Breast cancer risk in residents of Belarus exposed to Chernobyl fallout while pregnant or lactating: standardized incidence ratio analysis, 1997 to 2016
Breast cancer risk in residents of Belarus exposed to Chernobyl fallout while pregnant or lactating: standardized incidence ratio analysis, 1997 to 2016
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DOI：
10.1093/ije/dyab226
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发表时间：
2021-10-23
影响因子：
7.7
通讯作者：
Velalkin, Ilya V.
中科院分区：
文献类型：
--
作者：
Cahoon, Elizabeth K.;Preston, Dale;Velalkin, Ilya V.
妊娠期和哺乳期可能是辐射敏感的生殖期，因为哺乳期乳腺细胞增殖迅速，放射性碘浓度较高。然而，在这些时期受到辐射的妇女的流行病学数据有限。方法我们检查了切尔诺贝利事故发生2个月内（1986年4月26日至6月30日）居住在白俄罗斯受污染地区的3214名怀孕和/或哺乳期妇女的乳腺癌发病率。通过与白俄罗斯国家癌症登记处的联系确定了33例乳腺癌。通过计算标准化发病率（SIR）和95%置信区间（CI），对达到的年龄、州、城市/农村居住地和日历年进行调整，将怀孕和/或哺乳期妇女的乳腺癌发病率与人口发病率进行比较。结果在哺乳期妇女中，我们发现与一般人群相比，乳腺癌的风险增加了2倍以上，SIR = 2.49（95%CI：1.55，3.75）。相比之下，怀孕女性的风险并未增加（SIR = 0.84 95%CI：0.46，1.38）。SIR最高的妇女谁是暴露在较年轻的年龄和最早的时间段，因为事故，虽然分层分析的样本量有限。结论：我们发现，与一般人群相比，居住在白俄罗斯受污染地区的妇女患乳腺癌的风险显著增加，这些妇女在事故发生时正在哺乳，并且可能暴露于放射性碘。有必要对哺乳期妇女的乳腺癌进行研究，并对个人辐射剂量进行估计。
Background Pregnancy and lactation may constitute radiation-sensitive reproductive periods due to rapid cell proliferation and concentration of radioiodine in the lactating breast. However, there are limited epidemiological data among women exposed to radiation during these periods. Methods We examined incidence of breast cancer in a cohort of 3214 women who were pregnant and/or lactating within 2 months (26 April to 30 June 1986) of the Chernobyl accident and residing in contaminated regions of Belarus. There were 33 breast cancers identified through linkage with the Belarusian National Cancer Registry. Breast cancer rates among women who were either pregnant and/or lactating were compared with population rates by calculating standardized incidence ratios (SIR) and 95% confidence intervals (CI) adjusting for attained age, oblast, urban/rural residence and calendar year. Results Among women who were lactating, we found a greater than 2-fold increased risk of breast cancer compared with the general population, SIR = 2.49 (95% CI: 1.55, 3.75). In contrast, women who were pregnant were not at increased risk (SIR = 0.84 95% CI: 0.46, 1.38). The SIR was highest in women who were exposed at a younger age and at the earliest time period since the accident, though stratified analyses had limited sample sizes. Conclusions We found a significantly increased risk of breast cancer among women residing in contaminated areas of Belarus who were lactating at the time of the accident and may have had elevated exposure to radioiodine, when compared with the general population. Studies of breast cancer with individual radiation dose estimates among women exposed during lactation are warranted.