Site-specific Solid Cancer Mortality After Exposure to Ionizing Radiation: A Cohort Study of Workers (INWORKS).
Site-specific Solid Cancer Mortality After Exposure to Ionizing Radiation: A Cohort Study of Workers (INWORKS).
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DOI：
10.1097/ede.0000000000000761
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发表时间：
2018-01
期刊：
影响因子：
--
通讯作者：
Kesminiene A
中科院分区：
文献类型：
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作者：
Richardson DB;Cardis E;Daniels RD;Gillies M;Haylock R;Leuraud K;Laurier D;Moissonnier M;Schubauer-Berigan MK;Thierry-Chef I;Kesminiene A
科学界对长期低剂量电离辐射照射与特定类型癌症的发生之间的关系非常感兴趣。在法国、英国和美国雇用的308，297名核工人中，研究了电离辐射与特定地点实体癌死亡率之间的关系。对工人的外部辐射照射进行了监测，随访涵盖了820万人年。使用最大似然法和马尔可夫链蒙特卡罗法估计辐射死亡率的关联，后者用于拟合分层回归模型以稳定关联估计。该分析包括17，957例死于实体癌的死亡，最常见的是肺癌，前列腺癌和结肠癌。使用最大似然法量化辐射剂量与特定部位癌症之间的关联，我们获得了口腔癌、食道癌、胃癌、结肠癌、直肠癌、胰腺癌、腹膜癌、喉癌、肺癌、胸膜癌、骨和结缔组织癌、皮肤癌、卵巢癌、睾丸癌和甲状腺癌的正点估计值;此外，我们获得了肝癌和胆囊癌、前列腺癌、膀胱癌、肾癌和脑癌的负点估计。大多数这些估计系数表现出很大的不精确性。采用分层模型进行稳定化对最常见结果的估计关联影响不大，但对于频率较低的癌症类型，稳定化估计值倾向于采用较少的极端值，并且比未进行此类稳定化的估计值具有更高的精度。这些结果为低剂量辐射照射与癌症之间的关联提供了进一步证据。
There is considerable scientific interest in associations between protracted low-dose exposure to ionizing radiation and the occurrence of specific types of cancer. Associations between ionizing radiation and site-specific solid cancer mortality were examined among 308,297 nuclear workers employed in France, the United Kingdom, and the United States. Workers were monitored for external radiation exposure and follow-up encompassed 8.2 million person-years. Radiation–mortality associations were estimated using a maximum-likelihood method and using a Markov chain Monte Carlo method, the latter used to fit a hierarchical regression model to stabilize estimates of association. The analysis included 17,957 deaths attributable to solid cancer, the most common being lung, prostate, and colon cancer. Using a maximum-likelihood method to quantify associations between radiation dose- and site-specific cancer, we obtained positive point estimates for oral, esophagus, stomach, colon, rectum, pancreas, peritoneum, larynx, lung, pleura, bone and connective tissue, skin, ovary, testis, and thyroid cancer; in addition, we obtained negative point estimates for cancer of the liver and gallbladder, prostate, bladder, kidney, and brain. Most of these estimated coefficients exhibited substantial imprecision. Employing a hierarchical model for stabilization had little impact on the estimated associations for the most commonly observed outcomes, but for less frequent cancer types, the stabilized estimates tended to take less extreme values and have greater precision than estimates obtained without such stabilization. The results provide further evidence regarding associations between low-dose radiation exposure and cancer.