Title: Recent trends in the incidence, geographical distribution, and survival from thyroid cancer in Wales: 1985-2010.
Author: Amphlett B, Lawson Z, Abdulrahman GO, White C, Bailey R, Premawardhana L, Okosieme OE.
Reference: Thyroid. 2013 Mar 14. [Epub ahead of print]
Keywords:
Abstract: Abstract Background Previous studies of thyroid cancer incidence in Wales have given varying results with suggestions of an excess of cases in geographic areas that were previously exposed to the radioactive fallout from the 1986 Chernobyl nuclear reactor incident. Our objective in this study was to provide an up to date comprehensive analysis of time trends in the incidence, geographical distribution, and survival from thyroid cancer in Wales. Methods We identified thyroid cancer cases, registered from 1985 through 2010 in the Welsh Cancer Intelligence and Surveillance Unit (WCISU). Age standardised rates were determined from the European standard population. A Poisson regression model was fitted to assess temporal trends and rate ratios (RR) and 95% confidence intervals (CI) were determined and compared across consecutive time periods: 1985-1997 and 1998-2010. Standardised incidence ratios were calculated for each of the 22 local authority areas. Relative survival and Kaplan Meier curves were computed to analyse all cause and thyroid cancer-specific survival. Results A total of 1747 thyroid cancer cases were registered from 1985-2010. Age standardised incidence rates were 2.8 and 1.2 per 100,000 population per year for females and males, respectively. Incidence rates increased with time (rate ratio 1.3, 95% CI 1.2-1.5, p<0.001, 1998-2010 vs.1985-1997). The incidence of papillary cancer increased progressively over the study period (RR 2.22, 95% CI 1.91-2.57, p<0.001; 1998-2010 vs.1985-1997), while rates for other (non-papillary) histological subtypes remained static (RR 0.95, 95% CI 0.84-1.08, p=0.45; 1998-2010 vs.1985-1997). We identified two geographical areas of increased incidence but the spatial distribution of cases was inconsistent with exposure to radioactive fallout. Five-year relative survival from all-cause mortality improved from 74.2 (95% CI 66.8-80.1) in 1985-1989, to 82.6 (95% CI 77.1-86.9) in 2000-2004 but remained poor for patients >65 years (p<0.001, >65 yrs vs. 15-64 years) and patients with anaplastic thyroid cancer (p<0.001, anaplastic vs. other histological varieties). Conclusions The incidence of thyroid cancer has increased in Wales, predominantly due to an increase in papillary cancers. The current geographical distribution of cases does not support a radiation effect in the region. Survival has remained poor for patients aged >65 years and those with anaplastic carcinoma.
URL: http://www.ncbi.nlm.nih.gov/pubmed/23488941
Title: Chernobyl cleanup workers from Estonia: follow-up for cancer incidence and mortality.
Author: Rahu K, Auvinen A, Hakulinen T, Tekkel M, Inskip PD, Bromet EJ, Boice Jr JD, Rahu M.
Reference: J Radiol Prot. 2013 Mar 27;33(2):395-411. [Epub ahead of print]
doi:
Keywords: incidence, mortality, cleanup workers
Abstract: This study examined cancer incidence (1986-2008) and mortality (1986-2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. The cohort of 4810 men was followed through nationwide population, mortality and cancer registries. Cancer and death risks were measured by standardised incidence ratio (SIR) and standardised mortality ratio (SMR), respectively. Poisson regression was used to analyse the effects of year of arrival, duration of stay and time since return on cancer and death risks. The SIR for all cancers was 1.06 with 95% confidence interval 0.93-1.20 (232 cases). Elevated risks were found for cancers of the pharynx, the oesophagus and the joint category of alcohol-related sites. No clear evidence of an increased risk of thyroid cancer, leukaemia or radiation-related cancer sites combined was apparent. The SMR for all causes of death was 1.02 with 95% confidence interval 0.96-1.08 (1018 deaths). Excess mortality was observed for mouth and pharynx cancer, alcohol-related cancer sites together and suicide. Duration of stay rather than year of arrival was associated with increased mortality. Twenty-six years of follow-up of this cohort indicates no definite health effects attributable to radiation, but the elevated suicide risk has persisted.
URL: http://www.ncbi.nlm.nih.gov/pubmed/23532116
Title: Chernobyl-related thyroid cancer: what evidence for role of short-lived iodines?
