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1.
Medicine (Baltimore) ; 99(45): e23105, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157985

RESUMO

The relationship between solar ultraviolet radiation and the risk of breast cancer is conflicting. The purpose of our study was to quantitatively assess the relationship between solar ultraviolet radiation and breast cancer risk and to analyze related factors such as age and sunscreen use.Articles indexed in PubMed and Embase and published between January 2005 and March 2020 were searched for relevant keywords. The relative risk was calculated using random-effect or fixed-effect models in the meta-analysis and dose-response meta-analysis, which were conducted according to the Meta-Analyses of Observational Studies in Epidemiology reporting guidelines. Sensitivity analyses for heterogeneity and publication bias were evaluated.Six studies were eligible for inclusion in the meta-analysis, and three of these were included in the dose-response analysis. We found a correlation between exposure to solar ultraviolet radiation and breast cancer risk (relative risk: 0.70, 95% confidence interval: 0.65, 0.75). We also found a linear dose-response relationship between the exposure and breast cancer risk (relative risk: 0.86, 95% confidence interval: 0.81, 0.91) in women over 40. Not tanning and covering the limbs were associated with breast cancer risk, but sunscreen use was not.Exposure to solar ultraviolet radiation is negatively correlated with breast cancer risk, and the association is linear in women over 40. This is the first dose-response meta-analysis on the topic, and the influence of factors such as estrogen receptor status, occupational exposure, and ethnicity requires in-depth study.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Exposição à Radiação/efeitos adversos , Luz Solar/efeitos adversos , Raios Ultravioleta/efeitos adversos , Relação Dose-Resposta à Radiação , Feminino , Humanos , Medição de Risco
2.
Radiother Oncol ; 153: 289-295, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33065184

RESUMO

BACKGROUND AND PURPOSE: The objective of this work is to evaluate the risk of carcinogenesis of low dose ionizing radiation therapy (LDRT), for treatment of immune-related pneumonia following COVID-19 infection, through the estimation of effective dose and the lifetime attributable risk of cancer (LAR). MATERIAL AND METHODS: LDRT treatment was planned in male and female computational phantoms. Equivalent doses in organs were estimated using both treatment planning system calculations and a peripheral dose model (based on ionization chamber measurements). Skin dose was estimated using radiochromic films. Later, effective dose and LAR were calculated following radiation protection procedures. RESULTS: Equivalent doses to organs per unit of prescription dose range from 10 mSv/cGy to 0.0051 mSv/cGy. Effective doses range from 204 mSv to 426 mSv, for prescription doses ranging from 50 cGy to 100 cGy. Total LAR for a prescription dose of 50 cGy ranges from 1.7 to 0.29% for male and from 4.9 to 0.54% for female, for ages ranging from 20 to 80 years old. CONCLUSIONS: The organs that mainly contribute to risk are lung and breast. Risk for out-of-field organs is low, less than 0.06 cases per 10000. Female LAR is on average 2.2 times that of a male of the same age. Effective doses are of the same order of magnitude as the higher-dose interventional radiology techniques. For a 60 year-old male, LAR is 8 times that from a cardiac CT, when prescription dose is 50 cGy.


Assuntos
/radioterapia , Carcinogênese/efeitos da radiação , Neoplasias Induzidas por Radiação/epidemiologia , Órgãos em Risco , Imagens de Fantasmas , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodos , Medição de Risco/métodos , Fatores de Risco , Fatores Sexuais , Adulto Jovem
3.
Clin Imaging ; 67: 226-236, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871427

RESUMO

PURPOSE: Digital radiography has the potential to improve the practice of radiography but it also has the potential to significantly increase patient doses. Considering rapidly growing digital radiography in many centers, concerns rise about increasing the collective dose of the human population and following health effects. This study aimed to estimate organ and effective doses and calculate the lifetime attributable risk (LAR) of cancer incidence and mortality in digital radiography procedures in Iran. METHODS: Organ and effective doses of 12 routine digital radiography examinations including the skull, cervical spine, chest, thoracic spine, lumbar spine, pelvic and abdomen were estimated using PCXMC software based on Monte Carlo simulation method. Then, LARs of cancer incidence and mortality were estimated using the BEIR VII method. RESULTS: Organ doses ranged from 0.01 to a maximum of 2.5 mGy while effective doses ranged from 0.01 to 0.7 mSv. Radiation risk showed dependence on the X-ray examination type and the patient's sex and age. In skull and cervical X-rays, the thyroid; in the chest and thoracic spine X-rays, the lung, and breast; and in the lumbar spine, pelvic and abdominal X-rays, the colon and bladder had the highest LAR of cancer incidence and mortality. Furthermore, younger patients and also females were at higher radiation risk. CONCLUSION: The lifetime attributable risk of cancer incidence and mortality due to radiation exposure is not trivial. Therefore efforts should be made to reduce patient doses while maintaining image quality.


