Studies of Atomic Bomb Survivors

目前正在与辐射影响研究基金会合作，对广岛和长崎原子弹爆炸的94 000名幸存者进行寿命研究。队列研究用于量化环境辐射剂量反应及其对肿瘤组织学亚型、受照年龄、性别、观察年龄、受照后时间和其他因素的依赖性。在原子弹爆炸后的半个多世纪，癌症的统计学显著超额风险仍然很明显。最新的《南苏丹综合症实体癌症发病率报告》包括南苏丹综合症幸存者中的17 448例第一原发癌症，其中估计有853例是由于辐射照射造成的超额病例。对于作为一个组的实体癌和对于许多个体癌症部位的剂量响应的形状继续由线性模型很好地描述。最重要的发现是，在所有年龄段的一生中，实体癌的绝对发病率都在增加。膀胱癌、乳腺癌和肺癌等癌症与辐射暴露相关的超额相对风险很高，而胃癌、乳腺癌、结肠癌和肺癌的超额绝对风险率很高。这些在子宫内和幼儿期接触的人患实体癌的风险特别高。然而，与辐射有关的癌症风险的时间模式仍然不确定，特别是在原子弹爆炸时年龄小于20岁的幸存者中，需要继续对这一群体进行跟踪，以澄清这种不确定性。在几项新的发现中，有一项是与辐射有关的男性乳腺癌的过度风险。甲状腺乳头状微小癌，辐射和丙型肝炎感染对肝癌风险的协同相互作用，辐射和吸烟对肺癌风险的加性/倍增效应，以及紫外线和电离辐射暴露对基底细胞皮肤癌的加性效应。目前正在采用多学科个案办法研究与辐射有关的乳腺癌和卵巢癌的遗传易感性。这与先前报告的早发性乳腺癌（35岁之前）的剂量特异性相对风险极高的现象相一致，这表明遗传易感人群对辐射的敏感性增加。在这项研究中，比较了早期和晚期乳腺癌病例，并使用存档组织研究了乳腺癌途径中的BRCA 1/2和其他候选基因。

The Life Span Study (LSS) cohort of 94,000 survivors of the Hiroshima and Nagasaki atomic bombings is being studied in collaboration with the Radiation Effects Research Foundation (RERF). Cohort studies are used to quantify environmental radiation dose response and its dependence on histological subtype of tumor, age at exposure, sex, age at observation, time following exposure and other factors. More than half a century after the atomic bombings, a statistically significant excess risk of cancer is still apparent. The latest LSS solid cancer incidence report includes 17,448 first primary cancers among the LSS survivors, of which 853 are estimated to be excess cases attributable to radiation exposure. The shape of the dose response for solid cancers as a group and for many individual cancer sites continues to be well described by a linear model. The most important finding is that the excess absolute rates for solid cancer increase throughout life for all ages. The excess relative risks associated with radiation exposure are high for cancers of the bladder cancer, breast cancer and lung cancer, whereas excess absolute rates are high for stomach cancer, breast cancer, colon cancer and lung cancer. Solid cancer risks are especially high among these exposed in utero and early childhood. However, the uncertainty remains regarding the temporal patterns of the radiation-related cancer risk, especially among the survivor younger than 20 years of age at the time of the atomic bombings, and continued follow-up of this cohort is needed to clarify this uncertainty. Among several new findings are the radiation-related excess risk of male breast cancer. Thyroid papillary microcarcinoma, a synergistic interaction between radiation and hepatitis C infection on liver cancer risk, an additive/multiplicative effects of radiation and smoking on lung cancer risk, and also an additive effect of ultraviolet and ionizing radiation exposures on basal cell skin cancer. A multidisciplinary case-case approach is in progress to study genetic susceptibility to radiation-related breast cancer and ovarian cancer. This follows the previously reported phenomenon of extremely high, dose-specific relative risks for early-onset breast cancer (before age 35), which suggests increased sensitivity to radiation among a genetically predisposed population subgroup. In this study, early and late-onset breast cancer cases are compared and BRCA 1/2 and other candidate genes in breast cancer pathways are investigated using archived tissues.