Author: J P Bleuer, Y I Averkin, and T Abelin
Reference: Environ Health Perspect. 1997 December; 105(Suppl 6): 1483–1486.
doi:
Keywords:
Abstract: Over 500 cases of thyroid cancer were diagnosed in Belarus between 1986 and 1995 among persons exposed as children (under 15 years of age) to radioactive contamination from the Chernobyl nuclear accident. There is little doubt that radioactive iodine isotopes emitted during the nuclear explosion and subsequent fire were instrumental in causing malignancy in this particular organ. Comparison of the observed geographic distribution of Chernobyl-associated thyroid cancer incidence rates by districts with contamination maps of radioactive fallout shows a better fit for estimated 131I contamination than for 137Cs. Because 131I used for medical purposes had not been considered carcinogenic in humans in the past, and in view of the unusually short latency period between exposure and clinical manifestation of cancer, it is suspected that not only 131I but also energy-rich shorter-lived radioiodines may have played a role in post-Chernobyl thyroid carcinogenesis. Measurements of iodine isotopes are not available, but reconstruction of geographic distributions and estimations of radioactive fallout based on meteorological observations immediately following the accident could provide a basis for comparison with the distribution of thyroid cancer cases. In this paper, data from the Epidemiological Cancer Register for Belarus will be used to show geographic and time trends of thyroid cancer incidence rates in the period from 1986 to 1995 among persons who were exposed as children, and these will be compared with the estimated contamination by radioiodines. Tentative conclusions are drawn from the available evidence and further research requirements discussed.
URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1469926/
Title: Occult thyroid carcinomas in the region of Minsk, Belarus. An autopsy study of 215 patients.
Author: Furmanchuk AW, Roussak N, Ruchti C. Research Institute for Oncology and Medical Radiology, Minsk, Republic of Belarus.
Reference: Histopathology. 1993 Oct;23(4):319-25.
doi:
Keywords:
Abstract: Thyroid glands from 215 patients, aged 19 to 88 years, without known thyroid disease, were serially sectioned at 2-3 mm intervals and microscopically examined for occult disease. Glands were normal in 32.5%, while nodules were observed in 60% and adenomas in 13%. Carcinomas were found in 20 cases (9.3%): occult papillary carcinomas in 19 (8.8%) and one medullary carcinoma. No carcinomas were found in the thyroids of 15 patients less than 40 years of age. There were no significant differences in frequency of occult carcinomas between female and male patients and, for patients over 40 years, with increasing age. Of the 19 papillary tumours more than one focus was found in six cases (a total of 28 foci). The diameter of 27 of these tumours was less than or equal to 5 mm (96.4%), with one exception (diameter 6.3 mm). These findings were compared with those obtained in 86 thyroid glands of children surgically resected for carcinomas between 1986 and 1991. Only 10 of these tumours (11.6%) were less than or equal to 1 cm. These tumours, however, were significantly larger than the occult papillary carcinomas and their morphological features were quite different. Our results are discussed with regard to the possible role of factors other than irradiation due to the nuclear accident at Chernobyl, and the observed sharp numerical increase of thyroid carcinomas in children of the Republic of Belarus after this event.
URL: http://www.ncbi.nlm.nih.gov/pubmed/8300067
Title: Childhood thyroid diseases around Chernobyl evaluated by ultrasound examination and fine needle aspiration cytology.
Author: Ito M, Yamashita S, Ashizawa K, Namba H, Hoshi M, Shibata Y, Sekine I, Nagataki S, Shigematsu I. Department of Pathology, Nagasaki University School of Medicine, Japan.
Reference: Thyroid. 1995 Oct;5(5):365-8.
