Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA.
Laryngoscope. 2012 Jun;122(6):1415-21. doi: 10.1002/lary.23314. Epub 2012 May 7.
OBJECTIVES/HYPOTHESIS: To determine differences in disease characteristics between the thyroid cancer populations in the area around the Three Mile Island (TMI) nuclear power plant and the rest of the state of Pennsylvania.
Retrospective cross-sectional study.
Data from the Pennsylvania Cancer Registry from 1985 to 2008 were reviewed and information regarding age at diagnosis, sex, race, residential status, county of residence, thyroid pathology, thyroid surgery, and staging was recorded. Dauphin, Lancaster, and York counties were defined as the TMI area.
Records of 26,357 thyroid cancer patients were reviewed, with 2,611 patients within the TMI area. A higher proportion of papillary thyroid cancer (P < .001) and lower proportion of follicular thyroid cancer (P < .001) were noted in the TMI area population. Thyroid cancer cases from the TMI area were found to be more likely to be diagnosed before the age of 65 years (P < .001), be Pennsylvania born (P < .001), be well differentiated (P < .001), be <10 mm in size (P < .001), and be localized without spread (P < .001). Although the TMI area shows a higher incidence of thyroid cancer as compared to the rest of the state, this was not statistically significant.
The TMI population showed a higher proportion of papillary thyroid cancer and less aggressive pathology and earlier diagnosis compared to the rest of Pennsylvania. No statistically significant difference in thyroid cancer incidence was noted. Overall, the study does not show a clear link with more advanced thyroid cancer and proximity to the TMI nuclear reactors.
目的/假设:确定三哩岛(TMI)核电厂周边地区与宾夕法尼亚州其他地区甲状腺癌患者人群的疾病特征差异。
回顾性横断面研究。
回顾分析了 1985 年至 2008 年宾夕法尼亚癌症登记处的数据,记录了诊断时的年龄、性别、种族、居住状况、居住县、甲状腺病理、甲状腺手术和分期等信息。达芬、兰卡斯特和约克县被定义为 TMI 地区。
共回顾了 26357 例甲状腺癌患者的记录,其中 2611 例来自 TMI 地区。TMI 地区人群中,甲状腺乳头状癌的比例较高(P <.001),而甲状腺滤泡癌的比例较低(P <.001)。TMI 地区的甲状腺癌病例更有可能在 65 岁之前被诊断出来(P <.001),是宾夕法尼亚州出生的(P <.001),分化程度较高(P <.001),肿瘤直径小于 10mm(P <.001),且局限于局部而无扩散(P <.001)。尽管 TMI 地区的甲状腺癌发病率高于该州其他地区,但这并不具有统计学意义。
与宾夕法尼亚州其他地区相比,TMI 地区人群的甲状腺乳头状癌比例较高,病理侵袭性较低,诊断时间较早。甲状腺癌发病率无统计学差异。总的来说,该研究并未显示出与 TMI 核反应堆的接近程度与更晚期甲状腺癌之间存在明确的联系。