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Kruger E, Toraih EA, Hussein MH, Shehata SA, Waheed A, Fawzy MS, Kandil E. Thyroid Carcinoma: A Review for 25 Years of Environmental Risk Factors Studies. Cancers (Basel) 2022; 14:cancers14246172. [PMID: 36551665 PMCID: PMC9777404 DOI: 10.3390/cancers14246172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Environmental factors are established contributors to thyroid carcinomas. Due to their known ability to cause cancer, exposure to several organic and inorganic chemical toxicants and radiation from nuclear weapons, fallout, or medical radiation poses a threat to global public health. Halogenated substances like organochlorines and pesticides can interfere with thyroid function. Like phthalates and bisphenolates, polychlorinated biphenyls and their metabolites, along with polybrominated diethyl ethers, impact thyroid hormones biosynthesis, transport, binding to target organs, and impair thyroid function. A deeper understanding of environmental exposure is crucial for managing and preventing thyroid cancer. This review aims to investigate the relationship between environmental factors and the development of thyroid cancer.
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Affiliation(s)
- Eva Kruger
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Eman A. Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Medical Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Correspondence: (E.A.T.); (M.S.F.)
| | - Mohammad H. Hussein
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Shaimaa A. Shehata
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Amani Waheed
- Department of Community Medicine, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Manal S. Fawzy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 1321, Saudi Arabia
- Correspondence: (E.A.T.); (M.S.F.)
| | - Emad Kandil
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
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Sholl LM, Barletta JA, Hornick JL. Radiation-associated neoplasia: clinical, pathological and genomic correlates. Histopathology 2017; 70:70-80. [PMID: 27960236 DOI: 10.1111/his.13069] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 01/21/2023]
Abstract
Ionizing radiation is an established risk factor for the development of benign and malignant tumours. The epidemiology of radiation-associated neoplasia has been studied over the decades in diverse populations, including Japanese atomic bomb survivors, exposed communities following the Chernobyl nuclear power plant disaster, and paediatric and adult populations receiving therapeutic irradiation. Radiation has been associated with an increased risk of neoplasia throughout the human body, with some sites showing a markedly increased relative risk of developing tumours (thyroid; soft tissues), depending on patient age and the context of exposure. Although the mechanisms of cellular injury and repair resulting from ionizing radiation are well described, the genomics of radiation-induced tumours are still relatively poorly understood, with some exceptions, such as RET rearrangement in thyroid carcinomas following iodine-131 exposure and MYC amplification in cutaneous angiosarcoma following chest wall irradiation for breast cancer. This review will provide a general overview of the epidemiology, molecular mechanism, pathology and genomics of radiation-associated neoplasia in humans.
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Affiliation(s)
- Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Justine A Barletta
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Chronic diseases and mortality among immigrants to Israel from areas contaminated by the Chernobyl disaster: a follow-up study. Int J Public Health 2017; 62:463-469. [PMID: 28130563 DOI: 10.1007/s00038-017-0941-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 12/17/2016] [Accepted: 12/29/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To examine six chronic diseases and all-cause mortality among immigrants to Israel from areas contaminated by the Chernobyl accident. METHODS The medical data were obtained from the two largest HMOs in Israel. In the assessment of chronic diseases, individuals were divided into three groups: less exposed (n = 480), more exposed (n = 359), and liquidators (n = 45) and in the mortality analysis, into two groups: less exposed (n = 792) and more exposed (n = 590). RESULTS Compared to the less exposed, adults from the more exposed group had increased odds of respiratory disorders (OR = 2.34, 95% CI 1.21, 4.54) and elevated odds, with borderline significance, of ischemic heart disease (OR = 2.01, 95% CI 0.97, 4.20). In addition, the liquidators had increased odds of hypertension compared to the less exposed (OR = 2.64, 95% CI 1.24, 5.64). The Cox proportional-hazards model indicated no difference in the ratio of all-cause mortality between the exposed groups during the follow up period. CONCLUSIONS Our study, conducted approximately two decades after the accident, suggests that exposure to radionuclides may be associated with increased odds of respiratory disorders and hypertension.
