solid cancer and thyroid cancer

FGI FGI –– Kiev 6th Kiev 6th October October 2004 2004

FrenchFrench--GermanGerman Initiative Initiative -- HealthHealth ProjectProject

SOLID CANCER AND THYROID CANCER IN SOLID CANCER AND THYROID CANCER IN CONTAMINATED TERRITORIES OF RUSSIACONTAMINATED TERRITORIES OF RUSSIA

Ivanov V.K., Maksioutov M.A., Korelo A.M., Gorsky A.I., Bronsart von Schellendorff E.V., Birjukov A.P., Kruglova Z.G.,

Kochergina E.V., Vlasov O.K., Tirmarche M., Becker S.I., Valenty M.


Project 3Health Effects of the Chernobyl AccidentHealth Effects of the Chernobyl Accident

SUB-PROJECT 3.1.3.S

THYROID CANCER IN ADOLESCENTS AND ADULTS IN THYROID CANCER IN ADOLESCENTS AND ADULTS IN THE MOST AFFECTED TERRITORIES OF RUSSIA THE MOST AFFECTED TERRITORIES OF RUSSIA

AFTER THE CHERNOBYL ACCIDENTAFTER THE CHERNOBYL ACCIDENT

AIMS OF AIMS OF THETHE SUBPROJECTSUBPROJECT

• reconstruction of thyroid cancer incidence rates in adolescents and adults in the Bryansk and Orel oblasts of Russia; study period: 1982-1999;

• support of registration activities for thyroid cancer in the affected regions and evaluation of the validity of collected data;

• descriptive analysis of the collected data (geographical comparisons, time trend analysis, characteristics on a raion level);

• preparation of progress and final reports and scientific publication.

AVERAGE VALUES (kBq/m2) OF CONTAMINATION WITH 131I

BRYANSK oblast

OREL oblast

AVERAGE VALUES (kBq/m2) OF CONTAMINATION WITH 131I

NUMBER OF REGISTERED IN 1982-1999 THYROID CANCER CASES IN BRYANSK & OREL OBLASTS.

2 5381 0401 498TOTAL

21678951272FEMALE

371145226MALE

TOTALORELBRYANSKREGION

SEX

THYROID CANCER INCIDENCE RATES THYROID CANCER INCIDENCE RATES AS A FUNCTION OF AGE AT DIAGNOSISAS A FUNCTION OF AGE AT DIAGNOSIS

Male

0.0

2.0

4.0

6.0

8.0

10.0

1982 1984 1986 1988 1990 1992 1994 1996 1998

Year

Rat

epe

r100

000

15-2930-4950+

THYROID CANCER INCIDENCE RATES THYROID CANCER INCIDENCE RATES AS A FUNCTION OF AGE AT DIAGNOSISAS A FUNCTION OF AGE AT DIAGNOSIS

Female

0.0

5.0

10.0

15.0

20.0

25.0

30.0

1982 1984 1986 1988 1990 1992 1994 1996 1998

Year

Rat

epe

r100

000

15-2930-4950+

BRYANSK oblast

STANDARDIZED INCIDENCE RATES (PER 100 000) OF THYROID CANCER

1982-1991FEMALE

BRYANSK oblast

STANDARDIZED INCIDENCE RATES (PER 100 000) OF THYROID CANCER

1992-1999FEMALE

The levels of Iodine -131 contamination The levels of stable Iodine in soils

RAIONS INCLUDED IN ANALYSIS

COMBINED MAP

<0.010.05<0.01

<0.01<0.010.460.08<0.01<0.0192-99

0.120.650.10

<0.010.400.940.68<0.010.6782-91

FemaleMaleBothSex

Period

P-VALUES OF TESTING OF NULL HYPOTHESIS -RELATIVE RISK IS 1

RISK ESTIMATION FOR THE ADOLESCENTS AND RISK ESTIMATION FOR THE ADOLESCENTS AND ADULTS (AT THE TIME OF ACCIDENT) ADULTS (AT THE TIME OF ACCIDENT)

0.74-2.32, 5.20

-1.96-3.89,2.32

2.92-2.75, 12.79

15.91-0.26, 45.4ERR

485 610185 449146 142154 019Size of population

114553920CasesMales

-0.92-2.35, 0.76

-2.42-4.15,-0.23

3.06-0.70, 7.8

5.810.63, 12.5ERR

553 592260 147139 915153 529Size of population

655287215153CasesFemales

15-69>4530-4415-29Age at exposure

BRYANSK OBLASTSBRYANSK OBLASTS


Project 3Health Effects of the Chernobyl AccidentHealth Effects of the Chernobyl Accident

SUB-PROJECT 3.1.3. SOLID CANCER INCIDENCE AMONG THE POPULATION SOLID CANCER INCIDENCE AMONG THE POPULATION OF THE MOST HIGHLY CONTAMINATED TERRITORIES OF THE MOST HIGHLY CONTAMINATED TERRITORIES

OF RUSSIAOF RUSSIA


TARGETS OF THE ACTIVITIESTARGETS OF THE ACTIVITIES

• collection of data on solid cancer incidence rates in the population of the most contaminated areas of Bryansk and Kaluga oblasts of Russia; study period: 1980-1998;

• epidemiological analysis of the collected data;

• radiation risk assessment;

• preparation of progress and final reports in co-operation with Western partners.

