International Journal of Epidemiology 2003;32:584-591
© International Epidemiological Association 2003
Cancer |
Iodine deficiency, radiation dose, and the risk of thyroid cancer among children and adolescents in the Bryansk region of Russia following the Chernobyl power station accident
1 Medical Radiological Research Center of the Russian Academy of Medical Sciences, Obninsk, Russia.
2 Institute of Experimental Meteorology of Scientific Production Association ‘Typhoon’, Obninsk, Russia.
3 Fred Hutchinson Cancer Research Center, Program in Epidemiology, Division of Public Health Sciences, and University of Washington, School of Public Health and Community Medicine, Seattle, Washington, USA.
Correspondence: Dr Scott Davis, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N MP-474, PO Box 19024, Seattle, WA 98109–1024, USA. E-mail: sdavis{at}fhcrc.org
Background Little is known about the joint effect of iodine deficiency and radiation exposure on the risk of thyroid cancer. No epidemiological studies have been published assessing the modifying effect of iodine deficiency on radiation-induced thyroid cancer following the Chernobyl accident.
Methods A population sample of 3070 individuals (2590 ages 6–18, and 480 adults) from 75 settlements in the most highly contaminated regions of the Bryansk Oblast of Russia was identified and sampled for urinary iodine measurements in 1996, and iodine deficiency in each geopolitical unit (raion) was estimated. All cases of thyroid cancer were identified in those born 1968–1986 who were resident in the study area in May–June 1986 (34 histologically confirmed cases). The risk of thyroid cancer was examined in relation to population estimates of thyroid radiation dose and urinary iodine excretion level.
Results The excess relative risk (ERR) of thyroid cancer was significantly associated with increasing thyroid radiation dose, and was inversely associated with urinary iodine excretion levels. There was a joint effect of radiation exposure and iodine deficiency. At 1 gray (Gy), the ERR in territories with severe iodine deficiency was approximately two times that in areas of normal iodine intake.
Conclusions These findings suggest that elimination of iodine deficiency in areas affected by Chernobyl may be important in reducing the effects of radiation exposure on the thyroid. If confirmed by studies based on individuals, they may have implications for the use of stable iodine in the case of population exposure to radioactive iodine.
Keywords Thyroid cancer, radiation, radioactive iodine, iodine deficiency, Chernobyl
Accepted 11 April 2003
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