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Exposure to 131I in childhood and thyroid cancer after Chernobyl accident
- Sergei V. Jargin (18 March 2009)
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Twas A Minor Glitch, Watson
- Dr. Herbert H. Nehrlich (19 March 2009)
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Sergei V. Jargin, Pathologist Clementovski per 6-82, 115184 Moscow, Russia
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Recently we reviewed several publications overestimating medical consequences of Chernobyl accident (1-3) and discussed possible causes of overestimation of thyroid carcinoma (TC) incidence increase after the Chernobyl accident (4). The case-control study (5) is one of the main pieces of evidence in support of the cause-and-effect relationship between exposure to 131I in childhood and TC increase after the Chernobyl accident. The study included 276 patients with TC from radiocontaminated areas, who were aged younger than 15 years at the time of the accident, and 1300 controls matched to the patients by age, sex and area of residence at the time of the accident. Individual dose estimates in patients and controls were “based on their whereabouts and dietary habits.” These data were obtained by means of a questionnaire. A strong dose-response relationship was observed between radiation dose to the thyroid, received in childhood, and thyroid cancer (P<.001) (5). It should be commented that questioning, performed years after the accident, can provide only approximate information. Such data can be easily adjusted to a preconceived idea. Manipulations with statistics were not uncommon in the Soviet medical science (6). A data adjustment could have contributed to the high level of statistical significance of the relationship between the dose and cancer risk, declared also for relatively low doses. These considerations are applicable also to other studies applying retrospective dose estimation (7,8). As we have discussed previously (3,4), the reported incidence increase of TC after the Chernobyl accident was partly caused by improved diagnostics, screening, and high tumor expectancy, which, in the circumstances of primitive laboratory equipment and shortage of modern literature, inevitably went along with some percentage of false-positive conclusions. Registration of borderline lesions (e.g. well-differentiated tumors of uncertain malignant potential) as carcinomas could have additionally contributed to the high incidence figures. Besides, it was known by physicians and general public that in contaminated areas medical examinations by means of modern equipment are performed. At a suspicion of thyroid disease, some children from other regions were brought to the contaminated areas for the purpose of medical examination or treatment within the framework of international programs. Required data on whereabouts during and after the accident could have been confabulated in such cases. Therefore, reported incidence increase of thyroid carcinoma after Chernobyl accident and, correspondingly, cause-and-effect relationship between the exposure to 131I in childhood and TC, should be regarded as overestimated. References 1. Jargin SV. Over-estimation of radiation-induced malignancy after the Chernobyl accident. Virchows Arch (2007) 451(1):105-106. 2. Jargin SV Re: Involvement of ubiquitination and sumoylation in bladder lesions induced by persistent long-term low dose ionizing radiation in humans. Re: DNA damage repair in bladder urothelium after the Chernobyl accident in Ukraine. J Urol (2007) 177(2):794. 3. Jargin SV. Overestimation of medical consequences of increased background radiation (in Russian). Meditsinskaia radiologiia i radiatsionnaia bezopasnost' [Med Radiol and Radiation Safety] (Moscow) (2008) 53(3):17-22. 4. Jargin SV. Overestimation of thyroid cancer incidence after Chernobyl. Health Phys (2009) 96(2):186. 5. Cardis E, Kesminiene A, Ivanov V, et al. Risk of thyroid cancer after exposure to 131I in childhood. J Natl Cancer Inst (2005) 97(10):724- 32. 6. Jargin SV. Manipulation with statistics in medical research. Dermatopathol: Pract & Conc (2009) 15(1):21. Available at: http://derm101.com 7. Tronko MD, Howe GR, Bogdanova TI, et al. A cohort study of thyroid cancer and other thyroid diseases after the chornobyl accident: thyroid cancer in Ukraine detected during first screening. J Natl Cancer Inst (2006) 98(13):897-903. 8. Davis S, Stepanenko V, Rivkind N, et al. Risk of thyroid cancer in the Bryansk Oblast of the Russian Federation after the Chernobyl Power Station accident. Radiat Res (2004) 162(3):241-8 Competing interests: None declared |
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Dr. Herbert H. Nehrlich, Private Practice Bribie Island, Australia
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The accident at Chernobyl took place in April 1986. From published reports it is clear to this observer that a whitewash of the handling of the aftermath by the Russian authorities occurred. Having spent my early years in communist East Germany I witnessed many times the editing of life events as they happened; if the "fallout" was obvious to all blame was assigned to outside forces such as capitalist governments unhappy with the allegedly tremendous achievments of the Soviet Union under communism. Russia has always had a culture of denying its own weaknesses and shortcomings and little has changed today. Overestimating the often devastating effects from Chernobyl due to better equipment, higher expectations of health problems and perhaps the listing of patients from outside the regions brought to Chernobyl.... Your Honour I object. Chernobyl was an accident waiting to happen, the cleanup cost lives and many were damaged permanently. Tell them about inflated figures. Competing interests: None declared |
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