Long-Term Analysis of the Incidence and Histopathology of Thyroid Cancer in Ukraine in Adult Patients Who Were Children and Adolescents at the Time of the Chernobyl Accident

Author(s):  
Tetiana Bogdanova ◽  
Vladimir A. Saenko ◽  
Victor Shpak ◽  
Liudmyla Zurnadzhy ◽  
Laryssa Voskoboynyk ◽  
...  
2021 ◽  
Vol 14 (4) ◽  
pp. 45-59
Author(s):  
I. A. Zvonova ◽  
M. I. Balonov

A review of methods for assessing doses in the thyroid gland, predictions of the long-term consequences of its irradiation and the actual incidence of thyroid cancer in residents of four regions of the Russian Federation with the most significant radioactive fallout after the Chernobyl accident are presented. The method for assessing doses in the thyroid gland is based on the results of monitoring in May-June 1986 of radioiodine in the environment, food and in the body of residents. Thyroid doses in the population were used to justify medical and social protection measures, as well as epidemiological studies. In addition, the authorities needed forecasts of the possible morbidity of the population in order to organize adequate medical care. Most of the thyroid cancer cases were predicted among the adult population, which was not confirmed by observations 35 years after the accident. The prognosis of the incidence of thyroid cancer in preschool children differed in different studies due to the use of different coefficients of reducing the biological effectiveness of 131I radiation in the thyroid gland and long-term external and internal irradiation of the whole body with a low dose rate compared to the effect of acute exposure. The increase in the incidence of thyroid cancer among children began five years after the accident at the Chernobyl nuclear power plant. Examples of the dynamics of the incidence for children in the Bryansk region of the Russian Federation are given. The 2018 UNSCEAR Report showed that for 1986-2015, among children and adolescents under 18 years of age on the day of the accident in Belarus, Ukraine and four regions of Russia, more than 19 thousand thyroid cancer cases were detected, of which the share of radiation-induced diseases was estimated at 25%. For four regions of Russia, this amounts to 460 cases with a range of possible estimates from 130 to 900 cases. The highest morbidity was manifested among younger children exposed at the age of 0-4 years. In older children and adolescents, the proportion of radiation-induced diseases has significantly decreased 30 years after the accident. In general, early forecasts of radiation-induced thyroid cancer incidence in children in four regions of the Russian Federation with high levels of radioactive fallout are consistent with the data of subsequent 30-year epidemiological observations within an order of magnitude. With regard to thyroid cancer in adults, such a comparison is difficult, since no radiogenic increase in the incidence has been detected.


2002 ◽  
Vol 1234 ◽  
pp. 293-300 ◽  
Author(s):  
Jacov E Kenigsberg ◽  
Elena E Buglova ◽  
Julianna E Kruk ◽  
Alla L Golovneva

2001 ◽  
Vol 37 ◽  
pp. S339
Author(s):  
T. Hadjieva ◽  
R. Gabrovski ◽  
R. Pandev ◽  
G. Vasilev ◽  
S. Danon

2006 ◽  
Vol 42 (8) ◽  
pp. 1167-1171 ◽  
Author(s):  
Anna But ◽  
Päivi Kurttio ◽  
Sirpa Heinävaara ◽  
Anssi Auvinen

2015 ◽  
Vol 100 (4) ◽  
pp. 1619-1629 ◽  
Author(s):  
Young Ah Lee ◽  
Hae Woon Jung ◽  
Hwa Young Kim ◽  
Hoonsung Choi ◽  
Hyun-Young Kim ◽  
...  

Context:Large-sample studies with long-term follow-up data are limited for pediatric patients with thyroid cancer.Objective:Secular changes in clinicopathological characteristics and outcomes in pediatric patients with thyroid cancer were investigated and compared with those of adults.Design and Patients:A retrospective review of 150 pediatric patients with thyroid cancer managed between 1980 and 2013 was conducted. The long-term outcomes of 124 patients followed up for 12 months or longer were evaluated. Predictors of recurrence-free survival (RFS) in pediatric patients with papillary thyroid cancer (ped-PTC group) were compared with those of 3071 adult patients.Results:The proportion of small tumors (<1 cm) increased from 9.0% before 2010 to 36.8% after 2010 (P < .001); however, neither pathological presentations such as multifocality, extrathyroidal extension (ETE), lymph node (LN) metastasis, or lung metastasis nor the RFS rate changed over time. The 5- and 10-year recurrence rates were 14.5% and 34.4% in pediatric patients, respectively. In respective analyses of the ped-PTC group and patients of all ages with papillary thyroid cancer (all ages group), the rates of ETE, LN metastasis, and lung metastasis were higher with younger age (all P for trend <.05). RFS was lower in the pediatric than the adult patients aged 20–54 years (P < .005) and was comparable with that of older patients (≥55 y). Only tumor multifocality and size predicted recurrence in the ped-PTC group (P < .05), whereas LN metastasis and ETE also predicted recurrence in the all-ages group (P < .01). Among patients in the all-ages group with multifocal tumors, pediatric patients had the lowest RFS (P < .05).Conclusions:The pathological characteristics and recurrence rates of pediatric thyroid cancer have not changed over 33 years. Although younger patients present with more advanced disease, multifocality rather than age at diagnosis predicted recurrence. Recurrence was higher in pediatric than adult patients with multifocal papillary thyroid cancer.


Haemophilia ◽  
2020 ◽  
Vol 26 (3) ◽  
pp. 467-477
Author(s):  
Wolfgang Miesbach ◽  
Sabine Kittler ◽  
Artur Bauhofer ◽  
Christoph Königs ◽  
Thomas Becker ◽  
...  

2010 ◽  
Vol 34 (6) ◽  
pp. 1192-1202 ◽  
Author(s):  
Ian D. Hay ◽  
Tomas Gonzalez-Losada ◽  
Megan S. Reinalda ◽  
Jennifer A. Honetschlager ◽  
Melanie L. Richards ◽  
...  

2007 ◽  
Vol 12 (3) ◽  
pp. 689-698 ◽  
Author(s):  
Keith Baverstock ◽  
Dillwyn Williams

Twenty years after the Chernobyl accident the WHO and the International Atomic Energy Authority issued a reassuring statement about the consequences. Our objectives in this study were to evaluate the health impact of the Chernobyl accident, assess the international response to the accident, and consider how to improve responses to future accidents. So far, radiation to the thyroid from radioisotopes of iodine has caused several thousand cases of thyroid cancer but very few deaths; exposed children were most susceptible. The focus on thyroid cancer has diverted attention from possible nonthyroid effects. The international response to the accident was inadequate and uncoordinated, and has been unjustifiably reassuring. Accurate assessment in future health effects is not currently possible in the light of dose uncertainties, current debates over radiation actions, and the lessons from the late consequences of atomic bomb exposure. Because of the uncertainties from and the consequences of the accident, it is essential that investigations of its effects should be broadened and supported for the long term. The United Nations should initiate an independent review of the actions and assignments of the agencies concerned, with recommendations for dealing with future international-scale accidents. These should involve independent scientists and ensure cooperation rather than rivalry.


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