Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Sweden; Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
Sci Total Environ. 2022 Sep 10;838(Pt 3):156349. doi: 10.1016/j.scitotenv.2022.156349. Epub 2022 May 31.
Uncertainty in the dose-response of low dose radiation raised concern of an increased cancer incidence in Sweden after the Chernobyl Nuclear Power Plant (NPP) accident.
A closed cohort was created of all males ≥18 years of age living in the Northern Sweden in 1986. In total 826,400 individuals were enrolled including 40,874 hunters. A nested case-control design was used with five controls randomly selected for each cancer case matched on year of diagnosis and year of birth. Individual absorbed colon dose was calculated 1986 to 2015. Allowing for a 5-year latency period Hazard Ratios (HR) per mGy with 95% Confidence Intervals (95% CI) were calculated in a conditional logistic regression adjusted by rural/non-rural living, length of education and pre-Chernobyl cancer incidence 1980 to 1985. A total of 127,109 cancer cases occurred from 1 January 1991 to 31 December 2015. Cancer was classified in: 1) Organ-specific (stomach, colon, liver, lung, prostate, urinary bladder, thyroid and leukaemia), 2) Other and 3) Not previously associated to ionizing radiation.
The average colon dose in cases was 1.77 mGy compared to controls 1.73 mGy. Hunters average colon dose was 2.32 mGy. Organ-specific cancers showed the highest HR per mGy both in the full cohort, adj HR 1.019 (1.014-1.024) and the hunter subcohort, adj HR 1.014 (1.001-1.027) during follow-up 1991 to 2015. Other cancer and Not previously associated with ionizing radiation showed lower HR per mGy. Therefore, the adj HR per mGy for Total cancer, 1.013 (1.009-1.017) was explained by Organ-specific cancer. Increased adj HR per mGy was seen in stomach, colon and prostate cancer, respectively in the full cohort and lung cancer in hunters.
Some cancer sites previously associated with ionizing radiation showed a positive adjusted HR per mGy both in the full cohort and in the hunter subcohort.
在切尔诺贝利核电站事故后，低剂量辐射的剂量反应不确定性引起了人们对瑞典癌症发病率增加的担忧。
创建了一个 1986 年居住在瑞典北部的所有 18 岁以上男性的封闭队列。共有 826400 人入组，其中包括 40874 名猎人。采用巢式病例对照设计，每例癌症病例匹配 5 名随机选择的对照，按诊断年份和出生年份匹配。1986 年至 2015 年计算个体吸收结肠剂量。在条件逻辑回归中，在调整农村/非农村居住、受教育程度和切尔诺贝利前癌症发病率（1980 年至 1985 年）后，计算每 mGy 的危害比（HR）及其 95%置信区间（95%CI）。从 1991 年 1 月 1 日至 2015 年 12 月 31 日共发生 127109 例癌症病例。癌症分为：1）器官特异性（胃、结肠、肝、肺、前列腺、膀胱、甲状腺和白血病），2）其他和 3）以前与电离辐射无关。
病例组平均结肠剂量为 1.77mGy，对照组为 1.73mGy。猎人的平均结肠剂量为 2.32mGy。在全队列和猎人亚队列中，器官特异性癌症的每 mGy 最高 HR 均为 1.019（1.014-1.024）和 1.014（1.001-1.027），随访时间为 1991 年至 2015 年。其他癌症和以前与电离辐射无关的癌症每 mGy 的 HR 较低。因此，全队列和 hunter 亚队列的总癌症调整后每 mGy 的 HR 为 1.013（1.009-1.017），由器官特异性癌症解释。全队列中，胃癌、结肠癌和前列腺癌的调整后每 mGy 的 HR 分别升高，而猎人组中则为肺癌。
在全队列和猎人亚队列中，以前与电离辐射相关的一些癌症部位的每 mGy 调整 HR 均为阳性。
