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Gu Y, Wang J, Wang Y, Xu C, Liu Y, Du L, Wang Q, Ji K, He N, Zhang M, Song H, Niu K, Liu Q. Association of low-dose ionising radiation with site-specific solid cancers: Chinese medical X-ray workers cohort study, 1950-1995. Occup Environ Med 2023; 80:687-693. [PMID: 37918914 DOI: 10.1136/oemed-2023-108875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The dose-response relationship between cancers and protracted low-dose rate exposure to ionising radiation is still uncertain. This study aims to estimate quantified relationships between low-dose radiation exposures and site-specific solid cancers among Chinese medical X-ray workers. METHODS This cohort study included 27 011 individuals who were employed at major hospitals in 24 provinces in China from 1950 to 1980 and had been exposed to X-ray equipment, and a control group of 25 782 physicians who were not exposed to X-ray equipment. Person-years of follow-up were calculated from the year of employment to the date of the first diagnosis of cancer or the end of follow-up, whichever occurred first. All cancers were obtained from medical records during 1950-1995. This study used Poisson regression models to estimate the excess relative risk (ERR) and excess absolute risk (EAR) for incidence of site-specific solid cancers associated with cumulative dose. RESULTS 1643 solid cancers were developed, the most common being lung, liver and stomach cancer. Among X-ray workers, the average cumulative colon dose was 0.084 Gy. We found a positive relationship between cumulative organ-specific dose and liver (ERR/Gy=1.48; 95% CI 0.40 to 2.83), oesophagus (ERR/Gy=18.1; 95% CI 6.25 to 39.1), thyroid (ERR/Gy=2.96; 95% CI 0.44 to 8.18) and non-melanoma skin cancers (ERR/Gy=7.96; 95% CI 2.13 to 23.12). We found no significant relationship between cumulative organ-specific doses and other cancers. Moreover, the results showed a statistically significant EAR for liver, stomach, breast cancer (female), thyroid and non-melanoma skin cancers. CONCLUSIONS These findings provided more useful insights into the risks of site-specific cancers from protracted low-dose rate exposure to ionising radiation.
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Affiliation(s)
- Yeqing Gu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Jinhan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Chang Xu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Liqing Du
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Qin Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaihua Ji
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Ningning He
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Manman Zhang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Huijuan Song
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaijun Niu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
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Mirkatouli NB, Hirota S, Yoshinaga S. Thyroid cancer risk after radiation exposure in adults-systematic review and meta-analysis. JOURNAL OF RADIATION RESEARCH 2023; 64:893-903. [PMID: 37816676 PMCID: PMC10665305 DOI: 10.1093/jrr/rrad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/16/2023] [Accepted: 09/11/2023] [Indexed: 10/12/2023]
Abstract
Notably, the growing use of radionuclear technology, especially in diagnostic and therapeutic procedures involving radiation exposure, raises concerns about the health effects of radiation. Although epidemiological studies have provided strong evidence for elevated thyroid cancer risk after radiation exposure in childhood, the risk of thyroid cancer associated with adult exposure remains to be investigated. We conducted a systematic review and meta-analysis of relevant studies on the risk of developing thyroid cancer after radiation exposure in adulthood. The PubMed and Web of Science databases were used to select eligible articles. After screening, a total of 15 studies were identified in which estimates of the standardized incidence ratio (SIR) and the relative risk (RR) of thyroid cancer were available in 8 and 11 studies, respectively. The overall SIR estimated by the random effects model was 2.19 [95% confidence interval (CI), 1.54, 3.10]. Cochran's Q test showed significant heterogeneity in the SIRs (Q = 178, P < 0.0001). The overall RR at 10 mGy was 1.0038 (95% CI, 0.9991, 1.0085), with no significant heterogeneity (Q = 9.30, P = 0.5041). The total SIR, as well as that from each study, indicated a statistically significant excess, which could be related to screening bias. Radiation-related thyroid cancer risk was elevated in a few studies; however, the overall estimate of the RR at 10 mGy was not significant. This study demonstrates no strong epidemiological evidence for the risk of thyroid cancer in radiation exposure during adulthood; however, further research is needed.
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Affiliation(s)
- Nafiseh Beygom Mirkatouli
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima City, Hiroshima 734-8553, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima City, Hiroshima 732-8553, Japan
| | - Seiko Hirota
- Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima City, Hiroshima 732-8553, Japan
| | - Shinji Yoshinaga
- Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima City, Hiroshima 732-8553, Japan
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Liu W, Liu H, Gao W, Xie L, Cao Y. Physiological Effects of Co-exposure to Ionizing Radiation and Noise within Occupational Exposure Limits. HEALTH PHYSICS 2023; 125:332-337. [PMID: 37552111 DOI: 10.1097/hp.0000000000001722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
ABSTRACT Workers are frequently exposed to the occupational hazards of ionizing radiation and noise. Co-exposure to these hazards is not well understood in terms of their physiological effects. The aim of this study was to investigate the physiological effects of co-exposure to ionizing radiation and noise within the occupational limit. This study extracted the physical examination parameters of workers who met the screening criteria from the occupational health surveillance database. The workers were divided into three groups: the co-exposure (COE) group, the ionizing radiation exposure (ION) group, and the non-exposure (NON) group. The age and sex of the three groups were matched with a sample size ratio of 1:3:3. The physical examination parameters of the three groups of workers were compared. The results showed that there was no significant difference in blood pressure and blood biochemical parameters among the three groups. The COE group had higher levels of free triiodothyronine than the ION group, but there was no difference with the NON group. Moreover, the COE group had lower levels of free tetraiodothyronine than the ION group and the NON group. There was no significant difference in thyroid stimulating hormone, total triiodothyronine, and total tetraiodothyronine among the three groups. Additionally, the number of white blood cells of the COE group was lower than that of ION group and NON group. This study suggests that co-exposure to low-dose ionizing radiation and noise can cause alterations in thyroid hormone and peripheral white blood cells. These alterations are different from those observed after single exposure to low-dose ionizing radiation and require further research.
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Affiliation(s)
- Wenyi Liu
- Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, and Shanghai Bluecross Medical Science Institute, Shanghai, The People's Republic of China; Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, The People's Republic of China
| | - Huaqing Liu
- Gusu District Health Supervision Institute, Suzhou, Jiangsu, The People's Republic of China
| | - Weimin Gao
- Department of Physical Examination Center, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, The People's Republic of China
| | - Liangbin Xie
- Department of general family medicine, Baita Community Health Service Center of Suzhou, Suzhou, Jiangsu, The People's Republic of China
| | - Yanmei Cao
- Department of Occupational Disease, The Fifth People's Hospital of Suzhou, Suzhou, Jiangsu, The People's Republic of China
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De Giorgi A, Bongiovanni A, De Sio S, Sernia S, Adamo G, La Torre G. Assessment of the Impact of Low-dose Ionizing Radiation Exposure on Health Care Workers: A Study of Methods Used from a Scoping Review. HEALTH PHYSICS 2023; 125:102-108. [PMID: 37022186 DOI: 10.1097/hp.0000000000001693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
ABSTRACT Healthcare workers may be exposed to ionizing radiation. Ionizing radiations are an important occupational risk factor for the potential damage they can cause to workers' health. Actually, the attention is focused on diseases caused by damage to radiosensitive organs. The aim of our study is to evaluate the methods used for the assessment of the impact of exposure to low-dose ionizing radiation in a population of healthcare workers (HCWs). The electronic database PubMed was searched by title, abstract, and medical subheadings (MeSH) terms. The extracted data were arranged into tables by dividing bibliographic reference, exposure, and statistical analysis information. The quality assessment was performed with the use of the Newcastle-Ottawa Quality Assessment Scale. The search strategy involved retrieving 15 studies (eight cohorts and seven cross-sectional studies). The univariate tests have been performed in 14 studies (93.3%), and Chi-square and T-test were the most commonly used. Multivariate tests have been performed in 11 studies (73.3%), and the most commonly performed were Logistic and Poisson Regressions. The most rated organ was the thyroid gland (six studies). The annual cumulative effective dose was the most used method to assess the dose rate (seven studies). Due to the characteristics of pathologies involved, a retrospective cohort study with an adequate control group and use of the annual cumulative effective dose to account for exposure could be useful features to obtain the best possible evidence. All the elements were found rarely in studies considered. The need is highlighted for more in-depth studies to investigate this topic.
