Department of Epidemiology and Biostatistics, University of California San Francisco, 3333 California Street, Suite 280, San Francisco, CA 94118, USA.
Br J Cancer. 2011 Jan 4;104(1):181-7. doi: 10.1038/sj.bjc.6605967. Epub 2010 Nov 23.
Previous studies showed an increased risk of thyroid cancer among children and adolescents exposed to radioactive iodines released after the Chornobyl (Chernobyl) accident, but the effects of screening, iodine deficiency, age at exposure and other factors on the dose-response are poorly understood.
We screened 11 970 individuals in Belarus aged 18 years or younger at the time of the accident who had estimated (131)I thyroid doses based on individual thyroid activity measurements and dosimetric data from questionnaires. The excess odds ratio per gray (EOR/Gy) was modelled using linear and linear-exponential functions.
For thyroid doses <5 Gy, the dose-response was linear (n=85; EOR/Gy=2.15, 95% confidence interval: 0.81-5.47), but at higher doses the excess risk fell. The EOR/Gy was significantly increased among those with prior or screening-detected diffuse goiter, and larger for men than women, and for persons exposed before age 5 than those exposed between 5 and 18 years, although not statistically significant. A somewhat higher EOR/Gy was estimated for validated pre-screening cases.
10-15 years after the Chornobyl accident, thyroid cancer risk was significantly increased among individuals exposed to fallout as children or adolescents, but the risk appeared to be lower than in other Chornobyl studies and studies of childhood external irradiation.
先前的研究表明,在切尔诺贝利(Chernobyl)事故后暴露于放射性碘的儿童和青少年患甲状腺癌的风险增加,但对筛查、碘缺乏、暴露年龄和其他因素对剂量反应的影响知之甚少。
我们对 1986 年事故时年龄在 18 岁或以下的 11970 名白俄罗斯人进行了筛查,这些人根据个体甲状腺活动测量和问卷调查的剂量学数据估算了(131)I 甲状腺剂量。使用线性和线性指数函数对每戈瑞的超额优势比(EOR/Gy)进行建模。
对于<5Gy 的甲状腺剂量,剂量反应呈线性(n=85;EOR/Gy=2.15,95%置信区间:0.81-5.47),但在更高剂量下,超额风险下降。有先前或筛查发现的弥漫性甲状腺肿的个体中 EOR/Gy 显著增加,男性高于女性,5 岁前暴露的个体高于 5-18 岁暴露的个体,尽管无统计学意义。验证性预筛查病例的 EOR/Gy 估计值略高。
在切尔诺贝利事故发生 10-15 年后,作为儿童或青少年暴露于放射性沉降物的个体患甲状腺癌的风险显著增加,但风险似乎低于其他切尔诺贝利研究和儿童外照射研究。