Shimizu Y, Kato H, Schull W J
Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan.
Radiat Res. 1990 Feb;121(2):120-41.
The present study, the ninth in a series that began in 1961, extends the time of surveillance 3 more years and covers the period 1950-1985. It is based on the recently revised doses, termed the DS86. The impact of the change from the T65D to the DS86 on the dose-response relationships for cancer mortality was described in the first of this series of reports. Here, the focus is on cancer mortality among the 76,000 A-bomb survivors within the LSS sample for whom DS86 doses have been estimated, with the emphasis on biological issues associated with radiation carcinogenesis. Briefly, the following is found: The excess in leukemia mortality has continued to decline with time, but remains slightly but significantly elevated in 1981-1985 in Hiroshima. For cancers other than leukemia, as a group, excess deaths continue to increase over time in direct proportion to the normal increase in natural cancer mortality with increasing age, and the relative risk seems unchanged over time within age ATB cohorts. The single exception is the cohort under 10 years of age ATB. Within this group of survivors, where the relative risk, although based on relatively few deaths, has been quite high at the higher doses, as judged by deaths before the age of 30, the risk has fallen and has remained fairly constant at a lower level thereafter. Thus the present analysis still supports, in the main, estimation of lifetime risk based on the assumption of a constant relative risk. For the same age ATD, both the relative and absolute risks are higher for younger age ATB cohorts than older ones for cancers other than leukemia. There is no statistically significant difference in excess deaths between males and females except for leukemia, though the relative risk is higher for females than for males, significantly so for cancers of the esophagus and lung, reflecting the higher background cancer rate for males. Significant dose responses are observed for leukemia, cancers of the esophagus, stomach, colon, lung, breast, ovary, and urinary bladder and multiple myeloma, as previously observed. No significant increase is demonstrable as yet for cancers of the rectum, gallbladder, pancreas, uterus, and prostate and malignant lymphoma. In the present report, cancers of the bone, pharynx, nose, and larynx, and skin except melanoma are also examined, but none of these sites show a significant increase with dose.(ABSTRACT TRUNCATED AT 400 WORDS)
本研究是始于1961年的系列研究中的第九项,将监测时间又延长了3年,涵盖1950 - 1985年这一时期。它基于最近修订的剂量,即DS86。本系列报告的第一篇描述了从T65D到DS86的变化对癌症死亡率剂量反应关系的影响。在此,重点是LSS样本中76000名原子弹幸存者的癌症死亡率,这些幸存者的DS86剂量已被估算,重点关注与辐射致癌相关的生物学问题。简而言之,发现以下情况:白血病死亡率的超额部分随时间持续下降,但在1981 - 1985年的广岛仍略有但显著升高。对于白血病以外的癌症,总体而言,超额死亡随时间持续增加,与自然癌症死亡率随年龄增长的正常增加成正比,并且在年龄ATB队列中相对风险随时间似乎没有变化。唯一的例外是10岁以下的ATB队列。在这群幸存者中,尽管基于相对较少的死亡人数,但在较高剂量下相对风险一直相当高,从30岁前的死亡情况判断,风险已经下降,此后一直保持在较低水平且相当稳定。因此,目前的分析在很大程度上仍然支持基于相对风险恒定的假设来估计终身风险。对于相同年龄的ATD,除白血病外,其他癌症中较年轻的ATB队列的相对风险和绝对风险都高于较年长的队列。除白血病外,男性和女性的超额死亡没有统计学上的显著差异,尽管女性的相对风险高于男性,食管和肺癌的情况尤为显著,这反映了男性较高的背景癌症发生率。如先前观察到的,白血病、食管癌、胃癌、结肠癌、肺癌、乳腺癌、卵巢癌、膀胱癌和多发性骨髓瘤出现了显著的剂量反应。直肠癌、胆囊癌、胰腺癌、子宫癌、前列腺癌和恶性淋巴瘤目前尚未显示出显著增加。在本报告中,还检查了骨癌以及咽、鼻、喉癌和除黑色素瘤外的皮肤癌,但这些部位均未显示出随剂量显著增加。(摘要截断于400字)