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Affiliation(s)
- Andrea De Giorgi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Andrea Bongiovanni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Simone De Sio
- Research Unit of Occupational Medicine, Sapienza University of Rome, Rome, Italy
| | - Sabina Sernia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Giuseppe Adamo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Xu L, Cao ZX, Weng X, Wang CF. Global thyroid cancer incidence trend and age-period-cohort model analysis based on Global Burden of Disease Study from 1990 to 2019. Front Endocrinol (Lausanne) 2023; 14:1133098. [PMID: 37124740 PMCID: PMC10130642 DOI: 10.3389/fendo.2023.1133098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/31/2023] [Indexed: 05/02/2023] Open
Abstract
Background In view of the rapid increase in the incidence of thyroid cancer (TC) and the spread of overdiagnosis around the world, the quantitative evaluation of the effect of age, period and birth cohort on the incidence of TC, and the analysis of the role of different factors in the incidence trend can provide scientific basis and data support for the national health departments to formulate reasonable prevention and treatment policies. Methods The study collated the global burden disease study data of TC incidence from 1990 to 2019, and used APC model to analyze the contribution of age, period and birth cohort to the incidence trend of TC. Results There was an obvious unfavorable upward trend in terms of age and cohort effect all over the world. Since 2007, the growth rate of risk slowed down and the risk in female even decreased since 2012, which mainly contributed to the developed countries. In all SDI countries, 2002 is the dividing point of risk between male and female. In 2019, The global age-standardized incidence rate (ASIR) of TC in the 5 SDI countries all showed a significant upward trend, with the largest upward trend in the middle SDI countries. Conclusion The trend of rapid increase in the incidence of TC has begun to slow down, but the global incidence of TC has obvious gender and regional/national heterogeneity. Policy makers should tailor specific local strategies to the risk factors of each country to further reduce the burden of TC.
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Affiliation(s)
- Le Xu
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhe Xu Cao
- Department of Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xin Weng
- Department of Pathology, The First Affiliated Hospital, Nanhua University, Hengyang, Hunan, China
| | - Can Fei Wang
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Can Fei Wang,
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El-Benhawy SA, Fahmy EI, Mahdy SM, Khedr GH, Sarhan AS, Nafady MH, Yousef Selim YA, Salem TM, Abu-Samra N, El Khadry HA. Assessment of thyroid gland hormones and ultrasonographic abnormalities in medical staff occupationally exposed to ionizing radiation. BMC Endocr Disord 2022; 22:287. [PMID: 36404320 PMCID: PMC9677629 DOI: 10.1186/s12902-022-01196-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/02/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Ionizing radiation (IR) is high-energy radiation that has the potential to displace electrons from atoms and break chemical bonds. It has the ability to introduce mutations, DNA strand breakage, and cell death. Being a radiosensitive organ, exposure of the thyroid gland to IR can lead to significant changes in its function. AIM OF THE WORK Was to measure the levels of thyroid hormones panel and ultrasonography abnormalities in medical staff occupationally exposed to IR. SUBJECTS AND METHODS A total of 120 subjects were divided into three main groups: Group I: radiation-exposed workers occupationally exposed to radioiodine (131I) (n = 40), Group II: radiation-exposed workers occupationally exposed to X-ray (n = 40), and Group III: non-exposed healthy professionals matched in age and sex with the previous groups (n = 40). Thyroid hormones panel including free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), anti-thyroperoxidase antibodies (anti-TPO), and thyroglobulin (Tg) were measured. Thyroid ultrasonography was performed. Oxidative stress markers such as malondialdehyde (MDA), hydrogen peroxide (H2O2), and total antioxidant capacity (TAC) were measured. RESULTS Group I had significantly higher fT3 levels than the control group. fT3 levels were considerably higher, while TSH was substantially lower in group II participants than in the control group. Tg was markedly lower in radiation-exposed workers. However, anti-TPO levels in radiation-exposed workers were significantly higher than in the control group. MDA and H2O2 were substantially higher; TAC was significantly lower in radiation-exposed workers compared to the control group. According to ultrasonographic examination, thyroid volume and the percentage of thyroid nodules in all radiation workers were significantly higher than in the control group. CONCLUSION Despite low exposure doses, occupational exposure to IR affects the thyroid hormones and links with a higher likelihood of developing thyroid immune diseases.
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Affiliation(s)
- Sanaa A. El-Benhawy
- Radiation Sciences Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Enayat I. Fahmy
- Radiation Sciences Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Sherien M. Mahdy
- Nuclear Medicine and thyroid gland Department, Naser Institute for Research and Treatment, Nasr City, Egypt
| | - Galal H. Khedr
- Radiology and Medical Imaging, Faculty of Applied Medical Sciences, Misr University for Science & Technology, Giza, Egypt
| | - Alyaa S. Sarhan
- Radiology and Medical Imaging, Faculty of Applied Medical Sciences, University of 6 October, Giza, Egypt
| | - Mohamed H. Nafady
- Radiology and Medical Imaging, Faculty of Applied Medical Sciences, Misr University for Science & Technology, Giza, Egypt
| | - Yousef A. Yousef Selim
- Radiology and Medical Imaging, Faculty of Applied Medical Sciences, Misr University for Science & Technology, Giza, Egypt
| | - Tarek M. Salem
- Department of Internal Medicine, (Endocrinology Unit), Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nehal Abu-Samra
- Department of Basic Sciences, Faculty of Physical Therapy, Pharos University, Alexandria, Egypt
| | - Hany A. El Khadry
- Applied Medical Chemistry Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
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Liu D, Linet MS, Albert PS, Landgren AM, Kitahara CM, Iwan A, Clerkin C, Kohler B, Alexander BH, Penberthy L. Ascertainment of Incident Cancer by US Population-Based Cancer Registries Versus Self-Reports and Death Certificates in a Nationwide Cohort Study, the US Radiologic Technologists Study. Am J Epidemiol 2022; 191:2075-2083. [PMID: 35872590 PMCID: PMC10144614 DOI: 10.1093/aje/kwac121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/23/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023] Open
Abstract
Follow-up of US cohort members for incident cancer is time-consuming, is costly, and often results in underascertainment when the traditional methods of self-reporting and/or medical record validation are used. We conducted one of the first large-scale investigations to assess the feasibility, methods, and benefits of linking participants in the US Radiologic Technologists (USRT) Study (n = 146,022) with the majority of US state or regional cancer registries. Follow-up of this cohort has relied primarily on questionnaires (mailed approximately every 10 years) and linkage with the National Death Index. We compared the level of agreement and completeness of questionnaire/death-certificate-based information with that of registry-based (43 registries) incident cancer follow-up in the USRT cohort. Using registry-identified first primary cancers from 1999-2012 as the gold standard, the overall sensitivity was 46.5% for self-reports only and 63.0% for both self-reports and death certificates. Among the 37.0% false-negative reports, 27.8% were due to dropout, while 9.2% were due to misreporting. The USRT cancer reporting patterns differed by cancer type. Our study indicates that linkage to state cancer registries would greatly improve completeness and accuracy of cancer follow-up in comparison with questionnaire self-reporting. These findings support ongoing development of a national US virtual pooled registry with which to streamline cohort linkages.