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Ostroumova E, Hatch M, Brenner A, Nadyrov E, Veyalkin I, Polyanskaya O, Yauseyenka V, Polyakov S, Levin L, Zablotska L, Rozhko A, Mabuchi K. Non-thyroid cancer incidence in Belarusian residents exposed to Chernobyl fallout in childhood and adolescence: Standardized Incidence Ratio analysis, 1997-2011. ENVIRONMENTAL RESEARCH 2016; 147:44-49. [PMID: 26851723 PMCID: PMC4821667 DOI: 10.1016/j.envres.2016.01.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/22/2015] [Accepted: 01/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND While an increased risk of thyroid cancer from post-Chernobyl exposure to Iodine-131 (I-131) in children and adolescents has been well-documented, risks of other cancers or leukemia as a result of residence in radioactively contaminated areas remain uncertain. METHODS We studied non-thyroid cancer incidence in a cohort of about 12,000 individuals from Belarus exposed under age of 18 years to Chernobyl fallout (median age at the time of Chernobyl accident of 7.9 years). During 15 years of follow-up from1997 through 2011, 54 incident cancers excluding thyroid were identified in the study cohort with 142,968 person-years at risk. We performed Standardized Incidence Ratio (SIR) analysis of all solid cancers excluding thyroid (n=42), of leukemia (n=6) and of lymphoma (n=6). RESULTS We found no significant increase in the incidence of non-thyroid solid cancer (SIR=0.83, 95% Confidence Interval [CI]: 0.61; 1.11), lymphoma (SIR=0.66, 95% CI: 0.26; 1.33) or leukemia (SIR=1.78, 95% CI: 0.71; 3.61) in the study cohort as compared with the sex-, age- and calendar-time-specific national rates. These findings may in part reflect the relatively young age of study subjects (median attained age of 33.4 years), and long latency for some radiation-related solid cancers. CONCLUSIONS We found no evidence of statistically significant increases in solid cancer, lymphoma and leukemia incidence 25 years after childhood exposure in the study cohort; however, it is important to continue follow-up non-thyroid cancers in individuals exposed to low-level radiation at radiosensitive ages.
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Affiliation(s)
- Evgenia Ostroumova
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, MSC 9776, Bethesda, 20892 MD, USA.
| | - Maureen Hatch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, MSC 9776, Bethesda, 20892 MD, USA.
| | - Alina Brenner
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, MSC 9776, Bethesda, 20892 MD, USA.
| | - Eldar Nadyrov
- The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040, Belarus.
| | - Ilya Veyalkin
- The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040, Belarus.
| | - Olga Polyanskaya
- The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040, Belarus.
| | - Vasilina Yauseyenka
- The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040, Belarus.
| | - Semion Polyakov
- State Institution "Republican Scientific and Practical Center for Medical Technologies, Informatization, Administration and Management of Health", 7-a Petrus Brovka Street, Minsk 220600, Belarus.
| | - Leonid Levin
- Cancer Registry, State Establishment "N.N.Alexandrov National Cancer Center of Belarus for Oncology and Medical Radiology", P.O., Lesnoy 223040, Belarus.
| | - Lydia Zablotska
- University of California, San Francisco, 3333 California Street, Laurel Heights, San Francisco, 94118 CA, USA.
| | - Alexander Rozhko
- The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040, Belarus.
| | - Kiyohiko Mabuchi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, MSC 9776, Bethesda, 20892 MD, USA.