doi:
Keywords:
Abstract: Screening by ultrasound examination and fine-needle aspiration cytological biopsy (FNA) was conducted in five regions in Belarus, Ukraine, and Russia to investigate the prevalence of childhood thyroid diseases around Chernobyl. Gomel, Zhitomir, Kiev, and the western area of Bryansk are the administrative regions where severe radioactive contamination occurred. The subjects from Mogilev, where contamination was relatively low, served as controls. Among 55,054 subjects (26,406 boys and 28,648 girls), the prevalence of ultrasonographic thyroid abnormalities such as nodule, cyst, and abnormal echogenity was significantly higher in the regions with severe contamination than in Mogilev. Of the 1,396 children showing echographic thyroid abnormalities 197 were selected for FNA, and a sample was successfully obtained for diagnosis from 171 (51 boys and 120 girls) of the 197 subjects. The aspirate was insufficient for diagnosis in the remaining 26 subjects. Thyroid cancer was encountered in four children (2.3%) from the contaminated regions, two children being from Gomel. The other thyroid diseases were follicular neoplasm, 6.4%; adenomatous goiter, 18.7%; chronic thyroiditis, 31.0%; and cyst, 24.0%, suggesting that a major cause of thyroid nodularity is nonneoplastic changes, mainly chronic thyroiditis and cysts. These results will serve as an important data base for further analyses and suggest that childhood thyroid diseases, including both neoplasms and immunological disorders, are consequences of radioactive fallout.
URL: http://www.ncbi.nlm.nih.gov/pubmed/8563473
Title: Pediatric thyroid cancer after the Chernobyl disaster. Pathomorphologic study of 84 cases (1991-1992) from the Republic of Belarus.
Author: Nikiforov Y, Gnepp DR.
Reference: Cancer. 1994 Jul 15;74(2):748-66.
doi:
Keywords:
Abstract: Post-Chernobyl pediatric thyroid carcinoma is characterized by a short latency, a higher proportion of tumors arising in young children, and an almost equal sex ratio. Microscopically, these tumors were usually aggressive, often demonstrating intraglandular tumor dissemination (92%), thyroid capsular and adjacent soft tissue invasion (89%), and cervical lymph node metastases (88%). Papillary carcinoma was diagnosed in 99% of cases, with an unusually high frequency of solid growth patterns. Morphologic changes in nonneoplastic thyroid tissue were present in 90% of the glands, and the most specific findings were vascular changes and perifollicular fibrosis.
URL: http://www.ncbi.nlm.nih.gov/pubmed/8033057
Title: Nuclear weapon and Chernobyl debris in the troposphere and lower stratosphere
Author: Ludwika Kownacka, Zbigniew Jaworowski
Reference: Science of The Total Environment, Volume 144, Issues 1–3, 29 April 1994, Pages 201-215
DOI: http://dx.doi.org/10.1016/0048-9697(94)90439-1
Keywords: Radionuclides; Troposphere; Stratosphere; Nuclear tests; Chernobyl
Abstract: High altitude aircraft sampling of aerosols has been carried out at 4–7 levels up to 15 km over Poland. From 1973 to 1991 a total of 102 vertical concentration profiles of 90Sr, 134Cs and 137Cs, and 83 profiles of 144Ce were determined. One year after the sub-megaton nuclear test in 1980, 137Cs was almost completely removed from the stratosphere. The Chernobyl debris was found in the stratosphere from the third day after the accident until the end of 1991. In May 1986 the concentration of 134Cs and 137Cs at stratospheric altitudes reached about 0.5% of that between the ground level and 3 km. Residence times of Chernobyl radiocesium in the lower stratosphere systematically increased between 1987 and 1991, in variance with those of the debris from nuclear tests. The vertical concentration profiles and the long residence times of radiocesium indicate that the non-violent meteorological processes were transporting the Chernobyl debris into the lower stratosphere, immediately and long after the accident. We postulate that the same quiescent processes transport vast amounts of resuspended particulate organics from the surface of land and sea into high altitudes, and may thus bear on the chemistry of the stratosphere.
URL: http://www.sciencedirect.com/science/article/pii/0048969794904391
Title: Radioactivity measurements in air over Europe after the Chernobyl accident
Author: Frank Raes, Giovanni Graziani, David Stanners, Franco Girardi
Reference: Atmospheric Environment. Part A. General Topics, Volume 24, Issue 4, 1990, Pages 909-916
DOI: http://dx.doi.org/10.1016/0960-1686(90)90293-V
Keywords: Chernobyl; air concentrations; LRT; Cs-134/Cs-137
Abstract: A comprehensive European data set of radioactivity in air caused by the accident at the Chernobyl nuclear power plant is presented. For the first 2 weeks after the beginning of the release, levels of particulate I-131, Cs-134 and Cs-137 (85 locations) and of total I-131 (10 locations) are given. All data are stored in a computerized data base. For the first time the passage of the Chernobyl cloud over Europe is mapped after re-averaging the time histories in each location to produce coherent daily concentrations. Cs-134/Cs-137 ratios were analyzed: the ‘European’ average ratio calculated from 1239 samples is 0.55, with a standard deviation of 0.25.
