Brief Report
Childhood Thyroid Cancer and Chernobyl
Source: Josefson D. Childhood thyroid cancers rise 10-fold in the Ukraine. BMJ 1999;319:145.
A large increase in the number of childhood thyroid cancers has occurred in areas of the previous USSR in the years following the Chernobyl reactor meltdown that occurred on April 26, 1986. This resulted in the release of huge quantities of radioactive materials into the environment, including large amounts of radioactive iodine, within the first two weeks after the accident. This resulted in significant fallout in the Ukraine, Belarus, and Russia. It has long been known that radiation exposure, especially to the head and neck, such as thymic radiation for putative thymic enlargement and radiation treatment for tonsillar and adenoidal hypertrophy in children, was associated with a markedly increased rate of thyroid malignancies.
Deborah Josefson reviewed data from Kiev, where long-term information has been compiled to create a registry of pediatric thyroid cancer in the Ukraine, before and after Chernobyl. From 1981 to 1985 there were only 59 cases of thyroid cancer in children from birth to age 18. In contrast, 577 cases were identified between 1985-1997. The rate of pediatric thyroid cancers rose more than tenfold from 0.04 per 100,000 children in 1985 to 0.45 per 100,000 children in 1996-1997. Sixty-four percent of the cancers occurred in children 15 years of age and younger and the highest rates were seen in areas with highest fallout contamination. Almost 80% of affected children were younger than 10 years old when the accident occurred and 42% were younger than 4 years of age, reflecting the age of peak vulnerability of the thyroid gland to ionizing radiation. Uptake of radioiodine can be reduced by administration of iodine before exposure, and "doomsday" advance preparations include distribution of supplies of nonradioactive iodine for consumption, especially by children, after an atomic explosion.
Not discussed in this brief report is the observation that malignancies other than thyroid cancer and congenital anomalies do not seem to have significantly increased as a result of the Chernobyl fallout (personal communications from Dr. Jack van Hoff, who has studied the epidemiology of childhood cancer in Belarus). —hap
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