Assuntos
Neoplasias Induzidas por Radiação/epidemiologia , Abdome , Mama , Feminino , Humanos , Incidência , Masculino , Método de Monte Carlo , Pescoço , Neoplasias Induzidas por Radiação/etiologia , Pelve , Doses de Radiação , Intensificação de Imagem Radiográfica , Radiografia , Fatores de Risco , Software , Coluna Vertebral , Tórax
4.
Adv Exp Med Biol ; 1268: 123-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918216

RESUMO

Melanoma and keratinocyte skin cancer (KSC) are the most common types of cancer in White-skinned populations. Both tumor entities showed increasing incidence rates worldwide but stable or decreasing mortality rates. Rising incidence rates of cutaneous melanoma (CM) and KSC are largely attributed to increasing exposure to ultraviolet (UV) radiation, the main causal risk factor for skin cancer.Incidence rates of KSC, comprising of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are much higher than that of melanoma. BCC development is mainly the cause of an intensive UV exposure in childhood and adolescence, while SCC development is related to chronic, cumulative UV exposure over decades. Although mortality is relatively low, KSC is an increasing problem for health care services causing significant morbidity.Cutaneous melanoma is rapidly increasing in White populations, with an estimated annual increase of around 3-7% over the past decades. In contrast to SCC, melanoma risk is associated with intermittent and chronic exposure to sunlight. The frequency of its occurrence is closely associated with the constitutive color of the skin and the geographical zone. Changes in outdoor activities and exposure to sunlight during the past 70 years are an important factor for the increasing incidence of melanoma. Mortality rates of melanoma show stabilization in the USA, Australia, and in European countries. In the USA even dropping numbers of death cases were recently reported, probably reflecting efficacy of the new systemic treatments.Among younger cohorts in some populations (e.g., Australia and New Zealand,), stabilizing or declining incidence rates of CM are observed, potentially caused by primary prevention campaigns aimed at reducing UV exposure. In contrast, incidence rates of CM are still rising in most European countries and in the USA. Ongoing trends towards thinner melanoma are largely ascribed to earlier detection.


Assuntos
Neoplasias Cutâneas/epidemiologia , Austrália/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Incidência , Melanoma/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Nova Zelândia/epidemiologia , Estados Unidos/epidemiologia
5.
Adv Exp Med Biol ; 1268: 155-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918218

RESUMO

To shed further light on the ongoing debate whether sunbed use may increase melanoma risk, we have critically assessed the scientific literature that is at present available, focussing on a meta-analysis that we published recently. Our literature search identified several meta-analyses that report a weak association for ever-exposure to UV radiation from a solarium with melanoma risk. However, the quality of studies included in these meta-analyses and the resulting evidence levels and grades of recommendation were very low due to the lack of interventional trials and because of severe limitations of many of the observational studies. The results of cohort and case-control studies published until today do not prove causality, not even by the Hill criteria. The overall quality of these observational studies and the resulting evidence levels are low due to severe limitations (including unobserved or unrecorded confounding), which leads to bias. It must be recognized that in the majority of studies, published to date, many of the confounding factors, including sun exposure, sunburns and skin type, have not been adequately and systematically recorded and adjusted for. We conclude that the many limitations of the individual studies and the resulting low levels of evidence and grades of recommendation do at present not allow postulation of a causal relationship between solarium use and melanoma risk. At present, there is no convincing evidence that moderate/responsible solarium use increases melanoma risk.


