Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
Eur J Cancer. 2013 Sep;49(13):2926-33. doi: 10.1016/j.ejca.2013.04.014. Epub 2013 May 15.
To assess site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers, 1986-2007.
The Baltic cohort includes 17,040 men from Estonia, Latvia and Lithuania who participated in the environmental cleanup after the accident at the Chernobyl Nuclear Power Station in 1986-1991 and who were followed up for cancer incidence until the end of 2007. Cancer cases diagnosed in the cohort and in the male population of each country were identified from the respective national cancer registers. The proportional incidence ratio (PIR) with 95% confidence interval (CI) was used to estimate the site-specific cancer risk in the cohort. For comparison and as it was possible, the site-specific standardised incidence ratio (SIR) was calculated for the Estonian sub-cohort, which was not feasible for the other countries.
Overall, 756 cancer cases were reported during 1986-2007. A higher proportion of thyroid cancers in relation to the male population was found (PIR=2.76; 95%CI 1.63-4.36), especially among those who started their mission shortly after the accident, in April-May 1986 (PIR=6.38; 95%CI 2.34-13.89). Also, an excess of oesophageal cancers was noted (PIR=1.52; 95% CI 1.06-2.11). No increased PIRs for leukaemia or radiation-related cancer sites combined were observed. PIRs and SIRs for the Estonian sub-cohort demonstrated the same site-specific cancer risk pattern.
Consistent evidence of an increase in radiation-related cancers in the Baltic cohort was not observed with the possible exception of thyroid cancer, where conclusions are hampered by known medical examination including thyroid screening among cleanup workers.
评估 1986-2007 年切尔诺贝利清理工作者中波罗的海队列的特定部位癌症风险。
波罗的海队列包括来自爱沙尼亚、拉脱维亚和立陶宛的 17040 名男性,他们于 1986-1991 年参加了切尔诺贝利核电站事故后的环境清理工作,并在 2007 年底之前对癌症发病率进行了随访。队列中诊断出的癌症病例和每个国家的男性人口中的癌症病例均从各自的国家癌症登记处确定。使用比例发病率比(PIR)和 95%置信区间(CI)来估计队列中的特定部位癌症风险。为了进行比较,并在可能的情况下,为爱沙尼亚子队列计算了特定部位标准化发病率比(SIR),这对于其他国家是不可行的。
总体而言,在 1986-2007 年期间报告了 756 例癌症病例。与男性人口相比,甲状腺癌的比例较高(PIR=2.76;95%CI 1.63-4.36),尤其是在那些在 1986 年 4 月至 5 月事故后不久开始任务的人群中(PIR=6.38;95%CI 2.34-13.89)。此外,还观察到食管癌的发病率偏高(PIR=1.52;95%CI 1.06-2.11)。未观察到白血病或辐射相关癌症部位的 PIR 增加。爱沙尼亚子队列的 PIR 和 SIR 显示出相同的特定部位癌症风险模式。
除了甲状腺癌之外,没有观察到波罗的海队列中与辐射相关的癌症增加的一致证据,在甲状腺癌中,由于已知的医疗检查(包括对清理工人进行甲状腺筛查),结论受到了阻碍。