URL: http://www.sciencedirect.com/science/article/pii/096016869090293V
Title: Radiocesium in muscle tissue of reindeer and pike from northern Sweden before and after the Chernobyl accident. A retrospective study on tissue samples from the Swedish Environmental Specimen Bank
Author: Sevald Forberg, Tjelvar Odsjö, Mats Olsson
Reference: Science of The Total Environment, Volume 115, Issue 3, 30 April 1992, Pages 179-189
DOI: http://dx.doi.org/10.1016/0048-9697(92)90328-P
Keywords: radiocesium; reindeer; pike; Chernobyl; environmental specimen bank
Abstract: After the Chernobyl accident in April 1986, considerable deposition of radionuclides occurred regionally in eastern, central and northwestern Sweden. Locally, the fallout of radiocesium exceeded the remainder from atmospheric nuclear weapons tests by several magnitudes. Since the end of the 1960s samples of organs from various plant and animal species, annually collected at different localities, have been preserved in the Swedish Environmental Specimen Bank (ESB). In this work samples from the ESB have been used for retrospective studies of radioactive pollution. The activities of Cs-134 and Cs-137 in muscle tissues from reindeer, Rangifer tarandus, and pike, Esox lucius, preserved in the ESB, were measured. The samples were collected annually; the reindeer at three localities in northern Sweden and the pike at one of them. In material collected prior to the Chernobyl accident, the levels of Cs-137 were 57–180 Bq/kg in reindeer and 14–24 Bq/kg in pike, fresh weight basis. These levels relate to earlier nuclear bomb tests. A significant decrease was found in pike during the pre-Chernobyl period (1971–1986). In post-Chernobyl samples the burden of Cs-137 varied from amounts equal to the former levels in the northernmost locality and up to 80 times higher for the maximum values in the southernmost locality. The highest value recorded was 18 425 Bq/kg in reindeer. The geographic variations in reindeer from Chernobyl fallout were in accordance with the pattern of deposition estimated by aircraft surveys performed in May 1986. The ratio between ‘new’ and ‘old’ radiocesium burdens in pike, caught in 1987, approached the corresponding ratio for reindeer grazing in the precipitation area of the lake; 33 and 19, respectively.
URL: http://www.sciencedirect.com/science/article/pii/004896979290328P
Title: Rural areas affected by the Chernobyl accident: Radiation exposure and remediation strategies
Author: P. Jacob, S. Fesenko, I. Bogdevitch, V. Kashparov, N. Sanzharova, N. Grebenshikova, N. Isamov, N. Lazarev, A. Panov, A. Ulanovsky, Y. Zhuchenko, M. Zhurba
Reference: Science of The Total Environment, Volume 408, Issue 1, 15 December 2009, Pages 14-25
DOI: http://dx.doi.org/10.1016/j.scitotenv.2009.09.006
Keywords: Caesium; Chernobyl; Ionizing radiation; Rehabilitation; Remediation
Abstract: Main objectives of the present work were to develop an internationally agreed methodology for deriving optimized remediation strategies in rural areas that are still affected by the Chernobyl accident, and to give an overview of the radiological situation in the three affected countries, Belarus, Russia and Ukraine. Study settlements were defined by having in 2004 less than 10,000 inhabitants and official dose estimates exceeding 1 mSv. Data on population, current farming practices, contamination of soils and foodstuffs, and remedial actions previously applied were collected for each of such 541 study settlements. Calculations of the annual effective dose from internal radiation were validated with extensive data sets on whole body counter measurements. According to our calculations for 2004, in 290 of the study settlements the effective dose exceeded 1 mSv, and the collective dose in these settlements amounted to about 66 person-Sv. Six remedial actions were considered: radical improvement of grassland, application of ferrocyn to cows, feeding pigs with uncontaminated fodder before slaughter, application of mineral fertilizers for potato fields, information campaign on contaminated forest produce, and replacement of contaminated soil in populated areas by uncontaminated soil.
URL: http://www.sciencedirect.com/science/article/pii/S004896970900850X
