Cotterill S J, Pearce M S, Parker L
Sir James Spence Institute of Child Health, University of Newcastle upon Tyne, Queen Victoria Road, NE1 4LP, Newcastle, UK.
Eur J Cancer. 2001 May;37(8):1020-6. doi: 10.1016/s0959-8049(00)00449-4.
Population-based data on thyroid carcinomas was obtained from the Northern Region Young Person's Malignant Disease Registry to analyse the incidence of thyroid cancers in young people (<25 years) in the North of England for the period 1968 and 1997 and to assess if changes in incidence were consistent with the spatial and temporal distribution of the fallout from the Chernobyl nuclear accident. We compared incidence rates for differentiated (papillary or follicular) thyroid carcinomas 1968-1986 with those for 1987-1997. There were 75 cases of thyroid carcinoma diagnosed over the study period, of which 63 were differentiated carcinoma and 12 were medullary carcinoma. There were 26 young adults (15-24 years) diagnosed with differentiated thyroid carcinoma in the 19-year period 1968-1986 and 30 in the subsequent 11 years 1987-1997, Age standardised rate (ASR) 3.0 versus 6.5, respectively (rate ratio 2.2, 95% confidence interval (CI): 1.3-3.6). There were three children (aged <15 years) diagnosed with differentiated carcinoma in the period 1968-1986 and four in the period 1987-1997, ASR 0.2 versus 0.6 (rate ratio 2.7, 95% CI: 0.6-12.1). Regression models showed a significant increase in the incidence of thyroid cancer after the Chernobyl accident (P=0.002). In Cumbria, the area receiving the heaviest fallout in the UK, the increase in incidence was much greater (rate ratio 12.19, 95% CI 1.5-101.2). These temporal and spatial changes in incidence are consistent with a causal association with the Chernobyl accident although a greater effect in the younger rather than the older age group would have been anticipated. However, factors including improvements in ascertainment and earlier detection of tumours may also have contributed to the increasing incidence. Further collaborative international studies are needed to investigate changes in the incidence of thyroid cancer in children and young adults.
基于人群的甲状腺癌数据来自北部地区青少年恶性疾病登记处，用于分析1968年至1997年英格兰北部年轻人（<25岁）甲状腺癌的发病率，并评估发病率的变化是否与切尔诺贝利核事故放射性尘埃的时空分布一致。我们比较了1968 - 1986年与1987 - 1997年分化型（乳头状或滤泡状）甲状腺癌的发病率。在研究期间共诊断出75例甲状腺癌病例，其中63例为分化型癌，12例为髓样癌。在1968 - 1986年的19年期间，有26名年轻成年人（15 - 24岁）被诊断为分化型甲状腺癌，在随后的1987 - 1997年的11年中有30例，年龄标准化率（ASR）分别为3.0和6.5（率比2.2，95%置信区间（CI）：1.3 - 3.6）。在1968 - 1986年期间有3名儿童（年龄<15岁）被诊断为分化型癌，在1987 - 1997年期间有4名，ASR为0.2和0.6（率比2.7，95% CI：0.6 - 12.1）。回归模型显示切尔诺贝利事故后甲状腺癌发病率显著增加（P = 0.002）。在英国受放射性尘埃影响最严重的坎布里亚郡，发病率的增加幅度更大（率比12.19，95% CI 1.5 - 101.2）。发病率的这些时空变化与切尔诺贝利事故存在因果关联一致，尽管预期在较年轻而非较年长年龄组中影响会更大。然而，包括肿瘤确诊和早期检测方面的改善等因素也可能导致了发病率的上升。需要进一步开展国际合作研究来调查儿童和年轻成年人甲状腺癌发病率的变化情况。
