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

2006年2月20日至3月22日，我们在马朱罗对1386名马绍尔人（平均年龄50.9 ± 12.34岁）进行了甲状腺检查（询问居住和吸烟史、触诊、超声断层扫描、甲状腺功能和自身抗体的血液采样; AB：TGAb、TPOAb）。这386人属于BRAVO队列。队列由1954年3月1日在比基尼岛BRAVO试验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岛进行了甲状腺检查。它有3714。在BRAVO试验中，队列中的1055例患者均在5岁以下。1055例患者中的322例此时进行了甲状腺复检。在322例中发现4例甲状腺癌疑似病例。CLEIA法检测抗体阳性率在20%左右。触诊典型的慢性甲状腺炎非常罕见，但自身抗体阳性率可能不低。截至2003年12月31日，我们发现BRAVO队列中有642例死亡。平均死亡年龄为63.9岁。107例死亡原因为癌症。最常见的是肺癌，有32例（23名男性和9名女性）。几乎所有男性的死亡证明中都有重度吸烟者的评论。乳腺癌死亡6例，甲状腺癌死亡2例。消化器官癌和子宫癌高发。其他常见的癌症死亡原因是肝，呼吸，心脏和肾衰竭，中风，糖尿病和败血症。我们已经建立了BRAVO队列死亡原因和甲状腺癌的数据库。根据数据库可以估计甲状腺癌的确切发病率，并可以从每个人的剂量学中得出马绍尔群岛人的辐射远期效应。

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.