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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previously, we conducted a study of 35,074 patients receiving diagnostic doses of 131I for suspected thyroid disorders between 1951 and 1969. We reported that, between 1958 and 1984, the incidence of thyroid cancers in these patients was insignificantly greater than the incidence expected in the general population. This increase was attributed to the underlying condition that prompted the examination and not to the administration of 131I. The purpose of the present study was to analyze the total cancer risk in the same cohort of patients examined with diagnostic doses of 131I. To further evaluate the underlying risk of disease in these patients, we compared the incidence of all cancers with that expected in the general population. The average radiation dose was approximately 500 mGy to the thyroid and less than 10 mGy to other organs. In the 35,074 patients, 3,746 cancers occurred following the first 5 years after examination, and the resulting standardized incidence rate (SIR) was 1.01 (95% confidence interval = 0.98-1.04). SIRs were significantly increased for endocrine tumors other than thyroid cancer (1.93) and for lymphomas (1.24), leukemias (1.34), and nervous system tumors (1.19). The risk of leukemia was similar for chronic lymphocytic leukemia (CLL) (SIR = 1.30) and non-CLL (SIR = 1.34). SIR was significantly decreased for cancers of the female genital organs (0.86). The risk for cancer of all sites and types combined was highest 5-9 years after examination (SIR = 1.07) and did not differ from unity thereafter. With greater than or equal to 10 years of follow-up, risk was not statistically associated with the dose of 131I. Overall, the data exclude cancer risk increments greater than 5% (SIR = 1.05) with 95% confidence. The significant increase in the risk of non-CLL, a prominent radiogenic malignancy, however, warrants special attention. We are continuing our study to determine the possible factors involved in the significant increase in the risk of leukemia.
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PMID:Cancer risk in population examined with diagnostic doses of 131I. 291 29

The authors have studied the different situations that prompt a request for genetic counseling if different members of the same family suffer from cancer. Six possibilities are considered: the cancer concerned is a genetic disease per se (e.g. retinoblastoma, thyroid cancer with amyloid stroma); the genetic disease is often complicated with cancer (e.g. intestinal polyposis); the genetic disease is occasionally complicated with cancer (e.g. neurofibromatosis); cancer is part and parcel of the genetic disease (e.g. chromosomal abnormalities); in addition, there are two special situations: "cancer-prone families" and families who request genetic counseling after one single case (e.g. cancer of leukaemia in a child).
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PMID:[Genetic counseling in cancerology]. 295 Apr 12

Studies in the 1980s of medically irradiated populations have increased our knowledge of radiation carcinogenesis. (1) Investigations of prenatal x-ray exposures, especially in twins, provide evidence that very low doses of ionizing radiation may cause cancer in humans. (2) Fractionated doses appear as effective as single exposures of the same total dose in causing breast cancer, but seem less effective for lung cancer. (3) Excess breast cancers can occur among women exposed under age 10, indicating that the immature breast is susceptible to the carcinogenic action of radiation. (4) Moderate doses on the order of 1 Gy to the brains of children can cause tumors later in life; moderately high doses to the skin can cause cancer when followed by frequent exposure to ultraviolet light. (5) Radiotherapy for cervical cancer can increase the rate of subsequent leukemia with the best fitting dose-response functions including a negative exponential term to account for cell-killing. (6) Low-dose exposures of about 10 cGy may increase the risk of thyroid cancer. (7) Second cancers following radiotherapy for a variety of cancers occur primarily among long-term survivors. (8) Radiotherapy may not significantly increase the risk of leukemia following childhood cancer, whereas chemotherapy with alkylating agents is a major risk factor. (9) Bone cancer occurs after high-dose radiotherapy for childhood cancer, but children with retinoblastoma are not more susceptible to radiation-induced disease than children with other malignancies. (10) High-dose external beam therapy can cause thyroid cancer, whereas high-dose radioactive 131I may not. (11) Studies of cervical cancer patients indicate that the risk of radiation-induced second malignancies follows a time-response model consistent with a constant multiplication of the underlying background incidence, i.e. a relative risk model seems to hold for projecting risks forward in time.
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PMID:Carcinogenesis--a synopsis of human experience with external exposure in medicine. 304 57

