ПОКАЗАТЕЛИ ЗАБОЛЕВАЕМОСТИ ЗЛОКАЧЕСТВЕННЫМИ НОВООБРАЗОВАНИЯМИ ЖЕНСКИХ ПОЛОВЫХ ОРГАНОВ В КОГОРТЕ ЖЕНЩИН, ПОДВЕРГШИХСЯ ПРОФЕССИОНАЛЬНОМУ ОБЛУЧЕНИЮ

Abstract

Purpose: To assess the association of incidence rates of malignant neoplasms of female genital organs (MNs of FGO) in women who were chronically occupationally exposed to ionizing radiation (IR) with radiation and non-radiation factors. Material and methods: To perform the study, the cohort of females employed at the Mayak PA during 1948–1982 and followed up until 31 December 2018 was considered. All members of the considered cohort were chronically exposed to IR. Results: 83.6 % of females were first diagnosed with a MN of FGO at age after 50 years. More than 50 % of MNs of FGO were reported during 1991–2010. Standardized rates of MNs FGO varied with the calendar period with the highest rates observed during 1996–2005. The analysis of the variation of the standardized rates with time demonstrated a significant tendency to increase by the end of the follow-up (R²=0.67, p=0.03). The incidence rates of MNs of FGO on average increased annually by 1.0 % (95 % CI 0.3–1.6). The standardized rates of MNs of FGO were significantly higher in females who had been diagnosed with endometriosis prior to MNs of FGO. The standardized rates of MNs of FGO were significantly higher in females externally exposed to gamma-rays at uterus absorbed dose of 0.2–0.5 Gy and above 0.5 Gy compared to females who had been exposed at lower doses. MNs of the uterine body were the most common among total MNs of FGO. More than 90 % of MNs of the uterine body were registered during menopause. The standardized rate of MNs of the uterine body in females of the study cohort was 0.37 ± 0.05. The decrease in the standardized rate of the MNs of the uterine body was observed in 1986–1995 calendar period. The spline regression analysis of the variation of the standardized rate of MNs of the uterine body demonstrated the annual increment by 0.9 % (95 % CI 0.7–2.5) on average. The analysis demonstrated a tendency of the standardized rate of MNs of the uterine body to increase in the study cohort of females (R²=0.46, p=0.16). The standardized rates of MNs of the uterine body were significantly higher in females who had been diagnosed with endometriosis prior to MNs of the uterine body. Standardized rates of MNs of the uterine body were significantly higher in females externally exposed to gamma rays at the cumulative uterus absorbed dose above 0.5 Gy compared to females exposed at lower doses. Conclusion: MNs of FGO were associated with both known non-radiation factors (age, calendar period, endometriosis) and the cumulative uterus absorbed dose from chronic occupational exposure to ionizing radiation.