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Zidane M, Haber M, Truong T, Rachédi F, Ory C, Chevillard S, Blanché H, Olaso R, Boland A, Conte É, Karimi M, Ren Y, Xhaard C, Souchard V, Gardon J, Taquet M, Bouville A, Deleuze JF, Drozdovitch V, de Vathaire F, Cazier JB. Genetic factors for differentiated thyroid cancer in French Polynesia: new candidate loci. PRECISION CLINICAL MEDICINE 2023; 6:pbad015. [PMID: 37383672 PMCID: PMC10294640 DOI: 10.1093/pcmedi/pbad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/09/2023] [Indexed: 06/30/2023] Open
Abstract
Background Populations of French Polynesia (FP), where France performed atmospheric tests between 1966 and 1974, experience a high incidence of differentiated thyroid cancer (DTC). However, up to now, no sufficiently large study of DTC genetic factors in this population has been performed to reach definitive conclusion. This research aimed to analyze the genetic factors of DTC risk among the native FP populations. Methods We analyzed more than 300 000 single nucleotide polymorphisms (SNPs) genotyped in 283 DTC cases and 418 matched controls born in FP, most being younger than 15 years old at the time of the first nuclear tests. We analyzed the genetic profile of our cohort to identify population subgroups. We then completed a genome-wide analysis study on the whole population. Results We identified a specific genetic structure in the FP population reflecting admixture from Asian and European populations. We identified three regions associated with increased DTC risk at 6q24.3, 10p12.2, and 17q21.32. The lead SNPs at these loci showed respective p-values of 1.66 × 10-7, 2.39 × 10-7, and 7.19 × 10-7 and corresponding odds ratios of 2.02, 1.89, and 2.37. Conclusion Our study results suggest a role of the loci 6q24.3, 10p12.2 and 17q21.32 in DTC risk. However, a whole genome sequencing approach would be better suited to characterize these factors than genotyping with microarray chip designed for the Caucasian population. Moreover, the functional impact of these three new loci needs to be further explored and validated.
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Affiliation(s)
- Monia Zidane
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Radiations Epidemiology", Villejuif 94805, France
| | - Marc Haber
- Centre for Computational Biology, University of Birmingham, Birmingham B152TT, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B152TT, UK
| | - Thérèse Truong
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif 94805, France
| | - Frédérique Rachédi
- Endocrinology Unit, Territorial Hospital Taaone, F-98713, Papeete, Tahiti 98713, French Polynesia
| | - Catherine Ory
- CEA, Laboratoire de Cancérologie Fondamentale, Institut de Biologie François Jacob, iRCM, SREIT, Laboratoire de Cancérologie Expérimentale (LCE), Université Paris-Saclay, Fontenay aux Roses 92265, France
| | - Sylvie Chevillard
- CEA, Laboratoire de Cancérologie Fondamentale, Institut de Biologie François Jacob, iRCM, SREIT, Laboratoire de Cancérologie Expérimentale (LCE), Université Paris-Saclay, Fontenay aux Roses 92265, France
| | - Hélène Blanché
- Fondation Jean Dausset-Centre d'Etude du Polymorphisme Humain, Paris 75010, France
| | - Robert Olaso
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry 91057, France
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry 91057, France
| | - Éric Conte
- U.S.R. 2003 (CNRS / UPF), Faa'a, Tahiti 98702, France
| | - Mojgan Karimi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Exposome and Heredity", Villejuif 94805, France
| | - Yan Ren
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Radiations Epidemiology", Villejuif 94805, France
| | - Constance Xhaard
- University of Lorraine, INSERM CIC 1433, Nancy CHRU, INSERM U1116, Nancy 54500, France
| | - Vincent Souchard
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Radiations Epidemiology", Villejuif 94805, France
| | - Jacques Gardon
- Hydrosciences Montpellier, Research Institute for Development, CNRS, University of Montpellier, Montpellier 62307, France
| | - Marc Taquet
- Research Institute for Development, Center IRD on Tahiti, Arue, Tahiti 98713, French Polynesia
| | - André Bouville
- National Cancer Institute (retired), Bethesda, MD 20892, USA
