Yoshimoto Y, Kato H, Schull W J
Radiation Effects Research Foundation, Hiroshima, Japan.
Lancet. 1988 Sep 17;2(8612):665-9. doi: 10.1016/s0140-6736(88)90477-1.
This study examines the risk of cancer (incidence) over 40 years among the in-utero exposed survivors of the atomic bombing of Hiroshima and Nagasaki, and adds eight years of follow-up to a previous report confined to mortality. Only two cases of childhood cancer were observed among these survivors in the first 14 years of life; both had been heavily exposed. Subsequent cancers have all been of the adult type. Not only did the observed cancers occur earlier in the 0.30 + Gy dose group than in the 0 Gy dose group but also the incidence continues to increase, and the crude cumulative incidence rate, 40 years after the A-bombing, is 3.9-fold greater in the 0.30 + Gy group. In the observation period 1950-84, based on the absorbed dose to the mother's uterus as estimated by the 1986 dosimetry system (DS86), the relative risk of cancer at 1 Gy is 3.77 with a 95% confidence interval of 1.14-13.48. For the entire 0.01 + Gy dose group the average excess risk per 10(4) person-year-gray is 6.57 (0.07-14.49) and the estimated attributable risk is 40.9% (2.9-90.2%). These results, when viewed in the perspective of fetus doses, suggest that susceptibility to radiation-induced cancers is higher in prenatally than in postnatally exposed survivors (at least those exposed as adults). However, definitive conclusions must await further follow-up studies.
本研究调查了广岛和长崎原子弹爆炸时子宫内受照幸存者在40年间患癌症的风险(发病率),并在之前仅局限于死亡率的报告基础上增加了8年的随访。在这些幸存者生命的头14年中,仅观察到2例儿童癌症病例;这2例均受到了高剂量照射。随后发生的癌症均为成人类型。不仅在0.30 + Gy剂量组中观察到的癌症发病时间早于0 Gy剂量组,而且发病率持续上升,原子弹爆炸40年后,0.30 + Gy组的粗累积发病率比0 Gy组高3.9倍。在1950 - 1984年观察期内,根据1986年剂量测定系统(DS86)估算的母亲子宫吸收剂量,1 Gy时癌症的相对风险为3.77,95%置信区间为1.14 - 13.48。对于整个0.01 + Gy剂量组,每10(4)人年-戈瑞的平均超额风险为6.57(0.07 - 14.49),估计归因风险为40.9%(2.9 - 90.2%)。从胎儿剂量的角度来看,这些结果表明,产前受照幸存者对辐射诱发癌症的易感性高于产后受照幸存者(至少是成年后受照者)。然而,确切结论尚需进一步的随访研究。