Radiation Research

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Radiation Research 169(4):373-383. 2008
doi: 10.1667/RR1063.1

Ultrasound-Detected Thyroid Nodule Prevalence and Radiation Dose from Fallout

C. E. Land1a, Z. Zhumadilovb, B. I. Gusevc, M. H. Hartshorned, P. W. Wieste, P. W. Woodwardf, L. A. Crooksd, N. K. Luckyanova, C. M. Fillmore2a, Z. Carr2a, G. Abishevab, H. L. Beckg, A. Bouvillea, J. Langerh, R. Weinstockg, K. I. Gordeevi, S. Shinkarevi, and S. L. Simona

aNational Cancer Institute, Division of Cancer Epidemiology and Genetics

bSemipalatinsk State Medical Academy

cKazakh Research Institute for Radiation Medicine and Ecology

dVA Medical Center Albuquerque

eUniversity of New Mexico Medical School, Department of Radiology

fArmed Forces Institute of Pathology

gContractor

hResearch Triangle Institute

iInstitute of Biophysics, Moscow

1Address for correspondence: National Cancer Institute, Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, Executive Plaza South, Room 7046, 6120 Executive Boulevard, Bethesda, MD 20892-7238;

2Present affiliation: Medical College of Wisconsin (CMF) and World Health Organization (ZC)

Abstract

Land, C. E., Zhumadilov, Z., Gusev, B. I., Hartshorne, M. H., Wiest, P. W., Woodward, P. W., Crooks, L. A., Luckyanov, N. K., Fillmore, C. M., Carr, Z., Abisheva, G., Beck, H. L., Bouville, A., Langer, J., Weinstock, R., Gordeev, K. I., Shinkarev, S. M. and Simon, S. L. Ultrasound-Detected Thyroid Nodule Prevalence and Radiation Dose from Fallout. Radiat. Res. 169, 373–383 (2008).

Settlements near the Semipalatinsk Test Site (SNTS) in northeastern Kazakhstan were exposed to radioactive fallout during 1949–1962. Thyroid disease prevalence among 2994 residents of eight villages was ascertained by ultrasound screening. Malignancy was determined by cytopathology. Individual thyroid doses from external and internal radiation sources were reconstructed from fallout deposition patterns, residential histories and diet, including childhood milk consumption. Point estimates of individual external and internal dose averaged 0.04 Gy (range 0–0.65) and 0.31 Gy (0–9.6), respectively, with a Pearson correlation coefficient of 0.46. Ultrasound-detected thyroid nodule prevalence was 18% and 39% among males and females, respectively. It was significantly and independently associated with both external and internal dose, the main study finding. The estimated relative biological effectiveness of internal compared to external radiation dose was 0.33, with 95% confidence bounds of 0.09–3.11. Prevalence of papillary cancer was 0.9% and was not significantly associated with radiation dose. In terms of excess relative risk per unit dose, our dose–response findings for nodule prevalence are comparable to those from populations exposed to medical X rays and to acute radiation from the Hiroshima and Nagasaki atomic bombings.

Received: April 15, 2007; Accepted: November 15, 2007



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FIG. 1. The Semipalatinsk Nuclear Test Site and areas affected by radioactive fallout from the Site. The lines represent the fallout tracks of 11 tests believed to have been responsible for nearly all of the exposure to the study population. Solid and open circles are the locations of named settlements in which substantial numbers (solid circles) and relatively few (open circles) of our study cohort are estimated to have received substantial exposure. Sixty-six of the study cohort received some exposure while living in the major city of the region, Semipalatinsk

FIG. 2. Scatter plot of individual estimates of external and internal thyroid dose. Clusters of dose estimates are labeled with the corresponding predominant villages of exposure

table

TABLE 1 Prevalence of Thyroid Nodules and Other Screening Outcomes, by Sex and Age at Screening

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TABLE 2 Average Cumulative Radiation Dose to Thyroid from all Fallout Events, by Age at Main Fallout Event for Village of Residence

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TABLE 3 Summary of Final Dose–Response Model Analyses for Nodule Prevalence (Models 1 and 2), by Treatment of Dose and Sex

Cited by

Alice J. Sigurdson, Charles E. Land, Parveen Bhatti, Marbin Pineda, Alina Brenner, Zhanat Carr, Boris I. Gusev, Zhaxibay Zhumadilov, Steven L. Simon, Andre Bouville, Joni L. Rutter, Elaine Ron, Jeffery P. Struewing. (2009) Thyroid Nodules, Polymorphic Variants in DNA Repair and RET-Related Genes, and Interaction with Ionizing Radiation Exposure from Nuclear Tests in Kazakhstan. Radiation Research 171:1, 77-88
Online publication date: 1-Jan-2009.

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