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Affiliation(s)
- Danping Liu
- Correspondence to Dr. Danping Liu, Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 7E630, Rockville, MD 20850 (e-mail: )
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Wang L, Sun X, He J, Liu Z. Identification and Validation of Prognostic Related Hallmark ATP-Binding Cassette Transporters Associated With Immune Cell Infiltration Patterns in Thyroid Carcinoma. Front Oncol 2022; 12:781686. [PMID: 35837087 PMCID: PMC9273952 DOI: 10.3389/fonc.2022.781686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
ATP-binding cassette (ABC) transporters are a large superfamily of membrane proteins that facilitate the translocation of heterogeneous substrates. Studies indicate that ABC transporters may play important roles in various carcinomas. However, the correlation between ABC transporters and immunomodulation in thyroid carcinoma (TC), as well as the prognoses for this disease, is poorly understood.TC data from The Cancer Genome Atlas (TCGA) database were used to identify prognostic hallmark ABC transporters associated with immune cell infiltration patterns via multiple bioinformatic analyses. Thereafter, quantitative real-time polymerase chain reaction (qRT-PCR) was performed to validate the expression of these selected hallmark ABC transporters in both TC and para-cancerous thyroid tissues. Of a total of 49 ABC transporters, five (ABCA8, ABCA12, ABCB6, ABCB8, and ABCC10) were identified as hallmark ABC transporters. All five were differentially expressed in TC and associated with the relapse-free survival rates of patients with TC. Immunoregulation by these five hallmark ABC transporters involved the modulation of various aspects of immune cell infiltration, such as hot or cold tumor subsets and the abundances of infiltrating immune cells, as well as specific immunomodulators and chemokines. Besides the diverse significantly correlated factors, the five hallmark ABC transporters and correlated genes were most highly enriched in plasma membrane, transporter activity, and transmembrane transport of small molecules. In addition, many chemicals, namely bisphenol A and vincristine, affected the expression of these five transporters. The qRT-PCR results of collected TC and para-cancerous thyroid tissues were consistent with those of TCGA. The findings in this study may reveal the role played by these five hallmark ABC transporters in regulating immune cell infiltration patterns in TC as well as the molecular mechanisms underlying their functions, leading to a better understanding of their potential prognostic and immunotherapeutic values.
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Affiliation(s)
- Lidong Wang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaodan Sun
- Postdoctoral Research Workstation, Jilin Cancer Hospital, Changchun, China
- Department of 1st Gynecologic Oncology Surgery, Jilin Cancer Hospital, Changchun, China
| | - Jingni He
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhen Liu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Zhen Liu,
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Mai JZ, Zhang R, Sargen MR, Little MP, Alexander BH, Tucker MA, Kitahara CM, Cahoon EK. Reproductive factors, hormone use, and incidence of melanoma in a cohort of US Radiologic Technologists. Hum Reprod 2022; 37:1059-1068. [PMID: 35174864 PMCID: PMC9308393 DOI: 10.1093/humrep/deac029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/05/2022] [Indexed: 12/17/2023] Open
Abstract
STUDY QUESTION Are reproductive factors and exogenous hormone use associated with incidence of cutaneous melanoma while accounting for ultraviolet radiation (UVR) exposure across different life periods and sun sensitivity factors? SUMMARY ANSWER Earlier age at menarche and late age at first birth, but not other estrogen-related factors were associated with an increased incidence rate of melanoma, with higher risks observed for earlier age at menarche and light hair color at age 15 years. WHAT IS KNOWN ALREADY Although estrogens have been recognized as photosensitizing, previous studies have reported inconsistent findings for the association of melanoma with estrogen-related factors. Most have not collected detailed skin cancer risk factors and have not thoroughly investigated effect modification by ambient UVR and sun sensitivity. STUDY DESIGN, SIZE, DURATION Participants in the US Radiologic Technologists study, an occupational cohort of 146 022 radiologic technologists (73% women), were included and followed during the four time periods (1983-1989, 1994-1998, 2003-2005 and 2012-2014). PARTICIPANTS/MATERIALS, SETTING, METHODS Non-Hispanic white female participants who completed both the second (baseline) and third questionnaires, and did not report having cancer (except keratinocyte carcinoma) at baseline, were included and followed from their age at completion of the second (baseline) questionnaire until the earlier of first primary cancer diagnosis, including invasive melanoma of the skin, or completion of either the third or fourth questionnaire. Reproductive and exogenous hormonal factors were ascertained from the second (baseline) questionnaire, which also collected information on demographic, lifestyle factors and sun sensitivity factors. Ambient UVR was assigned by linking geocoded residential locations, based on self-reported residential history information collected from the third questionnaire to satellite-based ambient UVR data from the National Aeronautics and Space Administration's Total Ozone Mapping Spectrometer database. To examine the association of reproductive factors, exogenous hormone use, and first primary invasive melanoma of the skin, we used Poisson regression to calculate rate ratios (RRs) and 95% likelihood-based CIs, adjusting for attained age, birth cohort, lifetime average annual ambient UVR, contraceptives and menopausal hormone therapy use. To address the effect modification of ambient UVR exposure and sun sensitivities on melanoma risk, we conducted likelihood-ratio tests for multiplicative interaction. MAIN RESULTS AND THE ROLE OF CHANCE Over a median follow-up time of 17.1 years, 0.95% of eligible participants had an incident first primary melanoma (n = 444). Higher melanoma incidence rates were observed in participants with older attained age, blue/green/gray eye color, blonde/red/auburn natural hair color at age 15, fair skin complexion, and higher UVR. We found an increased incidence rate of melanoma in women who experienced menarche at an earlier age (13, 12 and <12 years vs ≥14 years: RR = 1.48, 95% CI = 1.11-1.98; 1.19, 0.89-1.61; 1.26, 0.93-1.73), and in women with older age at first birth (25-29 and ≥30 years vs <25 years; 1.09, 0.86-1.39; 1.48, 1.12-1.95; P-value for trend = 0.006). However, no significant association was observed for other reproductive factors, and for all exogenous hormone use. The associations of melanoma incidence for most reproductive factors and exogenous hormone use were not modified by ambient UVR, eye color, natural hair color at age 15 and skin complexion. The exception was that natural hair color at age 15 modified the associations of melanoma for age at menarche (P-value for interaction = 0.004) and age at first birth among parous women (0.005). In participants with blonde/red/auburn natural hair color at age 15, we found increased risk of melanoma among women who experienced menarche at age 13, 12 and <12 years (vs ≥14 years: RR = 3.54, 95% CI = 1.98-6.90; 2.51, 1.37-4.98; 2.66, 1.41-5.36, respectively; P-value for trend = 0.10). However, the association between age at menarche and melanoma was null in participants with brown/black natural hair color at age 15. LIMITATIONS, REASONS FOR CAUTION Information on reproductive history and exogenous hormone use was self-reported. We did not have information on specific doses or formulations of exogenous hormone medications or breastfeeding. WIDER IMPLICATIONS OF THE FINDINGS Women residing in areas of high ambient UVR and those with blonde/red/auburn natural hair color may constitute an additional high-risk group in need of more frequent skin cancer screening. Identifying susceptible periods of exposure or factors that modify UVR susceptibility may aid in guiding more targeted guidelines for melanoma prevention. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Intramural Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services. Authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Jim Z Mai
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Rui Zhang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Michael R Sargen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Mark P Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Margaret A Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Elizabeth K Cahoon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
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Xiao Z, Zhao H. Ferroptosis-Related APOE, BCL3 and ALOX5AP Gene Polymorphisms are Associated with the Risk of Thyroid Cancer. Pharmgenomics Pers Med 2022; 15:157-165. [PMID: 35241926 PMCID: PMC8887669 DOI: 10.2147/pgpm.s352225] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/17/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose This study aimed to evaluate the association between polymorphisms in the ferroptosis-related genes apolipoprotein E (APOE), BCL3 transcription coactivator (BCL3) and arachidonate 5-lipoxygenase activating protein (ALOX5AP) and the risk of thyroid cancer. Methods Six single nucleotide polymorphisms (SNPs) of APOE (rs429358 and rs7412), BCL3 (rs34698726 and rs8100239) and ALOX5AP (rs4076128 and rs4073259) were genotyped in 520 papillary thyroid carcinoma cases and 520 healthy controls using the MassARRAY platform. Results The rs429358-TC, rs34698726-TA/TT, and rs8100239-AT/AA genotypes exhibited an elevated risk of thyroid cancer (prs429358 = 0.002, prs34698726 = 0.007, prs8100239 = 0.002), while rs7412-CT/TT and rs4076128-GA/GG were found to be protective genotypes against the risk of disease (prs7412 = 0.0003, prs4076128 = 0.0001). Genetic model analysis showed that APOE-rs429358 was correlated with an increased risk of disease under dominant and log-additive models (pdominant = 0.0004, plog-additive = 0.0006). BCL3-s34698726 and rs8100239 were associated with an elevated risk of disease under all three genetic models (p < 0.05). In contrast, APOE-rs7412 was related to a decreased risk of thyroid cancer under dominant and log-additive models (pdominant = 0.0001, plog-additive = 0.0001). Moreover, ALOX5AP-rs4076128 was also correlated with a reduced risk of disease under all three genetic models (p < 0.05). Conclusion The results help us better understand how genetic polymorphisms in ferroptosis-related genes are relevant to thyroid cancer susceptibility.
