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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Reanalysis of Epidemiological Investigation of Cancer Risk among People Residing near Nuclear Power Plants in South Korea
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Reanalysis of Epidemiological Investigation of Cancer Risk among People Residing near Nuclear Power Plants in South Korea

机译：韩国核电厂附近居民癌症风险的流行病学调查再分析

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Background: A 20-year follow-up study on cancer incidence among people living near nuclear power plants in South Korea ended in 2011 with a finding of significantly, but inconsistently, elevated thyroid cancer risk for females. Reanalysis of the original study was carried out to examine the dose–response relationship further, and to investigate any evidence of detection bias. Methods: In addition to replicating the original Cox proportional hazards models, nested case-control analysis was carried out for all subjects and for four different birth cohorts to examine the effects of excluding participants with pre-existing cancer history at enrollment. The potential for detection bias was investigated using the records of medical utilization and voluntary health checks of comparison groups. Results: The overall risk profile of the total sample was similar to that of the original study. However, in the stratified analysis of four birth cohorts, the cancer risk among people living near nuclear power plants became higher in younger birth cohorts. This was especially true for thyroid cancers of females (hazard ratio (HR) 3.38) and males (HR 1.74), female breast cancers (HR 2.24), and radiation-related cancers (HR 1.59 for males, HR 1.77 for females), but not for radiation-insensitive cancers (HR 0.59 for males, HR 0.98 for females). Based on medical records and health check reports, we found no differences between comparison groups that could have led to detection bias. Conclusions: The overall results suggest elevated risk of radiation-related cancers among residents living near nuclear power plants, controlling for the selective survival effect. This is further supported by the lack of evidence of detection bias and by records of environmental exposure from radiation waste discharge.
机译：背景：一项针对韩国核电厂附近居民癌症发病率的为期20年的随访研究于2011年结束，发现女性甲状腺癌风险显着但不一致地升高。对原始研究进行了重新分析，以进一步检查剂量-反应关系，并调查检测偏倚的任何证据。方法：除了复制原始的Cox比例风险模型外，还对所有受试者和四个不同的出生队列进行了嵌套病例对照分析，以研究排除入选时已有癌症史的受试者的影响。使用医疗使用记录和对照组的自愿健康检查来调查潜在的检测偏倚。结果：总样本的总体风险状况与原始研究相似。然而，在对四个出生队列的分层分析中，居住在核电厂附近人群中的癌症风险在年轻的出生队列中变得更高。对于女性的甲状腺癌（危险比（HR）3.38）和男性的甲状腺癌（HR 1.74），女性的乳腺癌（HR 2.24）以及与放射有关的癌症（男性的HR 1.59，女性的HR 1.77）尤其如此。不适用于对辐射不敏感的癌症（男性：HR 0.59，女性：HR 0.98）。根据病历和健康检查报告，我们发现对照组之间没有差异，可能导致检测偏倚。结论：总体结果表明，居住在核电厂附近的居民中与辐射有关的癌症的风险升高，控制了选择性生存效应。缺乏检测偏见的证据以及辐射废物排放对环境造成的影响的记录进一步证明了这一点。

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