Associate Chief of Research, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan.
Department of Statistics, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan.
Radiat Res. 2021 Feb 1;195(2):140-148. doi: 10.1667/RADE-20-00158.1.
As part of the recent series of articles to create a comprehensive description of the radiation risks of solid cancer incidence after ionizing radiation exposure, based on the atomic bomb survivors' Life Span Study (LSS), this work focuses on the risks of urinary tract cancer (UTC) and kidney cancer. Analyses covered a 52-year period of follow-up, through 2009, among 105,444 eligible survivors who were alive and cancer free in 1958. This represents an additional 11 years of follow-up since the last comprehensive report, with a total of 3,079,502 person-years. We observed 790 UTC and 218 kidney cancer cases. Adjusted for smoking, there was a strong linear radiation dose response for UTC. The sex-averaged excess relative risk per 1 Gy (ERR/Gy) was 1.4 (95% confidence interval, CI: 0.82 to 2.1). Both males and females showed significantly increased ERRs/Gy with female point estimates at a factor of 3.4 (95% CI: 1.4 to 8.6) greater than male estimates. UTC radiation risks were largely unmodified by age at exposure or attained age. The attributable fraction of UTC to radiation exposure was approximately 18% while that attributed to smoking was 48%. Kidney cancer showed an increased ERR due to smoking (0.56 per 50 pack-years; 95% CI -0.007 to 1.6; P = 0.054), but we did not observe any strong associations of kidney cancer with radiation exposure, although sex-specific dose responses were found to be statistically different.
作为最近一系列文章的一部分，旨在全面描述电离辐射暴露后实体癌发病的辐射风险，本研究基于原子弹幸存者寿命研究（LSS），重点关注了膀胱癌（UTC）和肾癌的风险。分析涵盖了 52 年的随访期，截至 2009 年，共有 105444 名符合条件的幸存者在 1958 年时存活且无癌症。这比上次全面报告增加了 11 年的随访时间，总随访时间达到了 3079502 人年。我们观察到了 790 例 UTC 和 218 例肾癌病例。在调整了吸烟因素后，UTC 存在明显的线性剂量反应。每 1 Gy 的超额相对风险（ERR/Gy）的性别平均估计值为 1.4（95%置信区间，CI：0.82 至 2.1）。男性和女性的 ERR/Gy 均显著增加，女性的点估计值比男性高 3.4 倍（95%CI：1.4 至 8.6）。UTC 的辐射风险基本不受暴露时的年龄或当前年龄的影响。UTC 归因于辐射暴露的比例约为 18%，归因于吸烟的比例为 48%。肾癌的发病风险由于吸烟而增加（50 包年每增加 0.56；95%CI：-0.007 至 1.6；P = 0.054），但我们并未观察到任何与辐射暴露强烈相关的肾癌病例，尽管发现了性别特异性剂量反应存在统计学差异。