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Affiliation(s)
- Zhifu Xiao
- Department of Thyroid Surgery, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, 030012, People’s Republic of China
- Correspondence: Zhifu Xiao, Department of Thyroid Surgery, Shanxi Provincial People’s Hospital, 29 Shuangtasi Road, Taiyuan, Shanxi, 030012, People’s Republic of China, Tel/Fax +86 0351-4960327, Email
| | - Haixia Zhao
- Central Lab, General Hospital of Taiyuan Iron and Steel Group, Taiyuan, Shanxi, 030003, People’s Republic of China
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Thyroid Cancer Diagnostics Related to Occupational and Environmental Risk Factors: An Integrated Risk Assessment Approach. Diagnostics (Basel) 2022; 12:diagnostics12020318. [PMID: 35204408 PMCID: PMC8870864 DOI: 10.3390/diagnostics12020318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 12/04/2022] Open
Abstract
There are still many questions remaining about the etiopathogenesis of thyroid cancer, the most common type of endocrine neoplasia. Numerous occupational and environmental exposures have been shown to represent important risk factors that increase its incidence. Updated information about thyroid cancer diagnostics related to occupational and environmental risk factors is reviewed here, considering an integrated risk assessment approach; new data concerning thyroid cancer etiology and pathogenesis mechanisms, diagnostic biomarkers and methodologies, and risk factors involved in its pathogenesis are presented. A special emphasis is dedicated to specific occupational risk factors and to the association between environmental risk agents and thyroid cancer development. The occupational environment is taken into consideration, i.e., the current workplace and previous jobs, as well as data regarding risk factors, e.g., age, gender, family history, lifestyle, use of chemicals, or radiation exposure outside the workplace. Finally, an integrative approach is presented, underlying the need for an accurate Risk Assessment Matrix based on a systematic questionnaire. We propose a complex experimental design that contains different inclusion and exclusion criteria for patient groups, detailed working protocols for achieving coherent and sustainable, well-defined research stages from sample collection to the identification of biomarkers, with correlations between specific oncometabolites integrated into the Risk Assessment Matrix.
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Gudzenko N, Mabuchi K, Brenner AV, Little MP, Hatch M, Drozdovitch V, Vij V, Chumak V, Bakhanova E, Trotsyuk N, Kryuchkov V, Golovanov I, Bazyka D, Cahoon EK. Risk of thyroid cancer in Ukrainian cleanup workers following the Chornobyl accident. Eur J Epidemiol 2022; 37:67-77. [PMID: 34897585 PMCID: PMC10655930 DOI: 10.1007/s10654-021-00822-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
Although much is known about the radiation-related risk of thyroid cancer in those exposed at young ages, less is known about the risk due to adult exposure, particularly in men. We aimed to examine the association between thyroid radiation dose received during adulthood and thyroid cancer risk in men. We conducted a nested case-control study (149 cases; 458 controls) of male, Ukrainian cleanup workers who first worked in the Chornobyl zone between ages 18 and 59 years, with cases identified through linkage with the National Cancer Registry of Ukraine from 1988 to 2012. Individual thyroid doses due to external and internal exposure during the cleanup mission and during residence in contaminated settlements were estimated (total dose mean 199 mGy; range 0.15 mGy to 9.0 Gy). The excess odds ratio per gray (EOR/Gy) for overall thyroid cancer was 0.40 (95% CI: - 0.05, 1.48; p-value = 0.118). Time since exposure was borderline significant (p-value = 0.061) in modifying this association so that less time since exposure was associated with a stronger EOR/Gy. An elevated, but nonsignificant association was observed for follicular thyroid cancer (EOR/Gy = 1.72; 95% CI: - 0.25, 13.69; p-value = 0.155) based on a small number of cases (n = 24). Our findings for radiation-related overall thyroid cancer risk are consistent with evidence of increased risks observed in most of the other studies of adult exposure, though the magnitude of the effect in this study is lower than in the previous case-control study of Chornobyl cleanup workers.
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Affiliation(s)
- Natalia Gudzenko
- National Research Centre for Radiation Medicine, Kyiv, 04050, Ukraine
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, DCEG, Division of Cancer Epidemiology and Genetics, NIH, DHHS, National Cancer Institute, 9609 Medical Center Dr., Rm 7E542, Bethesda, MD, MS 9778, USA
| | | | - Mark P Little
- Radiation Epidemiology Branch, DCEG, Division of Cancer Epidemiology and Genetics, NIH, DHHS, National Cancer Institute, 9609 Medical Center Dr., Rm 7E542, Bethesda, MD, MS 9778, USA
| | - Maureen Hatch
- Radiation Epidemiology Branch, DCEG, Division of Cancer Epidemiology and Genetics, NIH, DHHS, National Cancer Institute, 9609 Medical Center Dr., Rm 7E542, Bethesda, MD, MS 9778, USA
| | - Vladimir Drozdovitch
- Radiation Epidemiology Branch, DCEG, Division of Cancer Epidemiology and Genetics, NIH, DHHS, National Cancer Institute, 9609 Medical Center Dr., Rm 7E542, Bethesda, MD, MS 9778, USA
| | - Vibha Vij
- Radiation Epidemiology Branch, DCEG, Division of Cancer Epidemiology and Genetics, NIH, DHHS, National Cancer Institute, 9609 Medical Center Dr., Rm 7E542, Bethesda, MD, MS 9778, USA
| | - Vadim Chumak
- National Research Centre for Radiation Medicine, Kyiv, 04050, Ukraine
| | - Elena Bakhanova
- National Research Centre for Radiation Medicine, Kyiv, 04050, Ukraine
| | - Natalia Trotsyuk
- National Research Centre for Radiation Medicine, Kyiv, 04050, Ukraine
| | - Victor Kryuchkov
- Burnasyan Federal Medical and Biophysical Centre, 46 Zhivopisnaya Street, Moscow, 123182, Russia
| | - Ivan Golovanov
- Burnasyan Federal Medical and Biophysical Centre, 46 Zhivopisnaya Street, Moscow, 123182, Russia
| | - Dimitry Bazyka
- National Research Centre for Radiation Medicine, Kyiv, 04050, Ukraine
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, DCEG, Division of Cancer Epidemiology and Genetics, NIH, DHHS, National Cancer Institute, 9609 Medical Center Dr., Rm 7E542, Bethesda, MD, MS 9778, USA.
