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Thyroid Cancer Following Childhood Low-Dose Radiation Exposure: A Pooled Analysis of Nine Cohorts
Ist Teil von
The journal of clinical endocrinology and metabolism, 2017-07, Vol.102 (7), p.2575-2583
Ort / Verlag
Washington, DC: Endocrine Society
Erscheinungsjahr
2017
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
Abstract
Context:
The increased use of diagnostic and therapeutic procedures that involve radiation raises concerns about radiation effects, particularly in children and the radiosensitive thyroid gland.
Objectives:
Evaluation of relative risk (RR) trends for thyroid radiation doses <0.2 gray (Gy); evidence of a threshold dose; and possible modifiers of the dose-response, e.g., sex, age at exposure, time since exposure.
Design and Setting:
Pooled data from nine cohort studies of childhood external radiation exposure and thyroid cancer with individualized dose estimates, ≥1000 irradiated subjects or ≥10 thyroid cancer cases, with data limited to individuals receiving doses <0.2 Gy.
Participants:
Cohorts included the following: childhood cancer survivors (n = 2); children treated for benign diseases (n = 6); and children who survived the atomic bombings in Japan (n = 1). There were 252 cases and 2,588,559 person-years in irradiated individuals and 142 cases and 1,865,957 person-years in nonirradiated individuals.
Intervention:
There were no interventions.
Main Outcome Measure:
Incident thyroid cancers.
Results:
For both <0.2 and <0.1 Gy, RRs increased with thyroid dose (P < 0.01), without significant departure from linearity (P = 0.77 and P = 0.66, respectively). Estimates of threshold dose ranged from 0.0 to 0.03 Gy, with an upper 95% confidence bound of 0.04 Gy. The increasing dose–response trend persisted >45 years after exposure, was greater at younger age at exposure and younger attained age, and was similar by sex and number of treatments.
Conclusions:
Our analyses reaffirmed linearity of the dose response as the most plausible relationship for “as low as reasonably achievable” assessments for pediatric low-dose radiation-associated thyroid cancer risk.
A pooling of nine cohort studies of childhood external radiation exposure revealed a linear increase in risk of thyroid cancer and reaffirmed the “as low as reasonably achievable” principal for pediatric low dose radiation.