Verger P, Catelinois O, Tirmarche M, Chérié-Challine L, Pirard Ph, Colonna M, Hubert Ph
Regional Health Observatory Provence Alpes Cô6te d'Azur (ORS PACA), 23 rue Stanislas Torrents, 13006 Marseille, France.
Health Phys. 2003 Sep;85(3):323-9. doi: 10.1097/00004032-200309000-00008.
From 1975 to 1995, the incidence of thyroid cancer in the French population increased by a factor of 5.2 in men and 2.7 in women, thereby raising public concerns about its association with the nuclear accident at Chernobyl. A study performed at the request of French health authorities sought to quantify the potential risk of thyroid cancer associated with the Chernobyl fallout in France in order to determine if this risk could be observed through an epidemiological approach. The study focused on the most exposed population: those living in eastern France and younger than 15 y at the time of the Chernobyl nuclear power plant accident (26 April 1986). The number of spontaneous thyroid cancers in this population was predicted from French cancer registry data, and the thyroid doses were estimated from all available data about contamination in France. Associated risks were calculated with different risk models, all based on a linear no-threshold dose-effect relationship. Under this hypothesis, from 1.3 to 22 excess thyroid cancer cases were predicted for the 1991-2000 period, compared with the 212 spontaneous cases (0.5 to 10.5%) predicted, and from 11.2 to 55.2 excess cases were predicted for 1991-2015, compared with the 1,342 spontaneous cases (0.8 to 4.1%) predicted. These risk calculations indicate that the Chernobyl fallout cannot explain the entire increase in thyroid cancers in France, and that it is improbable that an epidemiological study could demonstrate such an excess. The surveillance of thyroid cancers in France should be enhanced.
1975年至1995年期间，法国男性甲状腺癌发病率增长了5.2倍，女性增长了2.7倍，这引发了公众对其与切尔诺贝利核事故关联的担忧。应法国卫生当局要求开展的一项研究，旨在量化法国与切尔诺贝利核事故放射性沉降相关的甲状腺癌潜在风险，以确定能否通过流行病学方法观察到这种风险。该研究聚焦于受影响最严重的人群：那些在切尔诺贝利核电站事故（1986年4月26日）发生时居住在法国东部且年龄小于15岁的人。根据法国癌症登记数据预测该人群中甲状腺癌的自发病例数，并根据法国所有可用的污染数据估算甲状腺剂量。使用不同的风险模型计算相关风险，所有模型均基于线性无阈剂量效应关系。在此假设下，预计1991年至2000年期间会出现1.3至22例额外的甲状腺癌病例，而预测的自发病例数为212例（0.5%至10.5%）；预计1991年至2015年期间会出现11.2至55.2例额外病例，而预测的自发病例数为1342例（0.8%至4.1%）。这些风险计算表明，切尔诺贝利核事故放射性沉降无法解释法国甲状腺癌增加的全部原因，而且流行病学研究不太可能证明存在这种超额情况。法国应加强对甲状腺癌的监测。
