American Journal of Epidemiology Vol. 137, No. 10: 1068-1080
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health
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Thyroid Cancer among Persons Given X-ray Treatment in Infancy for an Enlarged Thymus Gland
1Department of Environmental Medicine, New York University Medical Center New York, NY
2Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry Rochester, NY
3Department of Pathology, University of Rochester School of Medicine and Dentistry Rochester, NY
Reprint requests to Dr. Roy E. Shore, Department of Environmental Medicine, New York University Medical Center, 341 East 25th St., New York, NY 10010-2598
A cohort of 2,657 infants in Rochester, New York, who were given x-ray treatment for a purported enlarged thymus gland, along with 4,833 siblings, have been followed by mail surveys through about 1986, which represents an average of 37 years of follow-up, to determine their incidence of thyroid cancer. Estimated thyroid doses ranged from 0.03 to >10 Gy, with 62% receiving <0.5 Gy. There were 37 pathologically diagnosed thyroid cancers in the irradiated group and five in the sibling controls. The dose-response relation was essentially linear, with no evidence of an additional dose-squared component. The estimated relative risk at 1 Gy was 10 (90% confidence interval 5–23). Thyroid cancer rates were elevated even at low doses; i.e., a dose-response analysis over the range of 0–0.3 Gy showed a significant positive slope. The risk ratio was declining over time but was still highly elevated to at least 45 years after irradiation. An examination of potential risk factors showed that older age at first childbirth was significantly associated with thyroid cancer risk. An evaluation of interactions between possible risk factors and radiation suggested that Jewish subjects and women with older ages at menarche or at first childbirth were at greater risk for radiogenic thyroid cancer.
dose-response relationship, radiation; neoplasms, radiation-induced; radiation, ionizing; thyroid neoplasms
4Present address: Department of Pathology, SUNY at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY
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