Abstract
BackgroundTwenty years after the nuclear accident in Chernobyl (Eastern Europe), there is still a controversial debate concerning a possible effect of the radioactive iodines, especially I-131, on the increase of thyroid carcinomas (TCs) in Western Europe. Time trends in incidence rates of TC in Luxembourg in comparison with other European countries and its descriptive epidemiology were investigated.MethodsThe population-based data of the national Morphologic Tumour Registry collecting new thyroid cancers diagnosed between 1983 and 1999 at a nation-wide level in the central division of pathology were reviewed and focused on incidence rates of TC. Data from 1990 to 1999 were used to evaluate the distribution by gender, age, histological type, tumour size and the outcome.ResultsOut of 310 new thyroid carcinomas diagnosed between 1990 and 1999, 304 differentiated carcinomas (A: 80% papillary; B: 14.5% follicular; C: 3.5% medullary) and 6 anaplastic/undifferentiated TCs (D: 2%) were evaluated. The M/F-ratio was 1:3.2, the mean age 48.3 years (range: 13–92). The overall age-standardized (world population) incidence rates over the two 5-year periods 1990–1994 and 1995–1999 increased from 7.4 per 100,000 to 10.1 per 100,000 in females, from 2.3 per 100,000 to 3.6 per 100,000 in males. Only 3 patients were children or adolescents (1%), the majority of the patients (50%) were between 45 and 69 years of age. The percentage of microcarcinomas (<1 cm) was A: 46.4%, (115/248); B: 13.3%, (6/45); C: 27.3%, (3/11). The unexpected increase of TCs in 1997 was mainly due to the rise in the number of microcarcinomas. The observed 5-year survival rates for both genders were A: 96.0+/-2%; B: 88.9%; C: 90.9%; D: 0%. Prognosis was good in younger patients, worse in males and elderly, and extremely poor for undifferentiated TCs.ConclusionThe increasing incidence rates of TC, especially of the papillary type, seem mainly due to a rise in diagnosed microcarcinomas due to some extent to a change in histologic criteria and to more efficient diagnostic tools. This rise appears to be independent of the number of surgical treatments, the immigration rate, and the Chernobyl fallout as the incidence of TC in children remained stable.
Highlights
Twenty years after the nuclear accident in Chernobyl (Eastern Europe), there is still a controversial debate concerning a possible effect of the radioactive iodines, especially I-131, on the increase of thyroid carcinomas (TCs) in Western Europe
Our objective was to assess whether these changes could be artefactual due a) to incorrect or changing histological diagnoses, b) to more complete case reporting in the postChernobyl era or c) to increased surgical interventions in individuals with an enlarged, diffuse or nodular pattern like thyroid gland in the years following the nuclear accident
Seven malignancies in the thyroid gland were excluded (3 sarcomas, 2 Non-Hodgkinlymphomas, 1 malignant plasmocytoma and 1 metastasis of a clear cell renal carcinoma). 111 of the 310 patients with TC were treated by lobectomy of the right thyroid lobe and 83 of the left lobe, 106 patients had total thyroidectomy
Summary
Twenty years after the nuclear accident in Chernobyl (Eastern Europe), there is still a controversial debate concerning a possible effect of the radioactive iodines, especially I-131, on the increase of thyroid carcinomas (TCs) in Western Europe. Time trends in incidence rates of TC in Luxembourg in comparison with other European countries and its descriptive epidemiology were investigated. Since April 1986, the day of the nuclear accident in Chernobyl (Ukraine) leading to the exposure of large populations to radioactive iodines ( I-131) in many Eastern European countries and to a lesser degree in Central and Western Europe, there has been an increased interest of the health care authorities to collect epidemiological data on cancer incidence, especially in leukaemia and thyroid cancer (TC) [1,2]. The study aim was to examine time trends (1983–1997) in the thyroid cancer age-standardized (world population) incidence rates in the Grand-Duchy of Luxembourg (Western Europe), an iodine deficient goitre endemic area, and to analyse the distribution of TC (1990–1999) by age, gender, histological type, tumour size, immigration rate and outcome. Our objective was to assess whether these changes could be artefactual due a) to incorrect or changing histological diagnoses, b) to more complete case reporting in the postChernobyl era or c) to increased surgical interventions in individuals with an enlarged, diffuse or nodular pattern like thyroid gland in the years following the nuclear accident
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
