title: Solid cancer incidence in atomic bomb survivors exposed in utero or as young children.
abstract: BACKGROUND
  In utero exposure to radiation is known to increase risks of childhood cancers, and childhood exposure is associated with increased risks of adult-onset cancers. However, little is known about whether in utero exposure to radiation increases risks of adult-onset cancers.
  
  
  METHODS
  Solid cancer incidence rates were examined among survivors of the atomic bombings of Hiroshima and Nagasaki who were in utero (n = 2452) or younger than 6 years (n = 15388) at the time of the bombings. Poisson regression was used to estimate and compare the levels and temporal patterns of the radiation-associated excess risks of first primary solid cancers among these survivors at ages 12-55. All statistical tests were two-sided.
  
  
  RESULTS
  There were 94 eligible cancers in the in utero group and 649 in the early childhood group. The excess relative risk (ERR) increased with dose for both in utero (age 50, ERR = 1.0 per Sv, 95% confidence interval [CI] = 0.2 to 2.3 per Sv) and early childhood (age 50, ERR = 1.7 per Sv, 95% CI = 1.1 to 2.5 Sv) exposures. The ERR declined (P = .046) with increasing attained age in the combined cohort. Excess absolute rates (EARs) increased markedly with attained age among those exposed in early childhood but exhibited little change in the in utero group. At age 50, the estimated EARs per 10,000 person-years per Sv were 6.8 (95% CI = <0 to 49) for those exposed in utero and 56 (95% CI = 36 to 79) for those exposed as young children.
  
  
  CONCLUSIONS
  Both the in utero and early childhood groups exhibited statistically significant dose-related increases in incidence rates of solid cancers. The apparent difference in EARs between the two groups suggests that lifetime risks following in utero exposure may be considerably lower than for early childhood exposure, but further follow-up is needed.
authors.affiliation: Hirosoft International Corporation, 1335 H St, Eureka, CA 95501-2331, USA. preston@hirosoft.net
authors.forename: Dale L
authors.initials: DL
authors.lastname: Preston
authors.forename: Harry
authors.initials: H
authors.lastname: Cullings
authors.forename: Akihiko
authors.initials: A
authors.lastname: Suyama
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Funamoto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Nishi
authors.forename: Midori
authors.initials: M
authors.lastname: Soda
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Mabuchi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kodama
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Kasagi
authors.forename: Roy E
authors.initials: RE
authors.lastname: Shore
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005333:Fetus / Q000528:radiation effects*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D054043:Nuclear Weapons; D016017:Odds Ratio; D016012:Poisson Distribution; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D018401:Sample Size; D017741:Survivors / Q000706:statistics & numerical data*