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Lee AW, Mendoza RA, Aman S, Hsu R, Liu L. Thyroid cancer incidence disparities among ethnic Asian American populations, 1990-2014. Ann Epidemiol 2021; 66:28-36. [PMID: 34774744 DOI: 10.1016/j.annepidem.2021.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE Asian/Pacific Islanders (APIs) are at high risk of thyroid cancer, hence we examined thyroid cancer's incidence among disaggregated API subgroups in the United States (U.S.) to identify potential ethnic-specific disparities. METHODS Data from 1990 to 2014 in the Surveillance, Epidemiology, and End Results Program (SEER) were used to compare age-adjusted incidence rates (AAIRs) of thyroid cancer for seven API ethnic subgroups to non-Hispanic whites (NHWs) using incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Sex, age, tumor histotype, and year of diagnosis were considered. Trends were evaluated using average annual percent change (AAPC) statistics. RESULTS The highest AAIRs (per 100,000 person-years) were among Filipinos (female AAIR=20.49, male AAIR=7.06) and the lowest among Japanese (female AAIR=8.36, male AAIR=3.20). However, Filipinos showed significantly lower incidence of medullary tumors when compared to NHWs (female IRR=0.60, 95% CI 0.40-0.87, male IRR=0.26, 95% CI 0.26-0.51). The largest increasing trends were among Asian Indian/Pakistanis for females (AAPC=5.19, 95% CI 3.81 to 6.58) and Koreans for males (AAPC=4.57, 95% CI 3.14 to 6.03). CONCLUSIONS There are clear differences in thyroid cancer incidence and trends when U.S. API ethnic subgroups are examined separately. Disaggregating APIs in research can provide critical information for understanding thyroid cancer risk.
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Key Words
- average annual percent change, APC, annual percent change, API, Asian/Pacific Islander, ASIR, age-specific incidence rate, CI, confidence interval, ICD-O-3, International Classification of Diseases for Oncology, Third Edition, IRR, incidence rate ratio, NHW, non-Hispanic white, NOS, not otherwise specified002C SEER, Surveillance, Epidemiology, and End Results Program, U.S., United States
- thyroid cancer, Asian Americans, racial/ethnic disparities, AAIR, age-adjusted incidence rate, AAPC
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Affiliation(s)
- Alice W Lee
- Department of Public Health, California State University, Fullerton, 800 N. State College Blvd., KHS-127, Fullerton, CA, 92831, USA.
| | - Roy A Mendoza
- Department of Biological Sciences, California State University, Fullerton, 800 N. State College Blvd., MH-112, Fullerton, CA, 92831, USA
| | - Shehla Aman
- Department of Public Health, California State University, Fullerton, 800 N. State College Blvd., KHS-127, Fullerton, CA, 92831, USA
| | - Robert Hsu
- Department of Oncology, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA, 90033, USA
| | - Lihua Liu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA, 90033, USA; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA, 90033, USA
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Yang WJ, Wu HB, Zhang C, Zhong Q, Hu MJ, He JL, Li GA, Zhu ZY, Zhu JL, Zhao HH, Zhang HS, Huang F. Exposure to 2,4-dichlorophenol, 2,4,6-trichlorophenol, pentachlorophenol and risk of thyroid cancer: a case-control study in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:61329-61343. [PMID: 34173948 DOI: 10.1007/s11356-021-14898-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/10/2021] [Indexed: 06/13/2023]
Abstract
Thyroid cancer (TC) has inflicted huge threats to the health of mankind. Chlorophenols (CPs) were persistent organic pollutant and can lead to adverse effects in human health, especially in thyroid. However, epidemiological studies have revealed a rare and inconsistent relationship between internal exposure to CPs and TC risk. The purpose of this study was to investigate the correlation between urinary CPs and TC risk in Chinese population. From June 2017 to September 2019, a total of 297 histologically confirmed TC cases were recruited. Age- and gender-matched controls were enrolled at the same time. Gas chromatography-mass spectrometry (GC-MS) was used to determine the levels of three CPs in urine. Conditional logistic regression models were adopted to assess the potential association. Restricted cubic spline function was used to explore the non-liner association. After adjusting for confounding factors, multivariate analysis showed that, compared with the first quartile, the fourth quartile concentrations of 2,4-dichlorophenol (2,4-DCP), 2,4,6-trichlorophenol (2,4,6-TCP), and pentachlorophenol (PCP) were associated with TC risk (odds ratio (OR)2,4-DCP =2.28, 95% confidence interval (CI): 1.24-4.18; OR2,4,6-TCP =3.09, 95% CI: 1.66-5.77; ORPCP =3.30, 95% CI: 1.71-6.36, respectively), when CPs were included in the multivariate model and restricted cubic spline function as continuous variables, presenting significant dose-response relationships. Meanwhile, whether in the TC group with tumor diameter > 1 cm or metastatic TC, the changes of 2,4,6 TCP and PCP concentrations were positively correlated with the risk of TC. Our study suggests that higher concentrations of urinary CPs are associated with increased TC risks. Moreover, 2,4,6-TCP and PCP have certain effects on the invasiveness of thyroid cancer. Targeted public health policies should be formulated to reduce the CP pollution. These findings need further in-depth studies to confirm and relevant mechanism also needed to be clarified.
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Affiliation(s)
- Wan-Jun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Hua-Bing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Chi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Qi Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Ming-Jun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Jia-Liu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Guo-Ao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Zhen-Yu Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Jin-Liang Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Huan-Huan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Han-Shuang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
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15
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Villoing D, Borrego D, Preston DL, Alexander BH, Rose A, Salasky M, Linet MS, Lee C, Kitahara CM. Trends in Occupational Radiation Doses for U.S. Radiologic Technologists Performing General Radiologic and Nuclear Medicine Procedures, 1980-2015. Radiology 2021; 300:605-612. [PMID: 34156301 DOI: 10.1148/radiol.2021204501] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Occupational doses to most medical radiation workers have declined substantially since the 1950s because of improvements in radiation protection practices. However, different patterns may have emerged for radiologic technologists working with nuclear medicine because of the higher per-procedure doses and increasing workloads. Purpose To summarize annual occupational doses during a 36-year period for a large cohort of U.S. radiologic technologists and to compare dose between general radiologic technologists and those specializing in nuclear medicine procedures. Materials and Methods Annual personal dose equivalents (referred to as doses) from 1980 to 2015 were summarized for 58 434 (62%) participants in the U.S. Radiologic Technologists (USRT) cohort who responded to the most recent mailed work history survey (years 2012-2014) and reported never regularly performing interventional procedures. Doses were partitioned according to the performance of nuclear medicine (yes or no, frequency, procedure type) by calendar year. Annual dose records were described by using summary statistics (eg, median and 25th and 75th percentiles). Results Median annual doses related to performance of general radiologic procedures decreased from 0.60 mSv (interquartile range [IQR], 0.10-1.9 mSv) in 1980 to levels below the limits of detection by 2015, whereas annual doses related to performance of nuclear medicine procedures remained relatively high during this period (median, 1.2 mSv; IQR, 0.12-3.0 mSv). Higher median annual doses were associated with more frequent (above vs below the median) performance of diagnostic nuclear medicine procedures (≥35 vs <35 times per week; 1.6 mSv [IQR, 0.30-3.3 mSv] and 0.9 mSv [IQR, 0.10-2.6 mSv]). Higher and more variable annual doses were associated with more frequent performance of cardiac nuclear medicine (≥10 times per week) and PET (nine or more times per week) examinations (median, 1.6 mSv [IQR, 0.30-2.2 mSv] and 2.2 mSv [IQR, 0.10-4.6 mSv], respectively). Conclusion Annual doses to U.S. radiologic technologists performing general radiologic procedures declined during a 36-year period. However, consistently higher and more variable doses were associated with the performance of nuclear medicine procedures, particularly cardiac nuclear medicine and PET procedures. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Mettler and Guiberteau in this issue.