| | - Jean-François Deleuze
- Fondation Jean Dausset-Centre d'Etude du Polymorphisme Humain, Paris 75010, France
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry 91057, France
| | - Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, USA
| | | | - Jean-Baptiste Cazier
- Centre for Computational Biology, University of Birmingham, Birmingham B152TT, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B152TT, UK
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de Vathaire F, Zidane M, Xhaard C, Souchard V, Chevillard S, Ory C, Rachédi F, Nunez S, Leufroy A, Noël L, Guérin T, Shan L, Bost-Bezeaud F, Petitdier P, Soubiran G, Allodji R, Ren Y, Doyon F, Taquet M, Gardon J, Bouville A, Drozdovitch V. Assessment of Differentiated Thyroid Carcinomas in French Polynesia After Atmospheric Nuclear Tests Performed by France. JAMA Netw Open 2023; 6:e2311908. [PMID: 37145599 PMCID: PMC10163383 DOI: 10.1001/jamanetworkopen.2023.11908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Importance Due to the amount of iodine 131 released in nuclear tests and its active uptake by the thyroid, differentiated thyroid carcinoma (DTC) is the most serious health risk for the population living near sites of nuclear tests. Whether low doses to the thyroid from nuclear fallout are associated with increased risk of thyroid cancer remains a controversial issue in medicine and public health, and a misunderstanding of this issue may be associated with overdiagnosis of DTCs. Design, Setting, and Participants This case-control study was conducted by extending a case-control study published in 2010 that included DTCs diagnosed between 1984 and 2003 by adding DTCs diagnosed between 2004 and 2016 and improving the dose assessment methodology. Data on 41 atmospheric nuclear tests conducted by France between 1966 and 1974 in French Polynesia (FP) were assessed from original internal radiation-protection reports, which the French military declassified in 2013 and which included measurements in soil, air, water, milk, and food in all FP archipelagos. These original reports led to an upward reassessment of the nuclear fallout from the tests and a doubling of estimates of the mean thyroid radiation dose received by inhabitants from 2 mGy to nearly 5 mGy. Included patients were diagnosed from 1984 to 2016 with DTC at age 55 years or younger and were born in and resided in FP at diagnosis; 395 of 457 eligible cases were included, and up to 2 controls per case nearest by birthdate and matched on sex were identified from the FP birth registry. Data were analyzed from March 2019 through October 2021. Exposure The radiation dose to the thyroid gland was estimated using recently declassified original radiation-protection service reports, meteorological reports, self-reported lifestyle information, and group interviews of key informants and female individuals who had children at the time of these tests. Main Outcomes and Measures The lifetime risk of DTC based on Biological Effects of Ionizing Radiation (BEIR) VII models was estimated. Results A total of 395 DTC cases (336 females [85.1%]; mean [SD] age at end of follow-up, 43.6 [12.9] years) and 555 controls (473 females [85.2%]; mean [SD] age at end of follow-up, 42.3 [12.5] years) were included. No association was found between thyroid radiation dose received before age 15 years and risk of DTC (excess relative risk [ERR] per milligray, 0.04; 95% CI, -0.09 to 0.17; P = .27). When excluding unifocal noninvasive microcarcinomas, the dose response was significant (ERR per milligray, 0.09; 95% CI, -0.03 to 0.02; P = .02), but several incoherencies with the results of the initial study reduce the credibility of this result. The lifetime risk for the entire FP population was 29 cases of DTC (95% CI, 8-97 cases), or 2.3% (95% CI, 0.6%-7.7%) of 1524 sporadic DTC cases in this population. Conclusions and Relevance This case-control study found that French nuclear tests were associated with an increase in lifetime risk of PTC in FP residents of 29 cases of PTC. This finding suggests that the number of thyroid cancer cases and the true order of magnitude of health outcomes associated with these nuclear tests were small, which may reassure populations of this Pacific territory.
