Risk of thyroid cancer after exposure to 131I in childhood.
BACKGROUND
After the Chernobyl nuclear power plant accident in April 1986, a large increase in the incidence of childhood thyroid cancer was reported in contaminated areas. Most of the radiation exposure to the thyroid was from iodine isotopes, especially 131I. We carried out a population-based case-control study of thyroid cancer in Belarus and the Russian Federation to evaluate the risk of thyroid cancer after exposure to radioactive iodine in childhood and to investigate environmental and host factors that may modify this risk.


METHODS
We studied 276 case patients with thyroid cancer through 1998 and 1300 matched control subjects, all aged younger than 15 years at the time of the accident. Individual doses were estimated for each subject based on their whereabouts and dietary habits at the time of the accident and in following days, weeks, and years; their likely stable iodine status at the time of the accident was also evaluated. Data were analyzed by conditional logistic regression using several different models. All statistical tests were two-sided.


RESULTS
A strong dose-response relationship was observed between radiation dose to the thyroid received in childhood and thyroid cancer risk (P<.001). For a dose of 1 Gy, the estimated odds ratio of thyroid cancer varied from 5.5 (95% confidence interval [CI] = 3.1 to 9.5) to 8.4 (95% CI = 4.1 to 17.3), depending on the risk model. A linear dose-response relationship was observed up to 1.5-2 Gy. The risk of radiation-related thyroid cancer was three times higher in iodine-deficient areas (relative risk [RR]= 3.2, 95% CI = 1.9 to 5.5) than elsewhere. Administration of potassium iodide as a dietary supplement reduced this risk of radiation-related thyroid cancer by a factor of 3 (RR = 0.34, 95% CI = 0.1 to 0.9, for consumption of potassium iodide versus no consumption).


CONCLUSIONS
Exposure to (131)I in childhood is associated with an increased risk of thyroid cancer. Both iodine deficiency and iodine supplementation appear to modify this risk. These results have important public health implications: stable iodine supplementation in iodine-deficient populations may substantially reduce the risk of thyroid cancer related to radioactive iodines in case of exposure to radioactive iodines in childhood that may occur after radiation accidents or during medical diagnostic and therapeutic procedures.
Cardis
Elisabeth
E
International Agency for Research on Cancer, Lyon, France. cardis@iarc.fr
Kesminiene
Ausrele
A
Ivanov
Victor
V
Malakhova
Irina
I
Shibata
Yoshisada
Y
Khrouch
Valeryi
V
Drozdovitch
Vladimir
V
Maceika
Evaldas
E
Zvonova
Irina
I
Vlassov
Oleg
O
Bouville
André
A
Goulko
Guennadi
G
Hoshi
Masaharu
M
Abrosimov
Alexander
A
Anoshko
Jadvyga
J
Astakhova
Larisa
L
Chekin
Sergey
S
Demidchik
Evgenyi
E
Galanti
Rosaria
R
Ito
Masahiro
M
Korobova
Elena
E
Lushnikov
Evgenyi
E
Maksioutov
Marat
M
Masyakin
Vladimir
V
Nerovnia
Alexander
A
Parshin
Vladimir
V
Parshkov
Evgenyi
E
Piliptsevich
Nikolay
N
Pinchera
Aldo
A
Polyakov
Semyon
S
Shabeka
Nina
N
Suonio
Eero
E
Tenet
Vanessa
V
Tsyb
Anatoli
A
Yamashita
Shunichi
S
Williams
Dillwyn
D
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D047852:Chernobyl Nuclear Accident; D002648:Child; D002675:Child, Preschool; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D015994:Incidence; D007455:Iodine / Q000172:deficiency*; D007457:Iodine Radioisotopes / Q000009:adverse effects*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D016017:Odds Ratio; D011193:Potassium Iodide / Q000008:administration & dosage; D002094:Republic of Belarus / Q000453:epidemiology; D018570:Risk Assessment; D012426:Russia / Q000453:epidemiology; D013961:Thyroid Gland / Q000528:radiation effects*; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
D007457:Iodine Radioisotopes; D011193:Potassium Iodide; D007455:Iodine