title: Total cancer incidence in relation to 137Cs fallout in the most contaminated counties in Sweden after the Chernobyl nuclear power plant accident: a register-based study.
abstract: To determine the total cancer incidence in relation to a 5-year exposure to caesium-137 (137Cs) from the 1986 Chernobyl nuclear power plant accident.
  
  
  
  A closed cohort was defined as all individuals living in the three most contaminated counties in mid-Sweden in 1986. Fallout of137Cs was retrieved as a digital map from the Geological Survey of Sweden, demographic data from Statistics Sweden, and cancer diagnosis from the National Board of Health and Welfare. Individuals were assigned an annual137Cs exposure based on their place of residence (1986-1990), from which 5-year cumulative137Cs exposures were calculated, accounting for the physical decay of137Cs and changing residencies. HRs were adjusted for age, sex, rural/non-rural residence and pre-Chernobyl total cancer incidence.
  
  
  
  The 734 537 people identified were categorised by exposure: the first quartile was low exposure (0.0-45.4 kBq/m2), the second and third quartiles were intermediate exposure (45.41-118.8 kBq/m2), and the fourth quartile was the highest exposure (118.81-564.71 kBq/m2). Between 1991 and 2010, 82 495 cancer cases were registered in the 3 counties. Adjusted HRs (95% CI) were 1.03 (1.01 to 1.05) for intermediate exposure and 1.05 (1.03 to 1.07) for the highest exposure compared to the reference exposure.
  
  
  
  We found a small overall exposure-response pattern of the total cancer incidence related to137Cs after adjustment for age, sex, rural residence and pre-Chernobyl cancer incidence.
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: Hassan
authors.initials: H
authors.lastname: Alinaghizadeh
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: Robert
authors.initials: R
authors.lastname: Wålinder
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Vingård
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Tondel
mesh_terms: D002588:Cesium Radioisotopes / Q000009:adverse effects*; D047852:Chernobyl Nuclear Accident; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D055848:Nuclear Power Plants; D000069079:Radiation Exposure / Q000009:adverse effects* / Q000032:analysis; D013548:Sweden / Q000453:epidemiology
chemical_list: D002588:Cesium Radioisotopes; C000614989:Cesium-137
keywords: Cancer; Chernobyl; cesium; malignancy; nuclear accident; radiation