Assuntos
Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Banho de Sol , Humanos , Neoplasias Induzidas por Radiação/epidemiologia , Medição de Risco , Queimadura Solar/epidemiologia
6.
Adv Exp Med Biol ; 1268: 335-353, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918227

RESUMO

Although great progress has been achieved during the last decades, the clinical management of organ transplant recipients (OTRs) remains a challenge. OTRs need in general lifelong immunosuppressive therapy that is associated with an increased risk to develop skin cancer and with an unfavorable clinical outcome of these malignancies. Skin cancer prevention measures, including regular full-body examinations, are therefore necessary in OTRs to detect and treat suspicious lesions at an early stage. The frequency of aftercare depends on the individual risk factors of the patient. Patients should apply consistent sun protection with sunscreens and clothing, as well as a monthly self-examination. On the other hand, the need of UVR avoidance increases the risk of vitamin D deficiency, which itself is associated with an increased risk for many diseases, including malignancies. OTRs should therefore be monitored for 25(OH)D status and/or should take vitamin D supplements. It has to be emphasized that an interdisciplinary approach, coordinated by the transplant center, that includes regular skin examinations by a dermatologist, is needed to ensure the best care for the OTRs.


Assuntos
Neoplasias Cutâneas/diagnóstico , Transplantados , Raios Ultravioleta , Vitamina D , Humanos , Imunossupressão/efeitos adversos , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Cutâneas/epidemiologia , Transplantados/estatística & dados numéricos , Vitamina D/administração & dosagem , Vitamina D/sangue , Vitaminas/administração & dosagem , Vitaminas/sangue
7.
Environ Res ; 189: 109968, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32736146

RESUMO

BACKGROUND: Through a pooled case-control study design, we have assessed the relationship between residential radon exposure and lung cancer risk. Other objectives of the study were to evaluate the different risk estimates for the non-small cell lung cancer histological types and to assess the effect modification of the radon exposure on lung cancer risk by tobacco consumption. METHODS: We collected individual data from various case-control studies performed in northwest Spain that investigated residential radon and lung cancer. Cases had a confirmed anatomopathological diagnosis of primary lung cancer and controls were selected because they were undergoing ambulatory evaluation or surgical procedures that were unrelated to tobacco use. Residential radon was measured using alpha track detectors. Results were analyzed using logistic regression. RESULTS: 3704 participants were enrrolled, 1842 cases and 1862 controls. Data show that lung cancer risk increases with radon exposure, finding a significant association of radon exposure with lung cancer at radon exposures above 50 Bq/m3. The estimated adjusted OR for individuals exposed to concentrations >200 Bq/m3 was 2.06 (95% CI: 1.61-2.64) compared with those exposed to ≤50 Bq/m3. Within a smoking category, lung cancer risk increases markedly as radon concentration increases, reaching an OR of 29.3 (95% CI: 15.4-55.7) for heavy smokers exposed to more than 200 Bq/m.3 CONCLUSIONS: This study confirms that residential radon exposure is a risk factor for lung cancer well below action levels established by international organizations. As expected, there is also an effect modification between radon exposure and tobacco consumption.


Assuntos
Poluição do Ar em Ambientes Fechados , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Neoplasias Induzidas por Radiação , Radônio , Estudos de Casos e Controles , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Habitação , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Radônio/análise , Radônio/toxicidade , Fatores de Risco , Espanha/epidemiologia
8.
Radiat Res ; 194(2): 180-187, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32845989

RESUMO

The findings from previously published studies have suggested that radiation exposure is associated with increased mortality and incidence of gastric cancer. However, few cohort studies have incorporated risk factors such as Helicobacter pylori (H. pylori) infection or chronic atrophic gastritis (CAG). The current study is aimed at evaluating the modifying effect of CAG on radiation risk of noncardia gastric cancer by histological type, by reanalyzing data from a nested case-control study conducted within the longitudinal clinical cohort of atomic bomb survivors. The analysis was restricted to 297 intestinal- or diffuse-type noncardia cases and 873 controls rematched to the cases on gender, age, city, and time and type of serum storage, and countermatched on radiation dose. Multivariable-adjusted relative risks [95% confidence interval (CI)] of noncardia gastric cancer were 3.9 (2.1-7.2) for H. pylori IgG seropositivity with cytotoxin-associated gene A (CagA) IgG low titer, 2.6 (1.9-3.6) for CAG, 1.9 (1.3-2.8) for current smoking, and 1.4 (1.1-1.9) for 1 Gy irradiation. Among subjects without CAG, the relative risk (95% CI) of noncardia gastric cancer at 1 Gy was 2.3 (1.4-3.7), whereas relative risk (95% CI) at 1 Gy was 1.1 (0.8-1.5) among subjects with CAG (for the overall interaction, P = 0.012). By histological type, the risk at 1 Gy was high for diffuse type without CAG, with adjusted relative risk (95% CI) of 3.8 (2.0-7.6), but was not high for diffuse type with CAG or for intestinal-type irrespective of CAG status. The results indicate that radiation exposure is associated with increased risk of diffuse-type noncardia gastric cancer without CAG, and this association exists despite adjustment for H. pylori infection and smoking habit.


