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Review
. 2009 Jun;85(6):467-82.
doi: 10.1080/09553000902883836.

Ionising radiation and cancer risks: what have we learned from epidemiology?

Ethel S Gilbert  1
Affiliations
Review

Ionising radiation and cancer risks: what have we learned from epidemiology?

Ethel S Gilbert. Int J Radiat Biol. 2009 Jun.

Abstract

Purpose: Epidemiologic studies of persons exposed to ionising radiation offer a wealth of information on cancer risks in humans. The Life Span Study cohort of Japanese A-bomb survivors, a large cohort that includes all ages and both sexes with a wide range of well-characterised doses, is the primary resource for estimating carcinogenic risks from low linear energy transfer external exposure. Extensive data on persons exposed for therapeutic or diagnostic medical reasons offer the opportunity to study fractionated exposure, risks at high therapeutic doses, and risks of site-specific cancers in non-Japanese populations. Studies of persons exposed for occupational and environmental reasons allow a direct evaluation of exposure at low doses and dose rates, and also provide information on different types of radiation such as radon and iodine-131. This article summarises the findings from these studies with emphasis on studies with well-characterised doses.

Conclusions: Epidemiologic studies provide the necessary data for quantifying cancer risks as a function of dose and for setting radiation protection standards. Leukaemia and most solid cancers have been linked with radiation. Most solid cancer data are reasonably well described by linear-dose response functions although there may be a downturn in risks at very high doses. Persons exposed early in life have especially high relative risks for many cancers, and radiation-related risk of solid cancers appears to persist throughout life.

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Conflict of interest statement

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.

Figures

Figure 1
Figure 1
Solid cancer dose-response function based on A-bomb survivor cancer incidence data. The thick solid line is the fitted linear gender-averaged excess relative risk (ERR) dose response at age 70 after exposure at age 30 based on data in the 0- to 2-Gy dose categories. The thick dashed line is a nonparametric smooth of the category-specific estimates and the thin dashed lines are one standard error above or below this smooth. From Preston et al. 2007, with permission.
Figure 2
Figure 2
Variation in solid cancer excess risks at 1 Gy with attained age for ages at exposure of 10, 30 and 50 years. The left panel presents the fitted excess relative risk (ERR) estimates while the right panel indicates excess rate (EAR) estimates. The curves are gender-averaged risks after exposure to 1 Gy. From Preston et al. 2007, with permission.
Figure 3
Figure 3
Thyroid cancer risk by radiation dose in cases and controls after adjustment for first cancer. Linear dose-response model for relative risk calculated as 1 + 0.5117(dose). Linear exponential dose-response model for relative risk calculated as 1 + 1.316(dose) exp(-0.00189[dosexdose]). Vertical lines=95% CI for OR. Reprinted from The Lancet, Vol. 365, Sigurdson et al., Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): a nested case-control study, 2014-2023, 2005, with permission from Elsevier.
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