide evidence that a particullar person was responsible for detecting a disproportionally large number of cancers within either time period.…”

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confidence: 99%

Investigation of excess thyroid cancer incidence in Los Alamos County

Athas¹

1996

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“…The literature remains controversial with regard to natural background radiation and cancer risk (Archer 1987;Wang et al 1990). Although the TMI area borders the Reading Prong, an area of granitic rock with higher levels of natural background radiation, the differential in background gamma levels between the low and the medium/high natural background exposure categories is small within the study area, covering a 5-mile radius (Reimer and Gundersen 1989).…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of the residents of the Three Mile Island accident area: 1979-1998.

Talbott

Youk

McHugh-Pemu

et al. 2003

Environ Health Perspect

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The Three Mile Island (TMI) nuclear power plant accident (1979) prompted the Pennsylvania Department of Health to initiate a cohort mortality study in the TMI accident area. This study is significant because of the long follow-up (1979-1998), large cohort size (32,135), and evidence from earlier reports indicating increased cancer risks. Standardized mortality ratios (SMRs) were calculated to assess the mortality experience of the cohort compared with a local population. Relative risk (RR) regression modeling was performed to assess cause-specific mortality associated with radiation-related exposure variables after adjustment for individual smoking and lifestyle factors. Overall cancer mortality in this cohort was similar to the local population [SMRs = 103.7 (male); 99.8 (female)]. RR modeling showed neither maximum gamma nor likely gamma exposure was a significant predictor of all malignant neoplasms; bronchus, trachea, and lung; or heart disease mortality after adjusting for known confounders. The RR estimates for maximum gamma exposure (less than or equal to 8, 8-19, 20-34, greater than or equal to 35 mrem) in relation to all lymphatic and hematopoietic tissue (LHT) are significantly elevated (RRs = 1.00, 1.16, 2.54, 2.45, respectively) for males and are suggestive of a potential dose-response relationship, although the test for trend was not significant. An upward trend of RRs and SMRs for levels of maximum gamma exposure in relation to breast cancer in females (RRs = 1.00, 1.08, 1.13, 1.31; SMRs = 104.2, 113.2, 117.9) was also noted. Although the surveillance within the TMI cohort provides no consistent evidence that radioactivity released during the nuclear accident has had a significant impact on the overall mortality experience of these residents, several elevations persist, and certain potential dose-response relationships cannot be definitively excluded.

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Thyroid Nodularity and Chromosome Aberrations Among Women in Areas of High Background Radiation in China

Cited by 84 publications

References 0 publications

Thyroid Disease 60 Years After Hiroshima and 20 Years After Chernobyl

Thyroid Disease 60 Years After Hiroshima and 20 Years After Chernobyl

Investigation of excess thyroid cancer incidence in Los Alamos County

Long-term follow-up of the residents of the Three Mile Island accident area: 1979-1998.

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