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Thyroid Cancer after Childhood Exposure to External Radiation: An Updated Pooled Analysis of 12 Studies
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2016 (English)In: Radiation Research, ISSN 0033-7587, E-ISSN 1938-5404, Vol. 185, no 5, 473-484 p.Article in journal (Refereed) PublishedText
Abstract [en]

Studies have causally linked external thyroid radiation exposure in childhood with thyroid cancer. In 1995, investigators conducted relative risk analyses of pooled data from seven epidemiologic studies. Doses were mostly <10 Gy, although childhood cancer therapies can result in thyroid doses >50 Gy. We pooled data from 12 studies of thyroid cancer patients who were exposed to radiation in childhood (ages <20 years), more than doubling the data, including 1,070 (927 exposed) thyroid cancers and 5.3 million (3.4 million exposed) person-years. Relative risks increased supralinearly through 2-4 Gy, leveled off between 10-30 Gy and declined thereafter, remaining significantly elevated above 50 Gy. There was a significant relative risk trend for doses <0.10 Gy (P < 0.01), with no departure from linearity (P = 0.36). We observed radiogenic effects for both papillary and nonpapillary tumors. Estimates of excess relative risk per Gy (ERR/Gy) were homogeneous by sex (P = 0.35) and number of radiation treatments (P = 0.84) and increased with decreasing age at the time of exposure. The ERR/Gy estimate was significant within ten years of radiation exposure, 2.76 (95% CI, 0.94-4.98), based on 42 exposed cases, and remained elevated 50 years and more after exposure. Finally, exposure to chemotherapy was significantly associated with thyroid cancer, with results supporting a nonsynergistic (additive) association with radiation.

Place, publisher, year, edition, pages
2016. Vol. 185, no 5, 473-484 p.
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Radiology, Nuclear Medicine and Medical Imaging Cancer and Oncology
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URN: urn:nbn:se:umu:diva-122578DOI: 10.1667/RR14213.1ISI: 000376755000004PubMedID: 27128740OAI: oai:DiVA.org:umu-122578DiVA: diva2:939992
Available from: 2016-06-20 Created: 2016-06-20 Last updated: 2016-06-20Bibliographically approved

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