American Journal of Epidemiology Vol. 153, No. 8 : 749-756
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Cancer Incidence after Childhood Nasopharyngeal Radium Irradiation: A Follow-up Study in Washington County, Maryland
1 Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD.
2 Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
3 Department of Biostatistics, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD.
4 Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC.
A population from a hearing clinic in Washington County, Maryland, in 1943–1960 was followed to assess the risk of developing neoplasms from radium treatment of the nasopharynx for adenoid hypertrophy. Of the 2,925 subjects who attended the clinic, 904 received radium treatment. A nonconcurrent prospective study compared the cancer incidence among the irradiated persons with that among persons with other treatments. Seven brain tumor cases (three malignant and four benign) were identified in the irradiated group versus none in the nonirradiated group (relative risk = 14.8, 95% confidence interval: 0.76, 286.3). A nonsignificant excess risk of thyroid cancer was detected in the irradiated group based on two cases in the exposed group and one case in the nonexposed group (relative risk = 4.2, 95% confidence interval: 0.38, 46.6). Decreased risks of breast cancer, female genital cancers, and prostate cancer were observed among the irradiated individuals, although these deficits were not statistically significant individually. The decreased risk of sex hormone-related cancers in the irradiated group suggests possible radiation damage to the pituitary, with consequent reduction in pituitary hormone output and alterations in sexual and other hormonal development in early life. This hypothesis needs further evaluation.
nasopharynx; neoplasms; radiation; radium
Abbreviations: CI, confidence interval; RR, relative risk
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