Cancer mortality among atomic bomb survivors exposed in utero or as young children, October 1950 May 1992
Cancer mortality among atomic bomb survivors exposed in utero or as young children, October 1950 May 1992
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DOI：
10.2307/3579348
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发表时间：
1997-03-01
影响因子：
3.4
通讯作者：
Preston, DL
中科院分区：
文献类型：
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作者：
Delongchamp, RR;Mabuchi, K;Preston, DL
对1950年10月至1992年5月期间在子宫中暴露的原子弹幸存者的癌症死亡率进行了分析。这一群体的风险估计也与暴露时不到6岁的幸存者的风险估计进行了比较。研究的队列包括807名宫内幸存者和5545名儿童时期接触过的人，两组所有成员的估计剂量都至少为0.01Sv。对照组包括10,453名接触很少(<；0.01Sv)或没有接触的人。分析主要限于发生在17岁至46岁之间的癌症死亡。在子宫内暴露的人中，只有10人死于癌症。然而，存在显著的剂量反应，估计每西弗的超额相对风险(ERR/Sv)为2.1(90%可信区间为0.2至6.0)。这一估计与在生命的头5年中暴露的幸存者的估计没有显著差异。在子宫暴露者中，癌症死亡涉及白血病(2例)、女性特有器官(3例)和消化器官(5例)。9例死亡发生在女性，所有实体癌症的超额风险在ERR/Sv为1.6到17之间有90%的可信区间。消化系统癌症[ERR/Sv在0.7到20之间的90%可信区间(CI)]和女性特有的癌症(ERR/Sv在0.7到42之间的90%CI)被发现有显著的风险。这些风险与儿童时期接触过的女性的风险没有显著差异。在子宫内暴露的男性中，没有死于实体癌症。ERR/Sv的95%置信限上限为2.5，与暴露儿童的95%置信限上限1.5没有什么不同。即使将女性特有的癌症排除在比较之外，性别也不同。虽然宫内暴露者中只有2人死于白血病，但该组的白血病死亡率高于对照组(P=0.054)，其暴露量约为儿童期暴露者的一半，与儿童期暴露者差异不显著(P=0.103)。然而，没有证据表明那些在子宫中暴露的人有剂量反应，因为没有观察到高剂量白血病死亡，这一结果与儿童时期暴露的人的结果有很大不同。在解释这些数据时需要谨慎。第一，癌症死亡人数很少；第二，固体癌症死亡率在性别之间存在无法解释的显著差异；第三，在子宫中暴露的人中，白血病的过量并没有反映在剂量反应的增加上。(C)1997年，由辐射研究学会提供。
Cancer mortality for the period from October 1950 through May 1992 was analyzed in atomic bomb survivors exposed in utero. Risk estimates for this group were also compared to those for survivors who were less than 6 years old at the time of exposure. The cohorts studied include 807 in utero survivors and 5,545 persons exposed during childhood with all members of both groups having estimated doses of at least 0.01 Sv. The comparison group includes 10,453 persons with little (< 0.01 Sv) or no exposure. Analyses were limited mainly to cancer deaths occurring between the ages of 17 and 46. Only 10 cancer deaths were observed among persons exposed in utero. However, there is a significant dose response with an estimate of excess relative risk per sievert (ERR/Sv) of 2.1 (90% confidence interval of 0.2 to 6.0). This estimate does not differ significantly from that for survivors exposed during the first 5 years of life. The cancer deaths among those exposed in utero involved leukemia (2), female-specific organs (3) and digestive organs (5). Nine deaths occurred in females, where the excess risk for all solid cancers has a 90% confidence interval on the ERR/Sv of 1.6 to 17. Significant risks were found for cancers of the digestive system [90% confidence interval (CI) on the ERR/Sv of 0.7 to 20] and for female-specific cancers (90% CI on the ERR/SV of 0.7 to 42). These risks do not differ significantly from those seen in females exposed as children. There were no deaths from solid cancer in men exposed in utero. The ERR/Sv has an upper 95% confidence bound of 2.5 which does not differ from that for exposed children, where the upper 95% confidence bound is 1.5. The sexes differ even when female-specific cancers are excluded from the comparison. Although there were only two leukemia deaths among those exposed in utero, the leukemia death rate for this group is higher than that in the comparison group (P = 0.054) with an exposure effect that is about half the magnitude and not significantly different from that seen after childhood exposure (P = 0.103). However, there is no evidence of a dose response among those exposed in utero because no high-dose leukemia deaths were observed, a result that differs considerably from that for those exposed as children. There is a need for caution in the interpretation of these data. First, the number of cancer deaths is small; second, there is unexplained significant difference in the mortality from solid cancer between the sexes; and third, the excess of leukemia in those exposed in utero is not reflected in an increasing dose response. (C) 1997 by Radiation Research Society.