3.988.4<200 Control

22.9222.6>400 Highly contaminated

mean effective dose, mSv

mean annual population, x103

137Cs,kBq/m2

STUDY AREASTUDY AREA

3018181761 055Control

7771 5794182 287Highly contaminated

BreastLungColonStomachCANCER CASES OVER ENTIRE STUDY PERIOD 1980CANCER CASES OVER ENTIRE STUDY PERIOD 1980--19981998

STOMACH CANCER INCIDENCE RATESSTOMACH CANCER INCIDENCE RATES

0

20

40

60

80

100

120

140

160

180

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Rat

es p

er 1

00 0

00

Crude rate - highly contaminated rayonsStandardised rate - highly contaminated rayonsCrude rate - control rayonsStandardised rate - control rayons

LUNG CANCER INCIDENCE RATESLUNG CANCER INCIDENCE RATES

0

20

40

60

80

100

120

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Rat

espe

r100

000


COLON CANCER INCIDENCE RATESCOLON CANCER INCIDENCE RATES

0

10

20

30

40

50

60

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Rat

es p

er 1

00 0

00


FEMALE BREAST CANCER INCIDENCE RATESFEMALE BREAST CANCER INCIDENCE RATES

0

20

40

60

80

100

120

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Rat

es p

er 1

00 0

00


STOMACH CANCER AGESTOMACH CANCER AGE--SPECIFIC INCIDENCE SPECIFIC INCIDENCE RATES OVER PERIOD 1986RATES OVER PERIOD 1986--19981998

0

50

100

150

200

250

300

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70-Age at diagnosis

Rat

es p

er 1

00 0

00

highly contaminated rayonscontrol rayons

LUNG CANCER AGELUNG CANCER AGE--SPECIFIC INCIDENCE SPECIFIC INCIDENCE RATES OVER PERIOD 1986RATES OVER PERIOD 1986--19981998

0

50

100

150

200

250

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70-Age at diagnosis

Rat

es p

er 1

00 0

00


COLON CANCER AGECOLON CANCER AGE--SPECIFIC INCIDENCE SPECIFIC INCIDENCE RATES OVER PERIOD 1986RATES OVER PERIOD 1986--19981998

0

10

20

30

40

50

60

70

80

90

100

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70-Age at diagnosis

Rat

es p

er 1

00 0

00


FEMALE BREAST CANCER AGEFEMALE BREAST CANCER AGE--SPECIFIC SPECIFIC INCIDENCE RATES OVER PERIOD 1986INCIDENCE RATES OVER PERIOD 1986--19981998

0

20

40

60

80

100

120

140

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70-

Age at diagnosis

Rat

es p

er 1

00 0

00

highly contaminated rayons control rayons

1.000.85,1.18

1.060.91,1.241.0Relative risk

90%CI

160205254CasesSTOMACH CANCER

0.980.82,1.16

1.12 0.96,1.321.0Relative risk

90%CI

142197231CasesLUNG CANCER

384 969465 922612 898Person*Years44.120.311.3Mean dose, mSv

27-50 mSv12-27 mSv0-12 mSv

ESTIMATES OF RISK MODEL PARAMETERS ESTIMATES OF RISK MODEL PARAMETERS USING USING EPICUREEPICURE

202 541243 706319 300Person*Years

384 969465 922612 898Person*Years

0.570.44,0.73

0.68 0.54,0.851.0Relative risk

90%CI

5681156Cases

BREAST CANCER

0.780.53,1.10

0.800.68,1.121.0Relative risk

90%CI

413964Cases

COLON CANCER44.120.311.3Mean dose, mSv

27-50 mSv12-27 mSv0-12 mSv

ESTIMATES OF RISK MODEL PARAMETERS ESTIMATES OF RISK MODEL PARAMETERS USING USING EPICUREEPICURE


•Growth of thyroid cancer incidence in all age groups under study (15-29, 40-49, 50+ years old) regardless of sex has been found.

•Statistical analysis of relationship between thyroid cancer incidence and the level of soil contamination with 131I as well as the content of stable iodine in soil showed that effects of iodine deficiency and radiocontamination were statistically significant in the period from 1992 to 1999.

•The radiation risk of thyroid cancer for the adolescents and adults of the Bryansk region in the observation period 1991–1998 has not been confirmed.

CONCLUSIONSCONCLUSIONS


•No dramatic increase of solid cancer incidence over timeoccurred in the study regions either before 1986 or between1986 and 1998.

•No statistically significant excess of different types of solid cancer incidence was found relative to controls during 1991-1998 in the population of the most contaminated areas of Russia.

•Stomach, colon, lung and breast cancer cases associated with possible radiation-induced cancer in the contaminated areas of the Bryansk oblast are comparable with the value of stochastic fluctuations.

CONCLUSIONS

solid cancer and thyroid cancer

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