Trends in Solid Tumor Incidence in Ukraine 30 Years After Chernobyl

Abstract

PURPOSE There is limited knowledge of the long-term health effects of the Chernobyl nuclear power plant accident that occurred more than 30 years ago in Ukraine. This study describes trends in the incidence of solid organ malignancy in Ukraine and the five regions most affected by the radioactive fallout. METHODS The National Cancer Registry of Ukraine was queried for age-standardized incidence rates (ASIRs) of solid organ malignancy in Ukraine and the regions of Kyiv, Chernihiv, Zhytomyr, Rivne, and Volyn covering the period of 1999 to 2016. Joinpoint analysis was used to calculate the average annual percentage of change. RESULTS The highest burdens of cancer incidence in Ukraine were seen in the lung, stomach, breast, and prostate. We observed significant increases in the ASIRs of colon (average annual percentage of change, 1.5 [95% CI, 1.3 to 1.7]), rectal (0.9 [95% CI, 0.6 to 1.2]), kidney (2.3 [95% CI, 1.8 to 2.9]), thyroid (4.2 [95% CI, 3.1 to 5.3]), breast (1 [95% CI, 0.6 to 1.4]), cervical (0.7 [95% CI, 0.3 to 1.2]), and prostate (3.9 [95% CI, 3.6 to 4.2]) cancers, with decreases in stomach (−2.4 [95% CI, −2.5 to −2.3]) and lung (−1.8 [95% CI, −2.1 to −1.5]) cancers. ASIRs in the affected regions were similar to nationwide rates, with the exception of those for Kyiv. CONCLUSION The incidence rates of many solid organ malignancies in Ukraine are rising. However, the rates of solid organ malignancy in the five regions most affected by fallout did not substantially differ from national patterns, with the exception of those for Kyiv. Ongoing monitoring of cancer incidence in Ukraine is necessary to understand how best to decrease disease burden nationwide and to elucidate the causes of regional variations in ASIRs, such as access to diagnostics and environmental exposures.

Breast cancer incidence in the regions of Belarus and Ukraine most contaminated by the Chernobyl accident: 1978 to 2016

“…We observed about 30% increase in age‐, urban/rural status‐, and rayon‐average 5‐year lagged cumulative dose adjusted breast cancer incidence rates per decade both in Belarus and Ukraine. Breast cancer incidence trends in both countries showed age‐, time‐ and urban lifestyle patterns similar to those observed worldwide 20,31‐33 …”

“…Breast cancer incidence trends in both countries showed age-, time-and urban lifestyle patterns similar to those observed worldwide. 20,[31][32][33] We found no evidence of increased breast cancer incidence in relation to rayon-average 5-year lagged cumulative breast dose nei- 34 We also observed some decrease in RR estimates with dose in Ukraine after 2000 where the relocation process from the most contaminated settlements after 2000 was incomplete and delayed, compared to Belarus. 35 Our study results did not show a higher radiation-related risk of breast cancer in women 45 years or younger at the time of the accident as compared to those women who were older than 45 years.…”

“…Estimation of breast cancer standardized incidence ratios (SIR) in the recovery operation female workers (mean effective dose of 162.7 mSv from 1986 to 1987, follow‐up of 1990‐2004), female residents of the most contaminated areas (mean effective dose of 22.4 mSv for the period 1986‐2005, follow‐up of 1980‐2004), and female evacuees from the 30 km zone around Chernobyl nuclear power plant and Prypiat town (mean effective dose of 30.6 mSv in 1986, follow‐up of 1990‐2004) showed an increased incidence only in recovery operation female workers with SIR estimate of 191% (95% CI: 164%, 218%) as compared to national incidence rates 4 . Analysis of solid cancer incidence in Ukraine 30 years after the Chernobyl accident (1999‐2016), especially in the most affected regions, showed age‐standardized breast cancer incidence rates to be similar to the national rates 32 . There were contradictory findings on breast cancer incidence trends in Belarus in relation to Chernobyl fallout that could be due to differences in study methods, catchment area and follow‐up period 5,38 .…”

“…4 Analysis of solid cancer incidence in Ukraine 30 years after the Chernobyl accident (1999-2016), especially in the most affected regions, showed age-standardized breast cancer incidence rates to be similar to the national rates. 32 There were contradictory findings on breast cancer incidence trends in Belarus in relation to Chernobyl fallout that could be due to differences in study methods, catchment area and follow-up period. 5,38 Recently, an ana- control study need to be replicated in other groups of women exposed due to Chernobyl fallout, and before that should be taken with caution.…”

Correlation Between Radioactive Cesium and the Increase of Pancreatic Cancer: A Hypothesis

“…[31], Leung et al [14] and Krystle et al [13] reported an increased incidence of PC and other tumors. 137 Cs concentrates in edible plants and fruit.…”