4.7 Article

Examining temporal effects on cancer risk in the international nuclear workers' study

期刊

INTERNATIONAL JOURNAL OF CANCER
卷 140, 期 6, 页码 1260-1269

出版社

WILEY
DOI: 10.1002/ijc.30544

关键词

cancer; epidemiology; longitudinal studies; dose-response; mortality studies

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资金

  1. National Institute for Occupational Safety and Health, The United States (U.S.) Department of Energy
  2. U.S. Department of Health and Human Services, University of North Carolina from the National Institute for Occupational Safety and Health [R03.OH-010056]
  3. Ministry of Health, Labour and Welfare of Japan

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The paper continues the series of publications from the International Nuclear Workers Study cohort that comprises 308,297 workers from France, the United Kingdom and the United States, providing 8.2 million person-years of observation from a combined follow-up period (at earliest 1944 to at latest 2005). These workers' external radiation exposures were primarily to photons, resulting in an estimated average career absorbed dose to the colon of 17.4 milligray. The association between cumulative ionizing radiation dose and cancer mortality was evaluated in general relative risk models that describe modification of the excess relative risk (ERR) per gray (Gy) by time since exposure and age at exposure. Methods analogous to a nested-case control study using conditional logistic regression of sampled risks sets were used. Outcomes included: all solid cancers, lung cancer, leukemias excluding chronic lymphocytic, acute myeloid leukemia, chronic myeloid leukemia, multiple myeloma, Hodgkin lymphoma and non-Hodgkin lymphoma. Significant risk heterogeneity was evident in chronic myeloid leukemia with time since exposure, where we observed increased ERR per Gy estimates shortly after exposure (2-10 year) and again later (20-30 years). We observed delayed effects for acute myeloid leukemia although estimates were not statistically significant. Solid cancer excess risk was restricted to exposure at age 351 years and also diminished for exposure 30 years prior to attained age. Persistent or late effects suggest additional follow-up may inform on lifetime risks. However, cautious interpretation of results is needed due to analytical limitations and a lack of confirmatory results from other studies.

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