Assuntos
Gastrite Atrófica/complicações , Neoplasias Induzidas por Radiação/complicações , Neoplasias Induzidas por Radiação/patologia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/patologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Infecções por Helicobacter/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/epidemiologia , Fatores de Risco , Fumar/efeitos adversos , Neoplasias Gástricas/epidemiologia
9.
Medicine (Baltimore) ; 99(30): e21328, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791729

RESUMO

The purpose of this study was to report the clinicopathological characteristics and treatment outcomes of 45 rectal cancer patients who have a history of cervical cancer with or without remote radiotherapy. Twenty-nine patients (64.4%) with a history of cervical cancer treated with pelvic radiotherapy were classified as group A, 16 (35.6%) patients with a history of cervical cancer not treated with radiotherapy were classified as group B. The median duration between radiotherapy for cervical cancer and rectal adenocarcinoma diagnosis was 18 years. At the time of rectal cancer diagnosis, 5 (17.2%) patients presented stage I disease, 15 (51.7%) had stage II, 1 (3.4%) had stage III, and 8 (27.6%) had stage IV. The patients in group A had older age, higher rates of gross ulcerative lesions, low hemoglobin levels, and a lower rate of lymph node metastases. The patients with secondary rectal cancer developed after radiotherapy for cervical cancer usually presented with abnormal abdominal symptoms, such as proctitis, cystitis, or rectal fistula. Higher colostomy rate was found in this group of patients due to severe pelvic fibrosis or proctitis.


Assuntos
Segunda Neoplasia Primária/patologia , Radioterapia/efeitos adversos , Neoplasias Retais/patologia , Neoplasias do Colo do Útero/patologia , Adenocarcinoma/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Colostomia/estatística & dados numéricos , Cistite/epidemiologia , Cistite/etiologia , Feminino , Humanos , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Induzidas por Radiação/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Proctite/epidemiologia , Proctite/etiologia , Prognóstico , Fístula Retal/epidemiologia , Fístula Retal/etiologia , Neoplasias Retais/mortalidade , Estudos Retrospectivos , Taiwan/epidemiologia , Resultado do Tratamento , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/radioterapia
10.
Artigo em Russo | MEDLINE | ID: mdl-32649814

RESUMO

BACKGROUND: Development of meningiomas correlating with irradiation has been described in the last century. Different biological features of radiation-induced meningiomas depending on dose and type of irradiation have been observed in recent years. MATERIAL AND METHODS: There were 8848 patients (women - 74.3%) with intracranial meningiomas for the period from 2000 to 2014 who underwent surgery at the Burdenko Neurosurgical Center. Radiation-induced meningiomas were identified in 33 patients (13 (38%) men and 20 (62%) women) aged 16-76 years (median 56 years). Medical data were retrospectively analyzed. Follow-up period ranged from 5 to 22 years (median 12) after verification of histological diagnosis. Meningiomas were preceded by X-ray irradiation of the scalp for ringworm (microsporia or trichophytosis) in 26 cases (79%) (group A). Group B enrolled 7 (21%) patients after previous radiotherapy for other tumors (retinoblastoma, chiasmal glioma, pituitary adenoma, basalioma). Data were compared using Mann-Whitney and Fisher's exact tests. RESULTS AND DISCUSSION: Incidence of radiation-induced meningiomas was 0.37% in our sample. Meningioma diagnosis dates after X-ray epilation (median 52 years) significantly differed from that after radiotherapy (median 22 years) (Mann-Whitney test, p=0.0003). Primary multiple meningiomas were diagnosed only in the 1st group (Fisher's exact test, p=0.0005). Recurrent meningiomas after the first surgery were more common in the first group (58%) compared to the second one (14%) (Mann-Whitney test, p=0.0003). CONCLUSIONS: The latency period is shorter after radiotherapy (median 22 years compared to 52 years after X-ray epilation). Incidence of atypical and malignant meningiomas directly correlates with irradiation dose. Approximately equal incidence of radiation-induced meningiomas after X-ray epilation in women and men can indicate other mechanisms of development of these tumors in comparison with spontaneous ones. Radiotherapy is followed by occurrence of meningiomas within the irradiated area. These tumors are usually single. In case of X-ray epilation, the tumors may be localized anywhere within the intracranial space (convexital and/or parasagittal localization in 77% of cases). Multiple neoplasms occur in 42% of cases. Refusal of head X-ray epilation for the treatment of a ringworm for the last 50 years may be followed by reduced incidence of radiation-induced meningiomas, especially multiple ones. However, extended indications for radiotherapy of various brain diseases can result an increase of the incidence of meningiomas within the irradiated area.