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Affiliation(s)
- Florent de Vathaire
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Monia Zidane
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Constance Xhaard
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
- Now with University of Lorraine, Institut National de la Santé et de la Recherche Médicale, CIC 1433, Nancy, Centre HospitalierRegional Universitaire, U1116, Nancy, France
| | - Vincent Souchard
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Sylvie Chevillard
- Laboratoire de recherche sur la Réparation et la Transcription dans les Cellules Souches Hématopoïétiques, Institut de Biologie François Jacob, Institut de Recherche en Cancérologie de Montpellier, Direction de la Recherche Fondamentale, Commissariat à l'Énergie Atomique, 92265 Fontenay-aux-Roses Cedex, France
| | - Catherine Ory
- Laboratoire de recherche sur la Réparation et la Transcription dans les Cellules Souches Hématopoïétiques, Institut de Biologie François Jacob, Institut de Recherche en Cancérologie de Montpellier, Direction de la Recherche Fondamentale, Commissariat à l'Énergie Atomique, 92265 Fontenay-aux-Roses Cedex, France
- University Paris-Saclay, 92265 Fontenay-aux-Roses Cedex, France
| | - Frédérique Rachédi
- Endocrinology Unit, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Sébastien Nunez
- Endocrinology Unit, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Axelle Leufroy
- Agence Nationale Sécurité Sanitaire Alimentaire Nationale, Laboratory for Food Safety, F94700 Maisons-Alfort, France
| | - Laurent Noël
- French Directorate General for Food, Ministry of Agriculture, Agro-16 Food and Forestry, Paris, France
| | - Thierry Guérin
- Agence Nationale Sécurité Sanitaire Alimentaire Nationale, Strategy and Programmes Department, Maisons-Alfort, France
| | - Larys Shan
- Private practice, Tahiti, French Polynesia
| | - Frédérique Bost-Bezeaud
- Laboratory of Anatomy and Cytopathology, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Patrice Petitdier
- Laboratory of Anatomy and Cytopathology, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Gilles Soubiran
- Endocrinology Unit, Centre Hospitalier Territorial, Tahiti, French Polynesia
| | - Rodrigue Allodji
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Yan Ren
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
- Gustave Roussy, Villejuif, France
- University Paris Saclay, Villejuif, France
| | - Françoise Doyon
- Radiation Epidemiology Team, Centre de Recherche en Epidémiologie en Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Unit 1018, Villejuif, France
| | - Marc Taquet
- Research Institute for Development, Arue, Tahiti, French Polynesia
| | - Jacques Gardon
- HydroSciences Montpellier, Univ Montpellier, Research Institute for Development, Centre National de la Recherche Scientifique, Montpellier, France
| | - André Bouville
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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Bouisset P, Nohl M, Cossonnet C, Boulet B, Thomas S, Cariou N, Salaun G. Contribution of close-in fallout from the French atmospheric tests in inventories of 137Cs, 241Am and plutonium (238, 239, 240) in Gambier Islands (French Polynesia) - Signatures of stratospheric fallout in the Southern Hemisphere. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2021; 235-236:106624. [PMID: 34059369 DOI: 10.1016/j.jenvrad.2021.106624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/10/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
The inventories of 137Cs (503 ± 34 Bq.m-2), 241Am (11.3 ± 1.2 Bq.m-2), 241Pu (33.7 ± 3.4 Bq.m-2), 238Pu (6.82 ± 0.87 Bq.m-2) and 239+240Pu (113.0 ± 5.9 Bq.m-2), sum of 239Pu (100 ± 11 Bq.m-2) and 240Pu (14.5 ± 1.7 Bq.m-2), in the Gambier archipelago (23°S) of the French Polynesia, are well higher the global fallout at this latitude, in unequal proportions for the different radionuclides. (240Pu/239Pu)AR (AR: atomic ratio) of 0.0394 ± 0.0062, and (241Pu/239Pu)AR of (2.03 ± 0.39)10-4, confirm that the overwhelmingly dominant source of these radionuclides comes from local fallout during the 1970s of the French atmospheric tests of Moruroa and Fangataufa located nearly 400 km from Gambier. The signatures of the local fallout were deduced from the excess of its inventory in 137Cs and from the mixing lines established from the signatures of the global fallout, some of the test sites and the isotopic ratios measured in Gambier. Signatures obtained are 2.0 ± 0.4 for 137Cs/239+240Pu, 0.045 ± 0.008 for 238Pu/239+240Pu, 0.031 ± 0.009 for 241Am/239+240Pu, 0.092 ± 0.027 for 241Pu/239+240Pu, 0.0163 ± 0.0049 for (240Pu/239Pu)AR, (0.78 ± 0.23)10-4 for (241Pu/239Pu)AR. The concordance of the mixing lines of the [(240Pu/239Pu)AR, (241Pu/239Pu)AR] and the linear regression of these ratios measured in the stratosphere (40°S) during the 1970s, indicates that the signatures of the close-in deposition are also those of the stratospheric injections of the French tests. The signatures of stratospheric fallout in the Southern Hemisphere were evaluated by considering that the fission energy of these injections represents 11% and that of the Northern Hemisphere represents 89% and that the isotopic ratios of stratospheric injections remained the same over the period 1970-1974. The activity ratios deducted are 21.9 ± 0.1 in 137Cs/239+240Pu, 0.11 ± 0.05 in 238Pu/239+240Pu, 1.03 ± 0.12 in 241Pu/239+240Pu and 0.35 ± 0.04 in 241Am/239+240Pu. The associated atom ratios are 0.157 ± 0.011 for (240Pu/239Pu)AR and (8.33 ± 0.48)10-4 for (241Pu/239Pu)AR. These signatures appear to be consistent with the results of the inventories at Hiva Oa, located more than 1,000 km north of both French test sites, and with those found in the Australian continent, in regions not impacted by UK-test debris. The proportions of close-in tropospheric fallout from the French tests are about 90% in Gambier. They represent a proportion in the inventories of 40% for the 137Cs, 60% for 241Am and in the range between 80 and 90% for Pu isotopes.
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Affiliation(s)
- P Bouisset
- Institut de Radioprotection et de Sûreté nucléaire, BP 182, 98725, Vairao, Tahiti, French Polynesia.
| | - M Nohl
- Institut de Radioprotection et de Sûreté nucléaire, BP 182, 98725, Vairao, Tahiti, French Polynesia
| | - C Cossonnet
- Institut de Radioprotection et de Sûreté nucléaire, Bât 501, bois des Rames, 91400, Orsay, France
| | - B Boulet
- Institut de Radioprotection et de Sûreté nucléaire, Bât 501, bois des Rames, 91400, Orsay, France
| | - S Thomas
- Institut de Radioprotection et de Sûreté nucléaire, Bât 501, bois des Rames, 91400, Orsay, France
| | - N Cariou
- Institut de Radioprotection et de Sûreté nucléaire, Bât 501, bois des Rames, 91400, Orsay, France
| | - G Salaun
- Institut de Radioprotection et de Sûreté nucléaire, Cadarache Bât 153, 13108, St Paul-lès-Durance, France
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Drozdovitch V, De Vathaire F, Bouville A. Radiological Impact of Atmospheric Nuclear Weapons Tests at Mururoa and Fangataufa Atolls to Populations in Oceania, South America and Africa: Comparison with French Polynesia. Asian Pac J Cancer Prev 2021; 22:801-809. [PMID: 33773544 PMCID: PMC8286683 DOI: 10.31557/apjcp.2021.22.3.801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Indexed: 11/26/2022] Open
Abstract
Objective: To evaluate the potential radiological impact of atmospheric nuclear weapons tests conducted in 1966-1974 at Mururoa and Fangataufa atolls on populations in Oceania, South America and Africa. Methods: Results of measurements of total beta(β)-concentrations in filtered air and 131I activity concentrations in locally produced cow’s milk in Oceania, South America and Africa after the tests were compared with those in French Polynesia. Radiation doses due to external irradiation and thyroid doses due to 131I intake with milk by local populations were also compared. Results: Higher total β-concentrations in filtered air, 131I activity concentrations in locally produced milk and radiation doses to local population were, in general, observed in French Polynesia than in other countries in the southern hemisphere. However, for specific years during the testing period, the radiological impact to South America was found to be similar or slightly higher than that to Tahiti. The resulting thyroid doses in the considered countries were lower than those in French Polynesia with two exceptions: thyroid doses due to 131I intake with cow’s milk for 1-y old child in 1968 were higher in Peru (0.35 mGy) and in Madagascar (0.30 mGy) than in Tahiti (0.25 mGy). However, the populations outside French Polynesia received doses lower than those from the natural sources of radiation. Conclusion: According to the current knowledge in radiation epidemiology, it is very unlikely that nuclear fallout due to French nuclear tests had a measurable radiological and health impact outside French Polynesia.
