© 2005 Oxford University Press
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Risk of Thyroid Cancer After Exposure to 131I in Childhood
Affiliations of authors: International Agency for Research on Cancer, Lyon, France (EC, AK, VD, VT); Medical Radiological Research Center RAMS, Obninsk, the Russian Federation (VI, OV, AA, SC, EL, MM, VP, EP, AT); Belarusian Center for Medical Technologies, Computer Systems, Administration and Management of Health, Minsk, Belarus (IM, SP, NS); Nagasaki University, Nagasaki, Japan (YS, SY); State Research Center—Institute of Biophysics, Moscow, the Russian Federation (VK); Institute of Physics, Vilnius, Lithuania (EM); Research Institute of Radiation Hygiene, St. Petersburg, the Russian Federation (IZ); National Cancer Institute, Bethesda, MD (AB); Clinic and Policlinic for Nuclear Medicine, Bayerische Julius-Maximilians University of Würzburg, Germany (GG); Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan (MH); Institute of Geological Sciences of the National Academy of Sciences of Belarus, Minsk, Belarus (JA); Center of Laser Medicine, Childhood Polyclinic No. 8, Minsk, Belarus (LA); Belarusian State Medical University, Minsk, Belarus (ED); Centre for Tobacco Prevention, Stockholm Centre of Public Health and Clinical Epidemiology Unit, Karolinska University Hospital, Sweden (RG); National Nagasaki Medical Center, Nagasaki, Japan (MI); Vernadsky Institute of Geochemistry and Analytical Chemistry, Russian Academy of Sciences, Moscow, the Russian Federation (EK); Republican Research Centre of Radiation Medicine and Human Ecology, Gomel, Belarus (VM); Belarusian State Medical University, Minsk, Belarus (AN, NP); Department of Endocrinology and Metabolism, University of Pisa, Italy (AP); Clinic of Oncology, Turku University Hospital, Turku, Finland (ES); Strangeways Research Laboratory, Cambridge, U.K. (DW)
Correspondence to: E. Cardis, PhD, International Agency for Research on Cancer, Lyon, France (e-mail: cardis{at}iarc.fr).
Background: After the Chernobyl nuclear power plant accident in April 1986, a large increase in the incidence of childhood thyroid cancer was reported in contaminated areas. Most of the radiation exposure to the thyroid was from iodine isotopes, especially 131I. We carried out a population-based case–control study of thyroid cancer in Belarus and the Russian Federation to evaluate the risk of thyroid cancer after exposure to radioactive iodine in childhood and to investigate environmental and host factors that may modify this risk. Methods: We studied 276 case patients with thyroid cancer through 1998 and 1300 matched control subjects, all aged younger than 15 years at the time of the accident. Individual doses were estimated for each subject based on their whereabouts and dietary habits at the time of the accident and in following days, weeks, and years; their likely stable iodine status at the time of the accident was also evaluated. Data were analyzed by conditional logistic regression using several different models. All statistical tests were two-sided. Results: A strong dose–response relationship was observed between radiation dose to the thyroid received in childhood and thyroid cancer risk (P<.001). For a dose of 1 Gy, the estimated odds ratio of thyroid cancer varied from 5.5 (95% confidence interval [CI] = 3.1 to 9.5) to 8.4 (95% CI = 4.1 to 17.3), depending on the risk model. A linear dose–response relationship was observed up to 1.5–2 Gy. The risk of radiation-related thyroid cancer was three times higher in iodine-deficient areas (relative risk [RR]= 3.2, 95% CI = 1.9 to 5.5) than elsewhere. Administration of potassium iodide as a dietary supplement reduced this risk of radiation-related thyroid cancer by a factor of 3 (RR = 0.34, 95% CI = 0.1 to 0.9, for consumption of potassium iodide versus no consumption). Conclusion: Exposure to 131I in childhood is associated with an increased risk of thyroid cancer. Both iodine deficiency and iodine supplementation appear to modify this risk. These results have important public health implications: stable iodine supplementation in iodine-deficient populations may substantially reduce the risk of thyroid cancer related to radioactive iodines in case of exposure to radioactive iodines in childhood that may occur after radiation accidents or during medical diagnostic and therapeutic procedures.
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Correspondence about this Article
- Re: Risk of Thyroid Cancer After Exposure to 131I in Childhood
- Bobby R. Scott
J Natl Cancer Inst 2006 98: 561.[Extract] [Full Text] [PDF]
- Re: Risk of Thyroid Cancer After Exposure to 131I in Childhood
- Charles M. Grossman and Rudi H. Nussbaum
J Natl Cancer Inst 2006 98: 641.[Extract] [Full Text] [PDF]
Editorial about this Article
- Radiation-induced Thyroid Cancer—What's New?
- John D. Boice, Jr.
J Natl Cancer Inst 2005 97: 703-705.[Extract] [Full Text] [PDF]
Related Memo to the Media
- Press Release: Iodine Deficiency, Supplementation Affect Thyroid Cancer Risk in Children Exposed to Radioactive Iodine
- Sarah L. Zielinski
J Natl Cancer Inst 2005 97: 701.[Extract] [Full Text]
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