Assuntos
Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Adulto Jovem
11.
PLoS One ; 15(6): e0234461, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32544209

RESUMO

Cardiac catheterization procedure is the gold standard to diagnose and treat cardiovascular disease. However, radiation safety and cancer risk remain major concerns. This study aimed to real-time dynamic radiation dose measurement to estimate lifetime attributable risk (LAR) of cancer incidence and mortality in operators. Coronary angiography (CA) with percutaneous coronary intervention (PCI), CA, and others (radiofrequency ablation, pacemaker and defibrillator implantation) procedures with different beam directions, were undertaken on x-ray angiography system. A real-time electronic personal dosimeter (EPD) system was used to measure the radiation dose of staff during all procedures. We followed the Biological Effects of Ionizing Radiation (BEIR) VII report to estimate the LAR of all cancer incidence and mortality. Primary operators received radiation dose in CA with PCI, CA, and others procedures were 59.33 ± 95.03 µSv, 39.81 ± 103.85 µSv, and 21.92 ± 37.04 µSv, respectively. As to the assistant operators were 30.03 ± 55.67 µSv, 14.67 ± 14.88 µSv, and 4 µSv, respectively. LAR of all cancer incidences for staffs aged from 18 to 65 are varied from 0.40% for males to 1.50% for females. LAR of all cancer mortality for staffs aged from 18 to 65 are varied from 0.22% for males to 0.83% for females. Our study provided an easy, real-time and dynamic radiation dose measurement to estimate LAR of cancer for staff during the cardiac catheterization procedures. The LAR for all cancer incidence is about twice that for cancer mortality. Although the radiation doses of staff are lower during each procedure, the increased years of service leads to greater radiation risk to the staff.


Assuntos
Cateterismo Cardíaco/efeitos adversos , Neoplasias Induzidas por Radiação/epidemiologia , Exposição Ocupacional/efeitos adversos , Doses de Radiação , Exposição à Radiação/efeitos adversos , Radiografia Intervencionista/efeitos adversos , Adolescente , Adulto , Idoso , Feminino , Pessoal de Saúde , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/métodos , Monitoramento de Radiação , Ablação por Radiofrequência/métodos , Fatores de Risco , Adulto Jovem
12.
Cancer Treat Rev ; 87: 102027, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32428791

RESUMO

Immune checkpoint inhibitors (ICI) have improved outcomes for patients with advanced cancers, and results in increasing numbers of long-term survivors. For registration studies, progression-free survival and disease-free survival often serve as primary endpoints. This requires repeated computed tomography (CT) scans for tumour imaging which might lead to major radiation exposure. To determine this, all immune checkpoint inhibitors trials that led to FDA approval were retrieved up to July 29, 2019. From the available protocols, imaging modalities and schedules used in each trial were identified. The anticipated cumulative number of scans made after 1, 3, 5, and 10 years study participation were calculated. The percentage of lifetime attributable cancer risk was calculated using the Biological Effects of Ionizing Radiation VII report. Fifty-one trials were identified, from which 39 protocols were retrieved. Four were adjuvant trials. All protocols required repeated chest-abdomen imaging and specified CT scans as preferred imaging modality. Median calculated cumulative numbers of chest-abdomen CT scans after 1, 3, 5, and 10 years study participation were 7, 16, 24 and 46, respectively. For ages 20-70 years at study entry, the average lifetime attributable cancer risk after 1 year of study participation ranged from 1.11 to 0.40% for men and from 1.87 to 0.46% for women. At 10 years study participation, this risk increased to a range of 5.91 to 1.96% for men and 9.64 to 2.32% for women. Given high imaging radiation exposure for long-term survivors in current ICI trials an adaptive imaging interval and imaging termination rules should be considered for long-term survivors.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias/diagnóstico por imagem , Adulto , Feminino , Humanos , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Neoplasias/tratamento farmacológico , Neoplasias/epidemiologia , Neoplasias/imunologia , Neoplasias Induzidas por Radiação/etiologia , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Adulto Jovem
13.
Ann Hematol ; 99(7): 1543-1550, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32430702