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LaFranchi SH. Inaugural Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer: Children Are Not Small Adults. Thyroid 2015; 25:713-5. [PMID: 26079318 DOI: 10.1089/thy.2015.0275] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Stephen H LaFranchi
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
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Association between a functional polymorphism rs712 within let-7-binding site and risk of papillary thyroid cancer. Med Oncol 2014; 31:221. [DOI: 10.1007/s12032-014-0221-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 09/02/2014] [Indexed: 02/06/2023]
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Cancer risks from low dose exposure to ionising radiation – Is the linear no-threshold model still relevant? Radiography (Lond) 2012. [DOI: 10.1016/j.radi.2011.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Jargin SV. Overestimation of Chernobyl consequences: calculation of a latent period for tumors with unproven radiation etiology. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2009; 48:433-435. [PMID: 19756687 DOI: 10.1007/s00411-009-0242-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 08/26/2009] [Indexed: 05/28/2023]
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Ivanov VK, Gorsky AI, Kashcheev VV, Maksioutov MA, Tumanov KA. Latent period in induction of radiogenic solid tumors in the cohort of emergency workers. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2009; 48:247-252. [PMID: 19326138 DOI: 10.1007/s00411-009-0223-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Accepted: 03/07/2009] [Indexed: 05/27/2023]
Abstract
The paper presents estimates for the latent period of the induction of radiogenic solid cancers among Chernobyl emergency workers (males) living in six central regions of Russia. The analysis is based on medical and dosimetry data gathered by the National Radiation and Epidemiological Registry over the time period from 1986 to 2005. The cohort includes 59,770 persons who stayed in the exposure zone (30-km zone around the Chernobyl nuclear power plant) in 1986-1987. There were 2,718 cases of solid tumors identified during the follow-up time in this cohort. The mean radiation dose in the cohort is 0.13 Gy. The radiation risk and latent period were estimated using the method of maximum likelihood. The excess relative risk per unit dose was found to be 0.96 (95% confidence interval (CI): 0.3-1.7) and the minimum latent period for induction of solid tumors is 4.0 years (95% CI: 3.3-4.9).
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Affiliation(s)
- Victor K Ivanov
- Medical Radiological Research Centre, Russian Academy of Medical Sciences, Kaluga Region, Russia.
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Jargin SV. Overestimation of Chernobyl consequences: biophysical aspects. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2009; 48:341-344. [PMID: 19350260 DOI: 10.1007/s00411-009-0224-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2009] [Accepted: 03/21/2009] [Indexed: 05/27/2023]
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Ostroumova E, Brenner A, Oliynyk V, McConnell R, Robbins J, Terekhova G, Zablotska L, Likhtarev I, Bouville A, Shpak V, Markov V, Masnyk I, Ron E, Tronko M, Hatch M. Subclinical hypothyroidism after radioiodine exposure: Ukrainian-American cohort study of thyroid cancer and other thyroid diseases after the Chornobyl accident (1998-2000). ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:745-50. [PMID: 19479016 PMCID: PMC2685836 DOI: 10.1289/ehp.0800184] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2008] [Accepted: 12/15/2008] [Indexed: 05/19/2023]
Abstract
BACKGROUND Hypothyroidism is the most common thyroid abnormality in patients treated with high doses of iodine-131 (131I). Data on risk of hypothyroidism from low to moderate 131I thyroid doses are limited and inconsistent. OBJECTIVE This study was conducted to quantify the risk of hypothyroidism prevalence in relation to 131I doses received because of the Chornobyl accident. METHODS This is a cross-sectional (1998-2000) screening study of thyroid diseases in a cohort of 11,853 individuals < 18 years of age at the time of the accident, with individual thyroid radioactivity measurements taken within 2 months of the accident. We measured thyroid-stimulating hormone (TSH), free thyroxine, and antibodies to thyroid peroxidase (ATPO) in serum. RESULTS Mean age at examination of the analysis cohort was 21.6 years (range, 12.2-32.5 years), with 49% females. Mean 131I thyroid dose was 0.79 Gy (range, 0-40.7 Gy). There were 719 cases with hypothyroidism (TSH > 4 mIU/L), including 14 with overt hypothyroidism. We found a significant, small association between (131)I thyroid doses and prevalent hypothyroidism, with the excess odds ratio (EOR) per gray of 0.10 (95% confidence interval, 0.03-0.21). EOR per gray was higher in individuals with ATPO < or = 60 U/mL compared with individuals with ATPO > 60 U/mL (p < 0.001). CONCLUSIONS This is the first study to find a significant relationship between prevalence of hypothyroidism and individual (131)I thyroid doses due to environmental exposure. The radiation increase in hypothyroidism was small (10% per Gy) and limited largely to subclinical hypothyroidism. Prospective data are needed to evaluate the dynamics of radiation-related hypothyroidism and clarify the role of antithyroid antibodies.