A large excess of non-Hodgkin's lymphoma has been documented in renal transplant patients and may be related to immunosuppressive therapy, persistent antigenic challenge from the graft, or both. To determine whether immuno-suppression resulting from chronic renal failure is associated with an elevated risk of certain tumors such as non-Hodgkin's lymphoma, the authors studied cancer incidence in a national cohort of 28,049 patients in the United States with chronic renal failure who received maintenance dialysis for at least six months (totaling 66,706 person-years of observation). Compared with national incidence rates, the relative risk (RR) of cancer was 0.9 (excluding nonmelanoma skin cancer, multiple myeloma, kidney cancer, and uterine cervix cancer). Moderate excesses of leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, thyroid cancer, and biliary tract cancer were found, but were not statistically significant for both sexes combined. A significantly elevated risk of non-Hodgkin's lymphoma among patients with chronic glomerulonephritis (RR = 2.6) accounted for the excess observed in the total series, raising the possibility of factors specific to this disease.
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PMID:Cancer in patients receiving long-term dialysis treatment. 311 33

Estimates of both individual and collective doses received by the United States population following the Chernobyl accident have been made by using the data obtained from the U.S. Environmental Protection Agency's Environmental Radiation Ambient Monitoring System. Radionuclides associated with the debris first were measured in precipitation and surface air particulates at Portland, OR and Olympia, WA on 5 May 1986. Iodine-131 was the most consistently measured nuclide in all media, although several Cs and Ru isotopes also were observed. Strontium and any actinides notably were absent from the samples at the lower level of detection. The highest calculated individual-organ dose due to intake during May and June 1986 was 0.52 mSv to the infant thyroid in the state of Washington. This was predominantly (98%) from the ingestion of milk. The maximum U.S. collective dose equivalent to any organ was calculated to be 3,300 person-Sv to the thyroid. Risk estimates project three excess lung cancer deaths and an additional four deaths due to cancers of thyroid, breast and leukemia in the U.S. population over the next 45 y from exposure during the May-June 1986 interval. The only long-lived radionuclide measured in milk samples following the accident was 137Cs. We estimate 20 excess fatalities from the ingestion of 137Cs in milk during all subsequent years, with six of these due to lung cancer and the majority of the remainder distributed approximately equally among cancers of the thyroid, breast, liver and leukemia. A total of 100 excess fatalities from all dietary components was estimated. Because of the uncertainty of risk estimates from data such as those available for this study, all calculated values carry a range of uncertainty from a minimum of one-half the calculated value to a maximum of two times the calculated value. The estimated excess fatalities given above may be compared with corresponding projected cancer mortality from all other causes: 41,000 fatalities from thyroid cancer and 3,800,000 fatalities from lung cancer are estimated to occur within the U.S. population during the next 45 y.
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PMID:Estimates of radiation dose and health risks to the United States population following the Chernobyl nuclear plant accident. 317 Feb 7

The risk of cancer associated with a broad range of organ doses was estimated in an international study of women with cervical cancer. Among 150,000 patients reported to one of 19 population-based cancer registries or treated in any of 20 oncology clinics, 4188 women with second cancers and 6880 matched controls were selected for detailed study. Radiation doses for selected organs were reconstructed for each patient on the basis of her original radiotherapy records. Very high doses, on the order of several hundred gray, were found to increase the risk of cancers of the bladder [relative risk (RR) = 4.0], rectum (RR = 1.8), vagina (RR = 2.7), and possibly bone (RR = 1.3), uterine corpus (RR = 1.3), cecum (RR = 1.5), and non-Hodgkin's lymphoma (RR = 2.5). For all female genital cancers taken together, a sharp dose-response gradient was observed, reaching fivefold for doses more than 150 Gy. Several gray increased the risk of stomach cancer (RR = 2.1) and leukemia (RR = 2.0). Although cancer of the pancreas was elevated, there was no evidence of a dose-dependent risk. Cancer of the kidney was significantly increased among 15-year survivors. A nonsignificant twofold risk of radiogenic thyroid cancer was observed following an average dose of only 0.11 Gy. Breast cancer was not increased overall, despite an average dose of 0.31 Gy and 953 cases available for evaluation (RR = 0.9); there was, however, a weak suggestion of a dose response among women whose ovaries had been surgically removed. Doses greater than 6 Gy to the ovaries reduced breast cancer risk by 44%. A significant deficit of ovarian cancer was observed within 5 years of radiotherapy; in contrast, a dose response was suggested among 10-year survivors. Radiation was not found to increase the overall risk of cancers of the small intestine, colon, ovary, vulva, connective tissue, breast, Hodgkin's disease, multiple myeloma, or chronic lymphocytic leukemia. For most cancers associated with radiation, risks were highest among long-term survivors and appeared concentrated among women irradiated at relatively younger ages.
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PMID:Radiation dose and second cancer risk in patients treated for cancer of the cervix. 318 29

