Thyroid cancer in children and young adults in the North of England. Is increasing incidence related to the Chernobyl accident?
Thyroid cancer in children and young adults in the North of England. Is increasing incidence related to the Chernobyl accident?
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DOI：
10.1016/s0959-8049(00)00449-4
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发表时间：
2001-05-01
影响因子：
8.4
通讯作者：
Parker, L
中科院分区：
文献类型：
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作者：
Cotterill, SJ;Pearce, MS;Parker, L
从北方地区青年恶性疾病登记处获得了以人口为基础的甲状腺癌数据，以分析1968年至1997年期间英格兰北部青年（< 25岁）甲状腺癌的发病率，并评估发病率的变化是否与切尔诺贝利核事故沉降物的时空分布一致。我们比较了1968-1986年和1987-1997年分化型（乳头状或滤泡状）甲状腺癌的发病率。在研究期间诊断出75例甲状腺癌，其中63例为分化型癌，12例为髓样癌。在1968-1986年的19年中，有26名年轻人（15-24岁）被诊断为分化型甲状腺癌，在随后的11年中，1987-1997年有30名，年龄标准化率（ASR）分别为3.0和6.5（率比2.2，95%置信区间（CI）：1.3-3.6）。1968-1986年期间有3名儿童（年龄< 15岁）被诊断为分化型癌，1987-1997年期间有4名儿童被诊断为分化型癌，ASR为0.2 vs 0.6（率比2.7，95%CI：0.6-12.1）。回归模型显示，切尔诺贝利事故后甲状腺癌的发病率显着增加（P = 0.002）。在坎布里亚郡。英国受放射性尘埃影响最严重的地区发生率的增加更大（率比12.19，95% CI 1.5-101.2）。发病率的这些时间和空间变化与切尔诺贝利事故的因果关系是一致的，尽管预计对年轻人而不是老年人的影响更大。然而，包括查明和早期发现谣言的改进等因素也可能导致发生率上升。需要进一步的国际合作研究来调查儿童和年轻人甲状腺癌发病率的变化。(C)2001爱思唯尔科技有限公司版权所有。
Population-based data on thyroid carcinomas was obtained from the Northern Region Young Person's Malignant Disease Registry to analyse the incidence of thyroid cancers in young people (< 25 years) in the North of England for the period 1968 and 1997 and to assess if changes in incidence were consistent with the spatial and temporal distribution of the fallout from the Chernobyl nuclear accident. We compared incidence rates for differentiated (papillary or follicular) thyroid carcinomas 1968-1986 with those for 1987-1997. There were 75 cases of thyroid carcinoma diagnosed over the study period, of which 63 were differentiated carcinoma and 12 were medullary carcinoma. There were 26 young adults (15-24 years) diagnosed with differentiated thyroid carcinoma in the 19-year period 1968-1986 and 30 in the subsequent 11 years 1987-1997, Age standardised rate (ASR) 3.0 versus 6.5, respectively (rate ratio 2.2, 95% confidence interval(CI): 1.3-3.6). There were three children (aged < 15 years) diagnosed with differentiated carcinoma in the: period 1968-1986 and four in the period 1987-1997, ASR 0.2 versus 0.6 (rate ratio 2.7, 95% CI: 0.6-12.1). Regression models showed a significant increase in the incidence of thyroid cancer after the Chernobyl accident (P = 0.002). In Cumbria. the area receiving the heaviest fallout in the UK. the increase in incidence was much greater (rate ratio 12.19, 95% CI 1.5-101.2). These temporal and spatial changes in incidence are consistent with a causal association with the Chernobyl accident although a greater effect in the younger rather than the older age group would have been anticipated. However, factors including improvements in ascertainment and earlier detection of rumours may also have contributed to the increasing incidence. Further collaborative international studies are needed to investigate changes in the incidence of thyroid cancer in children and young adults. (C) 2001 Elsevier Science Ltd. All rights reserved.