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Affiliation(s)
- Evgenia Ostroumova
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Alina Brenner
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
- Address correspondence to A. Brenner, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, MS 7238, 6120 Executive Blvd., Bethesda, MD 20892-7238 USA. Telephone: (301) 402-8680. Fax: (301) 402-0207. E-mail:
| | - Valery Oliynyk
- Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Robert McConnell
- Department of Medicine, The Thyroid Clinic, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Jacob Robbins
- Clinical Endocrinology Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | | | - Lydia Zablotska
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ilya Likhtarev
- Scientific Center for Radiation Medicine, Academy of Medical Science, Kyiv, Ukraine
| | - Andre Bouville
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Viktor Shpak
- Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | | | - Ihor Masnyk
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Elaine Ron
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Mykola Tronko
- Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Maureen Hatch
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Kaiser JC, Jacob P, Blettner M, Vavilov S. Screening effects in risk studies of thyroid cancer after the Chernobyl accident. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2009; 48:169-179. [PMID: 19214549 DOI: 10.1007/s00411-009-0211-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Accepted: 01/15/2009] [Indexed: 05/27/2023]
Abstract
In this article scenarios have been developed, which simulate screening effects in ecological and cohort studies of thyroid cancer incidence among Ukrainians, whose thyroids have been exposed to (131)I in the aftermath of the Chernobyl accident. If possible, the scenarios were based on directly observed data, such as the population size, dose distributions and thyroid cancer cases. Two scenarios were considered where the screening effect on baseline cases is either equal to or larger than that of radiation-related thyroid cancer cases. For ecological studies in settlements with more than ten measurements of the (131)I activity in the human thyroid in May-June 1986, the screening bias appeared small (<19%) for all risk quantities. In the cohort studies, the excess absolute risk per dose was larger by a factor of 4 than in the general population. For an equal screening effect on baseline and radiation-related cancer (Scenario 1) the excess relative risk was about the same as in the general population. However, a differential screening effect (Scenario 2) produced a risk smaller by a factor of 2.5. A comparison with first results of the Ukrainian-US-American cohort study did not give any indication that a differential screening effect has a marked influence on the risk estimates. The differences in the risk estimates from ecological studies and cohort studies were explained by the different screening patterns in the general population and in the much smaller cohort. The present investigations are characterized by dose estimates for many settlements which are very weakly correlated with screening, the confounding variable. The results show that under these conditions ecological studies may provide risk estimates with an acceptable bias.
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Affiliation(s)
- Jan Christian Kaiser
- Helmholtz-Zentrum München, German Research Centre for Environmental Health, Institute of Radiation Protection, 85764 Neuherberg, Germany.
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Abstract
A comprehensive review of the effects of exposure to low levels of ionizing radiation, BEIR VII-Phase 2: Health Risks From Exposure to Low Levels of Ionizing Radiation, was published in 2006. The BEIR (Biological Effects of Ionizing Radiation) reports are a series of publications by the National Academy of Sciences. The last BEIR report on the effects of low level radiation, BEIR V, was published in 1990. To update the risk estimates for exposure to low levels of ionizing radiation, the BEIR committee reviewed recent epidemiologic studies of the atomic bomb survivors, as well as recent studies of populations exposed to radiation from diagnostic and therapeutic medical studies, from occupational exposures and from exposure due to releases of radioactive materials into the environment. Additional increasingly sophisticated epidemiologic studies continue to be published. BEIR VII reconfirmed that the linear no threshold model is the most practical model to estimate radiation risks, especially for radiation protection purposes. The updated risk estimates have not changed significantly from the BEIR V estimates, but the confidence intervals have narrowed as the result of the availability of additional data. The effects of low doses of radiation should be of particular interest to medical professionals because radiation exposure from diagnostic medical studies is, by far, the largest source of radiation exposure from human activity. One recommendation of the BEIR VII report is to perform epidemiologic studies of patients, especially children, who have been exposed to radiation as part of their care. A large, sophisticated epidemiologic study will likely be able to detect an increase in cancer risk. The purpose of this article is to highlight the contents of this important publication with particular emphasis on what is new.