RESUMO

The major sources of the data on the hematological malignancies in the post-Chernobyl period in the regions of Ukraine differing by the levels of the residual contamination with radionuclides have been analyzed. According to the data collected from the primary hematological facilities in Ukraine in 2010-2017, the incidence of lymphoid neoplasms from mature B cells, acute myeloid leukemia, and multiple myeloma in the most contaminated regions was higher than in the less contaminated ones. For the first time, the relative contribution of the several specific types of leukemia in the total diagnosed hematological malignancies has been analyzed throughout 1997-2017 based on the in-house database compiled by the Reference Laboratory of RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, the National Academy of Sciences of Ukraine. In 2011-2017, the Reference Laboratory provided the diagnostic studies in about 26% of all Ukrainian patients with tumors of hematopoietic and lymphoid tissues (34% of patients with different forms of acute and chronic leukemia). The increased proportion of acute myeloid leukemia and chronic lymphocytic leukemia in the total diagnosed cases of overall leukemia in the patients from contaminated regions has been demonstrated following Chernobyl accident.


Assuntos
Acidente Nuclear de Chernobyl , Neoplasias Hematológicas/epidemiologia , Neoplasias Hematológicas/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Bases de Dados Factuais , Feminino , História do Século XX , História do Século XXI , Humanos , Incidência , Leucemia/epidemiologia , Leucemia/etiologia , Linfoma/epidemiologia , Linfoma/etiologia , Masculino , Dados Preliminares , Cinza Radioativa/efeitos adversos , Cinza Radioativa/estatística & dados numéricos , Sistema de Registros , Ucrânia/epidemiologia
15.
Eur J Cancer ; 133: 47-55, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32434110

RESUMO

BACKGROUND: Patients with heritable retinoblastoma are at risk for bilateral retinoblastoma and second primary malignancies (SPMs). The incidence of SPM is significantly raised after radiotherapy. We analysed the impact of the class of constitutional RB1 variant on the incidence of SPM in survivors with and without previous radiotherapy. METHODS: From 1940 to 2008, 655 national patients were treated for heritable retinoblastoma at the German referral centre. Data on SPM, therapy and constitutional RB1 variant were available for 317 patients (48.3%). Heterozygous RB1 variants were classified into variants with regular and incomplete penetrance for retinoblastoma. RESULTS: SPM occurred in 51 of 317 survivors of heritable retinoblastoma. The incidence rate (IR) of SPM per 1000 person years was 8.4 (95% confidence interval (CI): 6.3-11.1) in individuals heterozygous for an oncogenic RB1 variant and 2.1 (95% CI: 0.0-11.4) with RB1 mosaicism. The incidence of SPM was higher in patients with regular penetrance compared with incomplete penetrance RB1 variants (IR 10.3 [95% CI: 7.5-13.8] vs. IR 3.2 [95% CI: 1.0-7.5]; p < 0.05). In the subgroup without previous radiotherapy SPM were only observed in patients with regular penetrance variants (IR 6.3 [95% CI: 3.0-11.5]). Carriers of incomplete penetrance variants developed similar tumour entities as those with regular penetrance. CONCLUSIONS: Patients heterozygous for regular penetrance RB1 variants had a higher risk to develop SPM than patients with incomplete penetrance variants. Increased knowledge on genotype-phenotype relation regarding SPM may influence screening recommendations for SPM in survivors of heritable retinoblastoma.