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Affiliation(s)
- Daphnée Villoing
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - David Borrego
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Dale L Preston
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Bruce H Alexander
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - André Rose
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Mark Salasky
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Martha S Linet
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Choonsik Lee
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Cari M Kitahara
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
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Akyurt N. Health-related quality of life among radiology technicians in Turkish hospitals: a cross sectional study. Int Arch Occup Environ Health 2021; 94:1415-1425. [PMID: 34043057 DOI: 10.1007/s00420-021-01723-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 01/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Health related quality of life (HRQoL), despite its potential bi-directional interaction with occupational risks, has not been extensively addressed among radiology technicians. OBJECTIVE To evaluate HRQoL among radiology technicians in relation to sociodemographic and occupational factors. METHODS A total of 115 radiology technicians who were employed in three big hospitals located in Istanbul province were included on a voluntary basis in this cross sectional questionnaire-based study conducted between June 2019 and August 2019. The questionnaire form elicited items on socio-demographic characteristics, occupational characteristics and the 36-item Short-form Health Survey (SF-36), respectively. RESULTS Overall, 94.8% of technicians confirmed previous training on radiation protection and safety, while 92.2% noted distrust in their knowledge on radiation protection and patient dosage. In addition, 47.8% of technicians noted seldom use of radiation protection measures and 55.7% noted distrust in reliability of radiation exposure measurements. The multiple regression analysis revealed that older age, female gender, working at a university hospital and seldom use of protection significantly predicted poor HRQoL (p = 0.042 to 0.001), while working in interventional radiology and having trust in radiation exposure measurements predicted better HRQoL (p = 0.006 to 0.001) in terms of certain domains. CONCLUSION In conclusion, our findings revealed lack of trust in current self-knowledge on radiation protection and safety by majority of radiology technicians and seldom use of radiation protection measures by half of them, despite previously trained on radiation protection and safety. Certain occupational factors and factors related to radiation protection and safety were also amongst the significant determinants of poor HRQoL.
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Affiliation(s)
- Nuran Akyurt
- Department of Medical Imaging Techniques, Vocational School of Health Services, Marmara University Özcan Sabancı Binası, Kartal Yerleşkesi, Cevizli Mahallesi, D-100 Güney Yanyolu Üzeri, 34865, Kartal, Istanbul, Turkey.
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Lee WJ, Ko S, Bang YJ, Choe SA, Choi Y, Preston DL. Occupational radiation exposure and cancer incidence in a cohort of diagnostic medical radiation workers in South Korea. Occup Environ Med 2021; 78:876-883. [PMID: 34039756 PMCID: PMC8606456 DOI: 10.1136/oemed-2021-107452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/22/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022]
Abstract
Objectives We investigated the association between protracted low-dose ionising radiation and the risk of cancer in medical radiation workers, the largest group of workers with occupational radiation exposures. Methods Data of all South Korean diagnostic medical radiation workers enrolled at the National Dose Registry during 1996–2011 were merged with the death and cancer incidence data until 31 December 2017. SIRs, relative risks and excess relative risks (ERRs) for cancer were calculated to quantify the radiation dose–response relationship using Poisson regression models. Results A total of 3392 first primary cancer cases were identified among 93 920 diagnostic medical radiation workers. The mean cumulative badge dose in the cohort was 7.20 mSv. The ERRs for solid cancer with a 5-year lag and haematopoietic cancers with a 2-year lag for all workers were 0.15 per 100 mGy (95% CI −0.20 to 0.51) and 0.09 per 100 mGy (95% CI −2.02 to 2.20), respectively. The ERRs for cancers did not significantly vary by job title, different lag years or after excluding thyroid and lung cancers. Sensitivity analyses restricted to workers employed for at least 1 year, or who were employed in or after 1996, or who had exposure to a cumulative badge dose of 1 mSv or more showed similar results. Conclusions Occupational radiation doses were not significantly associated with cancer incidence among South Korean diagnostic medical radiation workers. However, cautious interpretation of ERRs is needed due to the limitations of short follow-up and low cumulative radiation doses.
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Affiliation(s)
- Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Seulki Ko
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ye Jin Bang
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Seung-Ah Choe
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yeongchull Choi
- Seoul Workers' Health Center, Ewha Womans University, Seoul, South Korea
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Seo S, Park S, Lee DN, Cha ES, Park S, Jin YW. Increased Incidence of Thyroid Cancer in Occupational Radiation Epidemiology: Attribution to Screening among Radiation Workers. Radiat Res 2021; 195:397-400. [PMID: 33577680 DOI: 10.1667/rade-20-00193.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/13/2021] [Indexed: 11/03/2022]
Abstract
In most studies on radiation workers, the incidence of thyroid cancer was determined to be higher than among the general population; this is generally assumed to be due to overdiagnosis through thyroid screening. However, there is a lack of evidence on the association between thyroid screening and increased thyroid cancer incidence in most occupational studies. In this study, we compared thyroid cancer screening rates between the general population and radiation workers with various occupations and examined the relationship between these rates and thyroid cancer incidence. We compared thyroid screening rates between radiation workers and the general population with age- and sex-standardized screening ratios (SSRs) using data from two national surveys conducted during 2015-2017 in Korea, and assessed the correlation between these ratios and age- and sex-standardized incidence ratios (SIRs) for thyroid cancer. Screening rates were higher among radiation workers than among the general population, with an overall SSR of 1.58 (95% confidence interval: 1.54-1.62). When various types of occupations were compared, those with an increased SSR also had an increased SIR. SSRs remained high even when the screening period was restricted to the year preceding the survey (the year after the establishment of guidelines for thyroid cancer screening aimed at reducing overdiagnosis). In conclusion, the increased incidence of thyroid cancer among radiation workers compared to that among the general population can be attributed mainly to increased thyroid screening rates. Additional efforts are needed to reduce unnecessary thyroid cancer screening in occupational populations, particularly in those with better access to healthcare, in terms of clinical rationale and for assessing the true increase in thyroid cancer incidence.
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Affiliation(s)
- Songwon Seo
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Soojin Park
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Dal Nim Lee
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sunhoo Park
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Young Woo Jin
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Xu J, Wang P, Yue W, Luo Y, Li Z. Application of ultrasonic shear wave elastography and contrast-enhanced ultrasound in the differential diagnosis of patients with benign and malignant thyroid lesions. Gland Surg 2020; 9:2136-2143. [PMID: 33447564 DOI: 10.21037/gs-20-819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Thyroid nodules are a common thyroid disorder. The aim of the present study was to observe the application value of ultrasonic shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of patients with benign and malignant thyroid lesions. Methods Eighty-two patients with thyroid nodules (96 thyroid nodules) at our hospital were enrolled. All patients underwent ultrasonic SWE and CEUS examination. With surgical pathology as the gold standard, the Young's modulus, CEUS imaging features, and quantitative parameters were compared between the benign and malignant groups. The diagnostic efficiency of SWE, CEUS, and their combination was analyzed by receiver-operating characteristic curve (ROC). Results The average of the Young's modulus in the malignant group was significantly higher than that of the benign group (P<0.05). There were significant differences in the CEUS images of nodules between the benign and malignant groups in terms of boundary conditions, morphology, perfusion intensity, homogeneous enhancement, and perfusion defects (P<0.05), while there were no significant difference in initial increase time, peak intensity, time to peak, and area under the curve (P>0.05). The curve sharpness in the benign group was significantly lower than that of the malignant group (P<0.05). ROC analysis found that the diagnostic sensitivity and specificity of SWE, CEUS, and their combination were 90.1% and 81.6%, 67.8% and 75.4%, and 97.3% and 71.5%, respectively. Conclusions Compared with CEUS, the sensitivity and specificity of SWE were relatively higher in the differential diagnosis of benign and malignant thyroid lesions, and a combination of both can improve the diagnostic sensitivity of SWE alone to a certain extent.
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Affiliation(s)
- Jing Xu
- Department of Radiology, East Branch Hospital of Sichuan Provincial People's Hospital, Chengdu, China
| | - Ping Wang
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Wensheng Yue
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yuqun Luo
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zukun Li
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Cioffi DL, Fontana L, Leso V, Dolce P, Vitale R, Vetrani I, Galdi A, Iavicoli I. Low dose ionizing radiation exposure and risk of thyroid functional alterations in healthcare workers. Eur J Radiol 2020; 132:109279. [DOI: 10.1016/j.ejrad.2020.109279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/01/2020] [Accepted: 09/05/2020] [Indexed: 02/07/2023]
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Chartier H, Fassier P, Leuraud K, Jacob S, Baudin C, Laurier D, Bernier MO. Occupational low-dose irradiation and cancer risk among medical radiation workers. Occup Med (Lond) 2020; 70:476-484. [DOI: 10.1093/occmed/kqaa130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Medical workers are the largest group of workers occupationally exposed to low doses of ionizing radiation (IR) worldwide.