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Affiliation(s)
- Henry D Royal
- Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
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Abstract
There is much interest in the application of genome biology to the field of thyroid neoplasia, despite the relatively low mortality rate associated with thyroid cancer in general. The principal reason for this interest is that the field of thyroid neoplasia stands to benefit from the application of genomic information to address a variety of pathologic and clinical issues. In addition to practical patient care issues, there is an excellent opportunity of expand the basic understanding of thyroid carcinogenesis. In this article, the most relevant genomic work on thyroid tumors performed to date is reviewed along with some general comments about the potential impact of genomic biology on thyroid pathology and the management of patients with thyroid nodules and cancer.
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Affiliation(s)
- Thomas J Giordano
- Department of Pathology, 1150 West Medical Center Drive, MSRB-2, C570D, University of Michigan Health System, Ann Arbor, MI 48109, USA.
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Grubbs EG, Rich TA, Li G, Sturgis EM, Younes MN, Myers JN, Edeiken-Monroe B, Fornage BD, Monroe DP, Staerkel GA, Williams MD, Waguespack SG, Hu MI, Cote G, Gagel RF, Cohen J, Weber RS, Anaya DA, Holsinger FC, Perrier ND, Clayman GL, Evans DB. Recent advances in thyroid cancer. Curr Probl Surg 2008; 45:156-250. [PMID: 18346477 DOI: 10.1067/j.cpsurg.2007.12.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Elizabeth G Grubbs
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Prysyazhnyuk A, Gristchenko V, Fedorenko Z, Gulak L, Fuzik M, Slipenyuk K, Tirmarche M. Twenty years after the Chernobyl accident: solid cancer incidence in various groups of the Ukrainian population. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2007; 46:43-51. [PMID: 17279359 DOI: 10.1007/s00411-007-0093-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 01/14/2007] [Indexed: 05/13/2023]
Abstract
Several major international studies such as those performed on the A-bomb survivors, have shown a clear linkage between the exposure to ionizing radiation and the occurrence of various cancer types including leukemia. While these studies are mostly characterized by high dose rates, studies on populations exposed after the Chernobyl accident are in most cases characterized by low dose rates which are typical for occupational radiation protection. Here, data on more than 60,000 Ukrainian workers who participated in recovery operation works in Chernobyl in 1986-1987, more than 50,000 evacuees from the city of Prypyat and the 30 km zone, and about 360,000 residents of most contaminated territories are presented, which cover a period of observation from 1980 to 2004. For all cancers combined, statistically significant higher incidence rates than the national rates were found only for the recovery workers (standardized incidence ratio (SIR) 117.2%, 95% confidence interval: 114.1-120.3), while those for the other investigated groups were lower. In all groups under study a significant increase of thyroid cancer incidence rates has been registered. This increase appears to be associated, at least partly, with the fallout of radioiodine, and it was found not only in children, but also in adolescents and adults. For example, the most significant excess was found for male recovery workers corresponding to a factor of 8.0. It is important to keep in mind, however, that the contribution of confounding factors such as an intensified thyroid screening after the Chernobyl accident could not be quantified, in the present study. For female recovery workers there was also an excess of breast cancer over the national rates (SIR 190.6%; 95% confidence interval: 163.6-217.7%). An analysis of the two other groups (evacuees and residents of contaminated territories) gave controversial results: relative to the local standard there was a statistically significant excess, while comparison with the national level did not substantiate this conclusion.
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Affiliation(s)
- A Prysyazhnyuk
- Research Centre for Radiation Medicine of AMS of the Ukraine, 53, Melnikov Str., 04050, Kiev, Ukraine.
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