Assuntos
Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/genética , Neoplasias da Retina/genética , Proteína do Retinoblastoma/genética , Retinoblastoma/genética , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/genética , Neoplasias da Retina/epidemiologia , Neoplasias da Retina/terapia , Retinoblastoma/epidemiologia , Retinoblastoma/terapia , Adulto Jovem
16.
Cancer Lett ; 487: 21-26, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32454144

RESUMO

We aimed to evaluate lung cancer survival in never-smokers, both overall and specifically by sex, exposure to residential-radon, age, histological type, and diagnostic stage. We included lung cancer cases diagnosed in a multicentre, hospital-based, case-control-study of never-smoker patients, diagnosed from January-2011 to March-2015 (Lung Cancer Research In Never Smokers study). 369 never-smokers (79% women; median age 71 years; 80% adenocarcinoma; 66% stage IV) were included. Median overall survival, and at one, 3 and 5 years of diagnosis was 18.3 months, 61%, 32% and 22%, respectively. Higher median survival rates were obtained for: younger age, adenocarcinoma, actionable mutations, and earlier-stage at diagnosis. Higher indoor radon showed a higher risk of death in multivariate analysis. Median lung cancer survival in never-smokers seems higher than that in ever-smokers. Patients with actionable mutations have a significantly higher survival. Higher indoor-radon exposure has a negative effect on survival.


Assuntos
Adenocarcinoma/epidemiologia , Neoplasias Pulmonares/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Radônio/efeitos adversos , Adenocarcinoma/patologia , Adulto , Idoso , Sobreviventes de Câncer , Exposição Ambiental , Feminino , Habitação , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/patologia , Fumar/efeitos adversos
17.
Artigo em Inglês | MEDLINE | ID: mdl-32235620

RESUMO

The Korean Radiation Worker Study investigated the health effects of protracted low-dose radiation among nuclear-related occupations in the Nuclear Safety and Security Commission in Korea. From 2016-2017, 20,608 workers were enrolled (86.5% men and 30.7% nuclear power plant workers). The mean cumulative dose ± standard deviation between 1984 and 2017 (1st quarter) was 11.8 ± 28.8 (range 0-417) mSv. Doses below recording level (≤0.1 mSv) were reported in 7901 (38.3%) cases; 431 (2%) had cumulative doses ≥100 mSv. From 1999-2016, 212 cancers (189 men, 23 women) occurred; thyroid cancer predominated (39.2%, 72 men, 11 women). In men, the standardized incidence ratio (SIR) for all cancers was significantly decreased (SIR = 0.76, 95% CI 0.66-0.88); however, that for thyroid cancer was significantly increased (SIR = 1.94, 95% CI 1.54-2.44). Compared to the non-exposed group (≤0.1 mSv), the relative risk (RR) in the exposed group (>0.1 mSv) after adjusting for sex, attained age, smoking status, and duration of employment was 0.82 (95% CI 0.60-1.12) for all cancers and 0.83 (95% CI 0.49-1.83) for thyroid cancer. The preliminary findings from this baseline study with a shorter follow-up than the latency period for solid cancer cannot exclude possible associations between radiation doses and cancer risk.


Assuntos
Neoplasias Induzidas por Radiação/epidemiologia , Centrais Nucleares , Exposição Ocupacional/efeitos adversos , Exposição à Radiação/efeitos adversos , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações , Doses de Radiação , República da Coreia
18.
Eur J Radiol ; 126: 108932, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32200290

RESUMO

PURPOSE: This survey was conducted to evaluate the radiation dose delivered to the patients through different CT procedures along with its corresponding risks in Yazd province. METHOD: Data for the five most common procedures were collected from six institutions from September 2017. The effective dose for each patient was estimated by ImpactDose software. The risk of exposure-induced death (REID) was calculated by coupling the BEIR VII model and ICRP 103 data for the Asian population. RESULTS: The median effective doses for the five most common procedures, in descending order, were as follows: 5.19 mSv for abdomen-pelvis, 3.30 mSv for routine chest, 3.00 mSv for chest HRCT, 0.76 mSv for Brain and 0.47 mSv for sinus. Averaged over all the procedures, the ratio of maximum to minimum of effective dose was 90-fold. The highest associated risk was tied to high-resolution CT scans for women which was estimated to be 1 exposure-induced death related to 2096 scans performed on a 20-year old patient. CONCLUSION: The estimated effective doses for all the procedures except sinus were comparably low, however, the variations among patient doses, even for a given procedure, were substantially high, indicating that further optimization processes need to be undertaken. Moreover, it was estimated that approximately 2000 scans of abdomen-pelvis performed on 20 year-old women could result in 1 radiation-induced cancer death, which in large scales may cause drastic health issues. In this regard, several approaches, one of which is the implementation of DRLs, can be suggested to reduce the collective dose from CT scans.