Aims
This review presents all the cohorts of medical workers exposed in the world and summarizes cancer risks associated with radiation exposure in this population.
Methods
Epidemiological studies on health professionals exposed to IR published from 1975 to 2019 were reviewed. Strength of evidence was assessed according to the modified Royal College of General Practitioners three-star system.
Results
Among the 16 epidemiological studies focusing on cancers from 11 cohorts among medical staff exposed to radiation, higher risks of cancer were observed for pre-1950 exposure and for medical workers who performed fluoroscopically guided interventional procedures or radionuclides procedures compared to those who did not. However, strength of evidence supporting the associations remains moderate as several methodological limits including the lack of dosimetry data, lifestyle factors and recent updates may obscure the link between medical occupational exposure and cancer occurrence.
Conclusions
Excess risk of cancer is suspected for high and former exposures. The more highly exposed professions, i.e. interventional physicians and nuclear medicine workers, should be monitored carefully. Collaborative projects aiming to increase the quantity and quality of information of the studied populations would be a key point
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Affiliation(s)
- H Chartier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
- Percy Hospital, Radiological Protection Service of the Armed Forces (SPRA), Clamart, France
| | - P Fassier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - K Leuraud
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - S Jacob
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - C Baudin
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - D Laurier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - M-O Bernier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
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Takahashi H, Yasumura S, Takahashi K, Ohira T, Ohtsuru A, Midorikawa S, Suzuki S, Shimura H, Ishikawa T, Sakai A, Suzuki S, Yokoya S, Tanigawa K, Ohto H, Kamiya K. Nested matched case control study for the Japan Fukushima Health Management Survey's first full-scale (second-round) thyroid examination. Medicine (Baltimore) 2020; 99:e20440. [PMID: 32629628 PMCID: PMC7337421 DOI: 10.1097/md.0000000000020440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Since Fukushima nuclear accident in 2011, thyroid ultrasound examinations have been conducted. The first full-scale examination detected 71 thyroid-cancer cases. This study examined whether radiation exposure was associated with thyroid-cancer incidence.Subjects were participants in the baseline screening and newborns during the 2011 fiscal year. Under nested matched case-control study design, 10 controls per each case were selected by matching the age, sex, baseline screening results, and interval between examinations. With 3 dose levels of external radiation: 1.3 + mSv (upper), 0.8 to 1.3 (middle), and 0.0 to 0.8 (reference), we applied 2 logistic models adjusting for 3 participation-proportions (primary, secondary, and fine-needle aspiratory cytology), overweight, and the B-result of baseline screening (Model 1), and past medical history, family history of thyroid cancer, and frequencies of eating seafood and seaweed in addition to the parameters in Model 1 (Model 2). We examined each model in 3 ways: (a) excluding subjects with a missing radiation exposure dose; and substituting (b1) median or (b2) mean dose of the municipality with missing dose.Odds ratios (ORs) of middle-dose exposure were (a) 1.35 (0.46-3.94), (b1) 1.55 (0.61-3.96), and (b2) 1.23 (0.50-3.03) for Model 1, and (a) 1.18 (0.39-3.57), (b1) 1.31 (0.49-3.49), and (b2) 1.02 (0.40-2.59) for Model 2. For upper-dose exposure, similar results were obtained. Past medical history was significantly associated (odds ratio = 2.04-2.08) with both (b1) and (b2) in Model 2.No significant associations were obtained between the external radiation exposure and thyroid-cancer incidence.
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Affiliation(s)
- Hideto Takahashi
- National Institute of Public Health, Saitama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima
| | - Kunihiko Takahashi
- Department of Biostatistics M&D Data Science Center Tokyo Medical and Dental University
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Epidemiology
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Health Management
| | - Sanae Midorikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Health Management
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Laboratory Medicine
| | - Tetsuo Ishikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Physics and Chemistry
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Life Sciences
| | - Shinichi Suzuki
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine
| | - Susumu Yokoya
- Thyroid and Endocrine Center, Fukushima Medical University, Fukushima
| | - Koichi Tanigawa
- Fukushima Global Medical Science Center, Fukushima Medical University
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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Adliene D, Griciene B, Skovorodko K, Laurikaitiene J, Puiso J. Occupational radiation exposure of health professionals and cancer risk assessment for Lithuanian nuclear medicine workers. ENVIRONMENTAL RESEARCH 2020; 183:109144. [PMID: 32028181 DOI: 10.1016/j.envres.2020.109144] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Reconstruction and analysis of low doses received by the occupationally exposed medical radiation workers, especially nuclear medicine staff dealing with radioisotopes may significantly contribute to the understanding of radiation impact on individuals, assess and predict radiation related risks for the development of cancer or other specific diseases. METHODS A pool of 2059 annual effective doses corresponding to 272 job's positions occupied by nuclear medicine and radiology workers for a certain time period over 26 years in five Lithuanian hospitals was investigated in order to analyze the occupational exposure tendencies to medical staff. Requested data, measured in terms of whole body dose, personal dose equivalent Hp(10), was obtained from the National Register of Sources of Ionizing Radiation and Occupational Exposure. Considering that nuclear medicine staff is dealing with open sources/radioisotopes, doses to extremities, Hp(0.07), were measured using thermoluminescent dosimeters (TLD) of LiF:Mg, Ti type. Lifetime risk estimations for the development of specific cancer (thyroid cancer and leukemia) for exposed radiation workers were performed using risk models included in BEIR VII report (BEIR VII, 2006). The conservative assessment of the thyroid exposure was performed using RadRAT 4.1.1 tool. RESULTS Doses to radiology technologists and radiology nurses were found to be highest over the years. However, their annual doses never exceeded dose limit of 20 mSv and were following the same decreasing tendency as the doses of other personnel. There was no increase of doses to nuclear medicine staff observed after installation of two new PET/CT machines, indicating increased radiation protection culture and application of relevant technical and protective measures by the staff. Measured fingertip doses were 2-3 times higher than the hand doses measured with TLD ring and were dependent on the type and frequency of the nuclear medicine examination procedure and on the type and activity of isotopes used for examination. CONCLUSIONS For the first time, retrospective dose evaluation for the cohort of medical radiation workers was performed in the country. It enabled estimation of lifetime attributable risk for the development of two cancer types: thyroid and leukemia cancer among occupationally exposed medical radiation staff. Projected risk was low, ~10-5, however it was found that the risk of thyroid cancer for female staff was 5.7 times higher than for the males. Obtained results will be used for the predictive assessment of possible radiation induced health effects to occupationally exposed medical radiation workers.
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Affiliation(s)
- D Adliene
- Kaunas University of Technology, Kaunas, Lithuania.
| | - B Griciene
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Department of Radiology, Nuclear Medicine and Medical Physics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - K Skovorodko
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; State Research Institute the Center for Physical Sciences and Technology, Vilnius, Lithuania
| | | | - J Puiso
- Kaunas University of Technology, Kaunas, Lithuania
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Herbal Active Ingredients: An Emerging Potential for the Prevention and Treatment of Papillary Thyroid Carcinoma. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1340153. [PMID: 32090065 PMCID: PMC7013308 DOI: 10.1155/2020/1340153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 02/06/2023]
Abstract
Papillary thyroid carcinoma (PTC) is the most common subtype of differentiated thyroid cancers in Asian coastal cities, where the patients have increased risk of potentially high or excessive iodine intake. Given the high metastasis and recurrence of patients with BRAFV600E mutation, the mortality rate of thyroid cancer has recently shown an upward trend. A variety of therapies, including surgery, radiotherapy, and chemotherapy, have been used to treat thyroid cancer, but these therapies still have limitations, including postoperative complications, drug resistance, poor efficacy, or serious side effects. Recent studies have shown the potential of active ingredients derived from herbal medicine in inhibiting PTC via various cell signaling pathways. Some plant-derived compounds, such as apigenin, genistein, and curcumin, are also known to prevent and treat PTC. This article summarizes the recent advances in the structure-functional impact of anti-PTC active ingredients and their effects on PTC cells and tumor microenvironments with an emphasis on their challenges from basic research to clinical practice.
