Study of the late effect on occurrence of thyroid and lung cancers of low dose irradiation from the atomic bomb tests in the Marshall Islands

我们于2006年2月20日至3月22日在马朱罗对1386名马绍尔人（平均年龄50.9±12.34岁）进行了甲状腺检查（包括住院医师和吸烟史访谈、扪诊、超超声断层扫描、甲状腺功能和自身抗体血样；AB: TGAb、TPOAb）。这386人属于BRAVO队列。该队列由1954年3月1日在比基尼进行BRAVO测试之前出生的马绍尔人组成，并于1993年至1997年在马朱罗和其他环礁进行了甲状腺检查。它有3714。在BRAVO测试中，这群人中有1055人年龄在5岁以下。1055人中有322人在这个时候复查了甲状腺。在322例患者中发现4例强烈甲状腺癌疑似病例。CLEIA抗体阳性率在20%左右。经触诊，典型慢性甲状腺炎非常罕见，但自身抗体阳性率可能不低。我们已经审查了RMI的死亡证明。截至2003年12月31日，我们已经发现642名BRAVO队列死亡。平均死亡年龄为63.9岁。这107人的死因是癌症。最常见的是肺癌，有32例（男性23例，女性9例）。几乎所有男性的死亡证明书上都写着“吸烟严重”。乳腺癌死亡6例，甲状腺癌死亡2例。消化器官和子宫癌多见。其他常见的癌症死亡原因是肝脏、呼吸系统、心脏和肾脏衰竭、中风、糖尿病和败血症。我们建立了关于死亡原因和甲状腺癌的BRAVO队列数据库。甲状腺癌的确切发病率可以在数据库中估计出来，并可以从每个人的剂量测定中得出辐照对马绍尔群岛人的后期影响。

We have done thyroid examinations (interviews on residency and smoking history, palpation, ultra-sono-tomography, blood sampling for thyroid function and auto-antibody ; AB : TGAb, TPOAb) for 1386 Marshalleses (mean age 50.9+/-12.34yo) from Feb 20 to Mar 22, 2006, at Majuro. The 386 people have belonged to the BRAVO cohort. The cohort was consisted of the Marshalleses born before BRAVO test on Mar 1,1954 at Bikini and had had our thyroid examination from 1993 to 1997 at Majuro and other atolls. It had had 3714. The 1055 of the cohort were under 5 yo at the BRAVO test. The 322 of the 1055 had thyroid re-examination at this time. We have found 4 strongly thyroid cancer suspected cases among the 322. The positive rate of Abs by CLEIA were around 20%. By palpation typical chronic thyroiditis was very rare, however, autoantibody positive ratio might not be low.We have reviewed the death certificates of the RMI. Till Dec 31, 2003 we have found 642 deaths of the BRAVO cohort. The mean death age was 63.9 yo. The 107 death causes were cancer. The most frequent was lung cancer and its number was 32 (23 men and 9 women). A comment of heavy smoker was seen in almost all men death certificates. The breast cancer death and the thyroid cancer death were 6 and two respectively. The cancers of digestive organs and uterus were popular. The other frequent death causes out of cancers were hepatic, respiratory, heart and renal failures, strokes, DM and sepsis.We have established the data base of the BRAVO cohort on death causes and thyroid cancers. The exact incidence of the thyroid cancer can be estimated on the data base and might be concluded the late effects of the irradiation among the Marshalleses from the dosimetry of each people.