Assuntos
Neoplasias Induzidas por Radiação/epidemiologia , Doses de Radiação , Tomografia Computadorizada por Raios X/efeitos adversos , Tomografia Computadorizada por Raios X/métodos , Adulto , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/estatística & dados numéricos
19.
Sci Rep ; 10(1): 4074, 2020 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-32139763

RESUMO

Environmental radioactive contamination caused by the Fukushima Dai-ichi Nuclear Power Plant accident has aroused great concern regarding a possible increase in the incidence of childhood thyroid cancer. The ultrasound examinations were conducted immediately after the accident as part of the Fukushima Health Management Survey (FHMS), which is divided into the preliminary baseline survey (PBLS) and the full-scale survey (FSS). Some of their outcomes are reported regularly and made available to the public. We have detailed measurements of the air-dose rates and radioactive elements in soil in many places all over the Fukushima prefecture. To study the dose-response relationship, we begin with the assumption that the external and internal doses are correlated with the air-dose rate and the amount of 131I in soil, respectively. We then investigate the relationship between these estimated doses and the PBLS and FSS thyroid cancer cases. Our analysis shows that the dose-response curve with the FSS data clearly differs from that with the PBLS data. Finally, we consider the potential mitigating effects of evacuation from highly contaminated areas in both external and internal exposure scenarios.


Assuntos
Poluição Ambiental/efeitos adversos , Acidente Nuclear de Fukushima , Inquéritos Epidemiológicos , Radioisótopos do Iodo/efeitos adversos , Neoplasias Induzidas por Radiação/epidemiologia , Monitoramento de Radiação , Neoplasias da Glândula Tireoide/epidemiologia , Criança , Humanos , Japão/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Doses de Radiação , Neoplasias da Glândula Tireoide/etiologia
20.
PLoS One ; 15(2): e0228549, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32023299

RESUMO

The effect of age and gender in risk estimates related to long-term residence in areas contaminated by nuclear power plant fallout was evaluated by applying the lifetime attributable risk (LAR) concept to an existing exposure model that was previously used for cumulative effective dose estimates. In this study, we investigated the influence of age distribution on the number of cancer cases by applying five different age distributions from nuclear power-producing countries (India, Japan, South Korea, and the United States), and Egypt because of intentions to develop nuclear power. The model was also used to estimate the effective dose and gender-specific LAR as a function of time after fallout for the offspring of the population living in 137Cs fallout areas. The principal findings of this study are that the LAR of cancer incidence (excluding non-fatal skin cancers) over 70 y is about 4.5 times higher for newborn females (5.4% per MBq m-2 of initial 137Cs ground deposition) than the corresponding values for 30 y old women (1.2% per MBq m-2 137Cs deposition). The cumulative LAR for newborn males is more than 3 times higher (3.2% versus 1.0% per MBq m-2 137Cs deposition). The model predicts a generally higher LAR for women until 50 y of age, after which the gender difference converges. Furthermore, the detriment for newborns in the fallout areas initially decreases rapidly (about threefold during the first decade) and then decreases gradually with an approximate half-time of 10-12 y after the first decade. The age distribution of the exposed cohort has a decisive impact on the average risk estimates, and in our model, these are up to about 65% higher in countries with high birth rates compared to low birth rates. This trend implies larger average lifetime attributable risks in countries with a highly proportional younger population. In conclusion, the large dispersion (up to a factor of 4 between newborns and 30 y olds) in the lifetime detriment per unit ground deposition of 137Cs over gender and age in connection with accidental nuclear releases justifies the effort in developing risk models that account for the higher radiation sensitivity in younger populations.


Assuntos
Radioisótopos de Césio/análise , Modelos Estatísticos , Neoplasias Induzidas por Radiação/etiologia , Centrais Nucleares/estatística & dados numéricos , Cinza Radioativa/efeitos adversos , Medição de Risco/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carga Corporal (Radioterapia) , Criança , Pré-Escolar , Egito/epidemiologia , Feminino , Humanos , Incidência , Índia/epidemiologia , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/epidemiologia , Doses de Radiação , Monitoramento de Radiação , República da Coreia/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
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