Abstract
Recent studies of children and adolescents who were exposed to radioactive iodine-131 (I-131) after the 1986 Chernobyl nuclear accident in Ukraine exhibited a significant dose-related increase in the risk of thyroid cancer, but the association of radiation doses with tumor histologic and morphologic features is not clear. A cohort of 11,664 individuals in Belarus who were aged ≤18 years at the time of the accident underwent 3 cycles of thyroid screening during 1997 to 2008. I-131 thyroid doses were estimated from individual thyroid activity measurements taken within 2 months after the accident and from dosimetric questionnaire data. Demographic, clinical, and tumor pathologic characteristics of the patients with thyroid cancer were analyzed using 1-way analysis of variance, chi-square tests or Fisher exact tests, and logistic regression. In total, 158 thyroid cancers were identified as a result of screening. The majority of patients had T1a and T1b tumors (93.7%), with many positive regional lymph nodes (N1; 60.6%) but few distant metastases (M1; <1%). Higher I-131 doses were associated with higher frequency of solid and diffuse sclerosing variants of thyroid cancer (P < .01) and histologic features of cancer aggressiveness, such as lymphatic vessel invasion, intrathyroidal infiltration, and multifocality (all P < .03). Latency was not correlated with radiation dose. Fifty-two patients with self-reported thyroid cancers which were diagnosed before 1997 were younger at the time of the accident and had a higher percentage of solid variant cancers compared with patients who had screening-detected thyroid cancers (all P < .0001). I-131 thyroid radiation doses were associated with a significantly greater frequency of solid and diffuse sclerosing variants of thyroid cancer and various features of tumor aggressiveness.
Highlights
The Chernobyl nuclear power plant accident in Ukraine on April 26, 1986 released large amounts of radiation, in particular radioactive iodines, into the atmosphere.[1]
We examined means and distributions of demographic, clinical, and pathologic characteristics across 3 groups of thyroid cancers diagnosed in the BelAm cohort and tested for statistically significant associations using 1-way analysis of variance for continuous variables and chi-square tests or Fisher exact tests for categorical variables
The International Pathology Panels (IPP) used pathology reports extracted from medical records to confirm thyroid cancer diagnoses for 52 of 56 thyroid cancers reported during interview at the initial screening
Summary
The Chernobyl nuclear power plant accident in Ukraine on April 26, 1986 released large amounts of radiation, in particular radioactive iodines, into the atmosphere.[1]. Recent studies of children and adolescents who were exposed to radioactive iodine-131 (I-131) after the 1986 Chernobyl nuclear accident in Ukraine exhibited a significant dose-related increase in the risk of thyroid cancer, but the association of radiation doses with tumor histologic and morphologic features is not clear. Higher I-131 doses were associated with higher frequency of solid and diffuse sclerosing variants of thyroid cancer (P
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