Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.
Cancer Control Department, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus.
Int J Cancer. 2021 Apr 15;148(8):1839-1849. doi: 10.1002/ijc.33346. Epub 2020 Oct 29.
Even 30 years after the accident, an association between breast cancer incidence and ionizing radiation exposure from Chernobyl fallout remains uncertain. We studied breast cancer incidence in the most contaminated regions of Belarus (Gomel and Mogilev) and Ukraine (Kyiv, Zhytomyr and Chernihiv) before (1978-1986) and after (1987-2016) the accident. Breast cancer cases and female population size data were received from the national cancer registries and the state departments of statistics. The study included 85 132 breast cancers with 150 million person-years at risk. We estimated annual rayon (district)-average absorbed doses to the breast from external and internal irradiation of the adult female population over the period of 1986-2016. We studied an association between rayon-average cumulative absorbed breast dose with 5-year lag, that is, excluding the exposure in 5 years prior to breast cancer diagnosis, and breast cancer incidence using negative binomial regression models. Mean (median) cumulative breast dose in 2016 was 12.3 (5.0) milligray (mGy) in Belarus and 5.7 (2.3) mGy in Ukraine, with the maximum dose of 55 mGy and 54 mGy, respectively. Breast cancer incidence rates statistically significantly increased with calendar year and attained age, and were higher in urban than in rural residents. Adjusting for time, age and urbanicity effects, we found no evidence of increasing incidence with rayon-average 5-year lagged cumulative breast dose. Owing to ecological study design limitations, a case-control study covering this area with individually reconstructed absorbed breast doses is needed testing for association between low-dose protracted radiation exposure and breast cancer risk after Chernobyl.
即使在切尔诺贝利事故发生 30 年后，乳腺癌发病率与切尔诺贝利沉降物致电离辐射暴露之间的关联仍然不确定。我们研究了白俄罗斯（戈梅利和莫吉廖夫）和乌克兰（基辅、日托米尔和切尔尼戈夫）污染最严重地区乳腺癌的发病率，包括事故前（1978-1986 年）和事故后（1987-2016 年）。乳腺癌病例和女性人口规模数据来自国家癌症登记处和国家统计局。该研究包括 85132 例乳腺癌，风险人群为 1.5 亿人年。我们估算了 1986-2016 年期间成年女性人口接受外部和内部照射的乳房平均年吸收剂量。我们研究了 5 年滞后的射线区平均累积吸收乳房剂量与乳腺癌发病率之间的关联，即排除乳腺癌诊断前 5 年的暴露，使用负二项回归模型进行研究。2016 年，白俄罗斯的平均（中位数）累积乳房剂量为 12.3（5.0）毫戈瑞（mGy），乌克兰为 5.7（2.3）mGy，最大剂量分别为 55 mGy 和 54 mGy。乳腺癌发病率与日历年份和达到年龄呈统计学显著相关，城市居民高于农村居民。调整时间、年龄和城市性效应后，我们没有发现射线区平均 5 年滞后累积乳房剂量与发病率增加之间存在证据。由于生态研究设计的限制，需要进行一项覆盖该地区的病例对照研究，用个体重建的吸收乳房剂量来检验切尔诺贝利后低剂量长期辐射暴露与乳腺癌风险之间的关联。
