title: Cancer risks near nuclear facilities: the importance of research design and explicit study hypotheses.
abstract: BACKGROUND
  In April 2010, the U.S. Nuclear Regulatory Commission asked the National Academy of Sciences to update a 1990 study of cancer risks near nuclear facilities. Prior research on this topic has suffered from problems in hypothesis formulation and research design.
  
  
  OBJECTIVE
  We review epidemiologic principles used in studies of generic exposure-response associations and in studies of specific sources of exposure. We then describe logical problems with assumptions, formation of testable hypotheses, and interpretation of evidence in previous research on cancer risks near nuclear facilities.
  
  
  CONCLUSIONS
  Advancement of knowledge about cancer risks near nuclear facilities depends on testing specific hypotheses grounded in physical and biological mechanisms of exposure and susceptibility while considering sample size and ability to adequately quantify exposure, ascertain cancer cases, and evaluate plausible confounders.
  
  
  CONCLUSIONS
  Next steps in advancing knowledge about cancer risks near nuclear facilities require studies of childhood cancer incidence, focus on in utero and early childhood exposures, use of specific geographic information, and consideration of pathways for transport and uptake of radionuclides. Studies of cancer mortality among adults, cancers with long latencies, large geographic zones, and populations that reside at large distances from nuclear facilities are better suited for public relations than for scientific purposes.
authors.affiliation: Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina 27599-7435, USA. steve_wing@unc.edu
authors.forename: Steve
authors.initials: S
authors.lastname: Wing
authors.forename: David B
authors.initials: DB
authors.lastname: Richardson
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
mesh_terms: D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D015340:Epidemiologic Research Design; D006798:Housing; D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D055848:Nuclear Power Plants / Q000706:statistics & numerical data*