Relative risks of radiation-associated cancer: Comparison of second cancer in therapeutically irradiated populations with the Japanese atomic bomb survivors

M. P. Little*, C. R. Muirhead, Richard Haylock, J. M. Thomas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

In this paper the radiation-associated relative risks of second primary cancer incidence in groups treated for first primary cancer by radiotherapy are compared with radiation-associated relative risk estimates in the Japanese atomic bomb survivor cancer incidence data. For four cancer sites, namely lung cancer, bone cancer, ovarian cancer and leukaemia, the relative risks in the comparable (age at exposure, time since exposure, sex matched) subsets of the Japanese data are significantly greater than those in the majority of second cancer studies. Even when the differences between the relative risks in the Japanese atomic bomb survivors and the medical series do not approach conventional levels of statistical significance, relative risks tend to be higher in the Japanese data than in the second cancer studies. At least for leukaemia, the discrepancy between the Japanese and second cancer risks can be largely explained by cell-sterilisation effects. There are few indications of modification of radiation-associated second cancer relative risk among those treated with adjuvant chemotherapy, nor are there strong indications of modification of radiation-associated relative risk by heritable genetic factors. If anything, there is evidence that second cancer relative excess risks are bower among those patients with cancer-prone disorders than among non-susceptible patients. However, the higher underlying cancer risk in some of these medically exposed populations should also be considered, in particular for those with cancer-prone conditions, so that the absolute excess risk is sometimes higher than in the Japanese data.

Original languageEnglish
Pages (from-to)267-283
Number of pages17
JournalRadiation and Environmental Biophysics
Volume38
Issue number4
DOIs
Publication statusPublished - Dec 1999

Bibliographical note

Funding Information:
Acknowledgements We gratefully acknowledge the detailed comments of the referee. This paper includes analyses carried out as part of a study on the epidemiology of second cancers by the NRPB Advisory Group on Ionising Radiation (Chairman Professor B.A. Bridges). This paper makes use of data obtained from the Radiation Effects Research Foundation (RERF) in Hiroshima, Japan. RERF is a private foundation funded equally by the Japanese Ministry of Health and Welfare and the US Department of Energy through the US National Academy of Sciences. The conclusions in this paper are those of the authors and do not necessarily reflect the scientific judgement of RERF or its funding agencies. This work was funded partially by the European Commission under contract FI4P-CT95-0009.

Keywords

  • A- bomb survivors
  • Chemotherapy
  • Ionising radiation
  • Radiotherapy
  • Second primary cancer

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