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Martinez Marignac V, Mondragon L, Gloria O, Cervantes L, Cantero F, Favant J. Preclinical study of genuine essiac formula: A cancer treatment eight-herbs' tea minimizes DNA insult of X-rays. CLINICAL CANCER INVESTIGATION JOURNAL 2020. [DOI: 10.4103/ccij.ccij_73_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lee WJ, Preston DL, Cha ES, Ko S, Lim H. Thyroid cancer risks among medical radiation workers in South Korea, 1996-2015. Environ Health 2019; 18:19. [PMID: 30857541 PMCID: PMC6413450 DOI: 10.1186/s12940-019-0460-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/01/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Thyroid cancer rates, especially among children, are known to be increased by radiation exposure. However, little is known about the impact of chronic low-dose radiation exposure on thyroid cancer risk in adulthood. This study examined radiation effects on thyroid cancer rates as well as an overall evaluation of thyroid cancer risk among medical radiation workers. METHODS Data on all diagnostic medical radiation workers enrolled in the national dosimetry registry between 1996 and 2011 were linked with the cancer registry data through 2015. Standardized incidence ratios (SIRs) were used to compare the observed cancer incidence rates in this population to those for the general population while internal comparisons were used to estimate relative risks (RRs) for occupational history and excess relative risks (ERRs) were used to quantify the radiation dose-response relationship. RESULTS Overall, 827 thyroid cancer cases were reported among 93,922 medical radiation workers. Thyroid cancer SIRs were significantly higher than expected for both men (SIR 1.72, 95% confidence interval [CI] 1.53 to 1.91) and women (SIR 1.18, 95% CI 1.08 to 1.28). However, RRs for thyroid cancer by job title and duration of employment showed no particular pattern among diagnostic medical radiation workers. There were no indications of a significant dose effect on thyroid cancer rates for either men (ERR/100 mGy 0.07, 95% CI -0.38 to 0.53) or women (ERR/100 mGy -0.13, 95% CI -0.49 to 0.23). The findings were similar for different job titles or when limited to workers employed for at least one year. CONCLUSIONS While thyroid cancer incidence rates among Korean medical radiation workers were somewhat higher than those in the general population, there was no significant evidence that this increase was associated with occupational radiation dose. Additional follow-up together with consideration of other risk factors should provide useful information on thyroid cancer rates in this cohort.
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Affiliation(s)
- Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | | | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Seulki Ko
- Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Hyeyeun Lim
- Environmental Health Center, Asan Medical Center, Seoul, South Korea
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Vimercati L, De Maria L, Mansi F, Caputi A, Ferri GM, Luisi V, Lovreglio P, Cannone ESS, Lorusso P, Gatti MF, Massagli CRS, Triggiani V. Prevalence of Thyroid Diseases in an Occupationally Radiation Exposed Group: A Cross-Sectional Study in a University Hospital of Southern Italy. Endocr Metab Immune Disord Drug Targets 2018; 19:803-808. [PMID: 30387406 DOI: 10.2174/1871530318666181102114627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. OBJECTIVE To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. METHODS We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or "A Category", and 203 less exposed, or "B Category") and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. RESULTS The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. CONCLUSION In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.
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Affiliation(s)
- Luigi Vimercati
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesca Mansi
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Giovanni M Ferri
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Vito Luisi
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Enza S S Cannone
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Pietro Lorusso
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Maria F Gatti
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Chiara R S Massagli
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine, Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari Aldo Moro, Bari, Italy
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28
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Polednik KM, Simpson MC, Adjei Boakye E, Mohammed KA, J Dombrowski J, Varvares MA, Osazuwa-Peters N. Radiation and Second Primary Thyroid Cancer Following Index Head and Neck Cancer. Laryngoscope 2018; 129:1014-1020. [PMID: 30208210 DOI: 10.1002/lary.27467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES/HYPOTHESIS Radiation is thought to increase risk of developing second primary thyroid cancer (SPTC). This study estimated the rate of SPTC following index head and neck cancer (HNC) and determined whether radiation treatment among HNC survivors increased SPTC risk. STUDY DESIGN Retrospective data analysis. METHOD The Surveillance, Epidemiology, and End Results database (1975-2014) was queried for cases of index HNC (N = 127,563) that developed SPTC. Adjusted multivariable competing risk proportional hazards model tested risk of developing a SPTC following index HNC. Sensitivity analyses using proportional hazards models were also performed restricting data to patients who 1) received both radiation and chemotherapy and 2) radiation alone. RESULTS Only 0.2% of index HNC survivors (n = 229) developed SPTC, yielding a rate of 26.1 per 100,000 person-years. For every increasing year of age at diagnosis, patients were 3% less likely to develop an SPTC (adjusted hazard ratio [aHR] = 0.97, 95% CI: 0.96-0.98). Males were also less likely to develop an SPTC (aHR = 0.73, 95% CI: 0.55-0.96). Radiation (aHR = 0.92, 95% CI: 0.68-1.25), surgery (aHR = 0.79, 95% CI: 0.56-1.11), and chemotherapy (aHR = 1.13, 95% CI: 0.76-1.69) were not significantly associated with developing SPTC. The sensitivity models also did not find an association between treatment and risk of SPTC. CONCLUSIONS Rate of developing SPTC following index HNC was very low, and previous exposure to radiation did not significantly increase risk in our study population. More studies are needed to understand the increasing incidence of thyroid cancer across the United States. LEVEL OF EVIDENCE NA Laryngoscope, 129:1014-1020, 2019.
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Affiliation(s)
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Eric Adjei Boakye
- Center for Health Outcomes Research, Saint Louis University, St. Louis, Missouri
| | - Kahee A Mohammed
- Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri.,Center for Health Outcomes Research, Saint Louis University, St. Louis, Missouri
| | - John J Dombrowski
- Department of Radiation Oncology, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Mark A Varvares
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Nosayaba Osazuwa-Peters
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri.,Saint Louis University Cancer Center, St. Louis, Missouri.,Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, U.S.A
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29
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Gaetani S, Monaco F, Bracci M, Ciarapica V, Impollonia G, Valentino M, Tomasetti M, Santarelli L, Amati M. DNA damage response in workers exposed to low-dose ionising radiation. Occup Environ Med 2018; 75:724-729. [DOI: 10.1136/oemed-2018-105094] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/12/2018] [Accepted: 07/25/2018] [Indexed: 02/06/2023]
Abstract
ObjectiveMedical personnel using radiation for diagnosis and therapeutic purposes are potentially at risk of cancer development. In this study, the effect of ionising radiation (IR) exposure was evaluated as DNA damage response (DDR) in the circulating cells of occupationally exposed subjects.MethodsThe study population consisted of IR-exposed workers included both in group B (effective dose ranging between 0.04 and 6 mSv/year) and group A (probable effective dose exceeding 6 mSv/year), and the control group consisted of healthy individuals who had never been occupationally exposed to IR or other known carcinogenic agents. DNA damage (single-strand breaks, oxidised purine and pyrimidine bases) and DNA repair (t1/2, half time to repair DNA damage, amount of repaired DNA and DNA repair activity) were measured in lymphocytes using the comet assay. To evaluate the influence of IR doses and genetic predisposition to cancer, the enrolled population was stratified according to IR exposure level and family history of cancer.ResultsIncreased DNA repair activity was found in IR-exposed group, and only subjects highly exposed to IR doses accumulated DNA damage in their circulating cells, thus supporting the hypothesis of ‘radiation hormesis’. A significant increase in DNA damage accumulation and a reduced 8-oxoguanine glycosylase 1-dependent DNA repair activity were found in IR-exposed subjects with cancer cases across their family.ConclusionOur results indicate that chronic exposure to a low dose of IR in occupational settings induces DDR in exposed subjects and may be mutagenic in workers with family history of cancer, suggesting that periodic surveillance might be advisable, along with exposure monitoring.
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