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Affiliation(s)
- Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Florent De Vathaire
- National Institute for Health and Medical Research, Center for Research in Epidemiology and Population Health (CESP), INSERM U1018 / Gustave Roussy, Radiation Epidemiology Group, Villejuif, France.,University Paris-Saclay, Villejuif, France
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Drozdovitch V, Bouville A, Taquet M, Gardon J, Tetuanui T, Xhaard C, Ren Y, Doyon F, de Vathaire F. Thyroid Doses to French Polynesians Resulting from Atmospheric Nuclear Weapons Tests: Estimates Based on Radiation Measurements and Population Lifestyle Data. HEALTH PHYSICS 2021; 120:34-55. [PMID: 33002966 PMCID: PMC7710602 DOI: 10.1097/hp.0000000000001262] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Thyroid doses were estimated for the subjects of a population-based case-control study of thyroid cancer in a population exposed to fallout after atmospheric nuclear weapons tests conducted in French Polynesia between 1966 and 1974. Thyroid doses due to (1) intake of I and of short-lived radioiodine isotopes (I, I, I) and Te, (2) external irradiation from gamma-emitting radionuclides deposited on the ground, and (3) ingestion of long-lived Cs with foodstuffs were reconstructed for each study subject. The dosimetry model that had been used in 2008 in Phase I of the study was substantially improved with (1) results of radiation monitoring of the environment and foodstuffs, which became available in 2013 for public access, and (2) historical data on population lifestyle related to the period of the tests, which were collected in 2016-2017 using focus-group discussions and key informant interviews. The mean thyroid dose among the study subjects was found to be around 5 mGy while the highest dose was estimated to be around 36 mGy. Doses from I intake ranged up to 27 mGy, while those from intake of short-lived iodine isotopes (I, I, I) and Te ranged up to 14 mGy. Thyroid doses from external exposure ranged up to 6 mGy, and those from internal exposure due to Cs ingestion did not exceed 1 mGy. Intake of I was found to be the main pathway for thyroid exposure accounting for 72% of the total dose. Results of this study are being used to evaluate the risk of thyroid cancer among the subjects of the epidemiologic study of thyroid cancer among French Polynesians.
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Affiliation(s)
- Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | | | - Marc Taquet
- Research Institute for Development, Center IRD on Tahiti, Arue, Tahiti, French Polynesia
| | - Jacques Gardon
- Hydrosciences Montpellier, Research Institute for Development, CNRS, University of Montpellier, Montpellier, France
| | - Tetuaura Tetuanui
- Research Institute for Development, Center IRD on Tahiti, Arue, Tahiti, French Polynesia
| | - Constance Xhaard
- National Institute for Health and Medical Research, Center for Research in Epidemiology and Population Health (CESP), INSERM U1018, Radiation Epidemiology Group, Villejuif, France
- Institute Gustave Roussy, Villejuif, France
- University Paris-Saclay, Villejuif, France
- Current affiliation: University of Lorraine, INSERM CIC 1433, Nancy CHRU, INSERM U1116, Nancy, France
| | - Yan Ren
- National Institute for Health and Medical Research, Center for Research in Epidemiology and Population Health (CESP), INSERM U1018, Radiation Epidemiology Group, Villejuif, France
- Institute Gustave Roussy, Villejuif, France
- University Paris-Saclay, Villejuif, France
| | - Françoise Doyon
- National Institute for Health and Medical Research, Center for Research in Epidemiology and Population Health (CESP), INSERM U1018, Radiation Epidemiology Group, Villejuif, France
- Institute Gustave Roussy, Villejuif, France
- University Paris-Saclay, Villejuif, France
| | - Florent de Vathaire
- National Institute for Health and Medical Research, Center for Research in Epidemiology and Population Health (CESP), INSERM U1018, Radiation Epidemiology Group, Villejuif, France
- Institute Gustave Roussy, Villejuif, France
- University Paris-Saclay, Villejuif, France
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