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Analysis of thyroid malignant pathologic findings identified during 3 rounds of screening (1997-2008) of a cohort of children and adolescents from Belarus exposed to radioiodines after the Chernobyl accident

  • Author(s): Zablotska, LB
  • Nadyrov, EA
  • Rozhko, AV
  • Gong, Z
  • Polyanskaya, ON
  • McConnell, RJ
  • O'Kane, P
  • Brenner, AV
  • Little, MP
  • Ostroumova, E
  • Bouville, A
  • Drozdovitch, V
  • Minenko, V
  • Demidchik, Y
  • Nerovnya, A
  • Yauseyenka, V
  • Savasteeva, I
  • Nikonovich, S
  • Mabuchi, K
  • Hatch, M
  • et al.

Published Web Location

http://onlinelibrary.wiley.com/doi/10.1002/cncr.29073/full
No data is associated with this publication.
Abstract

© 2014 American Cancer Society. BACKGROUND: Recent studies of children and adolescents who were exposed to radioactive iodine-131 (I-131) after the 1986 Chernobyl nuclear accident in Ukraine exhibited a significant dose-related increase in the risk of thyroid cancer, but the association of radiation doses with tumor histologic and morphologic features is not clear. METHODS: A cohort of 11,664 individuals in Belarus who were aged ≤18 years at the time of the accident underwent 3 cycles of thyroid screening during 1997 to 2008. I-131 thyroid doses were estimated from individual thyroid activity measurements taken within 2 months after the accident and from dosimetric questionnaire data. Demographic, clinical, and tumor pathologic characteristics of the patients with thyroid cancer were analyzed using 1-way analysis of variance, chi-square tests or Fisher exact tests, and logistic regression. RESULTS: In total, 158 thyroid cancers were identified as a result of screening. The majority of patients had T1a and T1b tumors (93.7%), with many positive regional lymph nodes (N1; 60.6%) but few distant metastases (M1; <1%). Higher I-131 doses were associated with higher frequency of solid and diffuse sclerosing variants of thyroid cancer (P < .01) and histologic features of cancer aggressiveness, such as lymphatic vessel invasion, intrathyroidal infiltration, and multifocality (all P < .03). Latency was not correlated with radiation dose. Fifty-two patients with self-reported thyroid cancers which were diagnosed before 1997 were younger at the time of the accident and had a higher percentage of solid variant cancers compared with patients who had screening-detected thyroid cancers (all P < .0001). CONCLUSIONS: I-131 thyroid radiation doses were associated with a significantly greater frequency of solid and diffuse sclerosing variants of thyroid cancer and various features of tumor aggressiveness.

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