Quantification of delayed low dose radiation (LDR) effects is still controversial. The current concept of the shape of the dose-response curve, particularly at the very low levels, is derived primarily by extrapolation from high doses and is affected by economic, social and political implications of cancer yield. Evidence based on epidemiological studies of populations exposed to fallout, occupational, intrauterine or background LDR is limited, due to methodological drawbacks and the need for extremely large sample sizes. Nevertheless, recent data indicate that LDR-induced childhood leukemia and thyroid cancer may exceed the rates predicted on the basis of the linear quadratic curve. The high yield in utero and in early childhood could be associated with low cumulative load of background radiation, and a consequently more effective radiation increment. A long term follow up of children exposed to 90 mSv after scalp X-irradiation revealed a relative risk of 3.8 and an excess risk of about 1.08 per 1000 man-sievert per year for thyroid cancer. Application of these findings to the post-Chernobyl state of events suggests that an increment of up to 20% in thyroid cancer might occur in a population exposed to 5 mSv as an aftermath of a similar accident. Prediction of future risk estimates should therefore be made with alertness and an open mind.
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PMID:Cancer and leukemia risks after low level radiation--controversy, facts and future. 332 79

Time trends and differentials in cancer incidence in the five Nordic countries, Denmark, Finland, Iceland, Norway and Sweden, were investigated, using material collected by the cancer registries in each country. The incidence at all sites combined and at 23 anatomical sites was studied by age, birth cohort and time period. The maximum lengths of the trends were used for each country. In Denmark the material comprised all the tumours diagnosed in 1943-1980, in Finland and Norway those diagnosed in 1953-1980, in Iceland those diagnosed in 1955-1980, and in Sweden those diagnosed in 1958-1980. For males the age-adjusted cancer incidence rates at all sites combined were highest in Denmark and Finland, and lowest in Sweden and Norway. In females the incidence was highest in Denmark and Iceland, and lowest in Finland. The rates increased slightly for both sexes. For cancer of the pancreas, Hodgkin's disease, acute leukaemia and childhood cancer (all sites combined) the rates in all the Nordic countries were similar every year. For cancers of the stomach, colon, breast, corpus uteri, ovary, prostate, testis, urinary bladder, melanoma of the skin and non-Hodgkin's lymphomas the trends were similar but on different levels. For cancers of the larynx and lung in males the rates in Finland decreased during the 1970s, whereas the rates were increasing in the other Nordic countries. For cancer of the rectum, the trend showed a decrease in Denmark but an increase in the other Nordic countries. For lip cancer the rate in Sweden was almost constant over time, but in Denmark, Finland and Norway a decrease occurred. For oesophageal cancer in males the rates decreased in Finland and Iceland in the 1970s, whereas in Denmark and Norway there was very little change, and in Sweden there was an increase in the rates. For cancer of the cervix uteri the rates started to decrease in Denmark, Finland, Iceland and Sweden in the mid-1960s, but in Norway not until some ten years later. The differentials between the countries were largest for cancers of the testis and thyroid, in which the highest incidence was five to six times as large as the lowest. For testicular cancer the rate was the highest in Denmark, for thyroid cancer in Iceland. For both of these cancers the rate was the lowest in Finland. Melanoma of the skin was the cancer with the most rapid increase in incidence with time in all the Nordic countries.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Trends in cancer incidence in the Nordic countries. A collaborative study of the five Nordic Cancer Registries. 346 96

We carried out a cohort study of mortality among 954 Canadian military personnel exposed to low-dose ionizing radiation during nuclear reactor clean-up operations at Chalk River Nuclear Laboratories, Chalk River, Ont., and during observation of atomic test blasts in the United States and Australia in the 1950s. Two controls matched for age, service, rank and trade were selected for each exposed subject. Mortality among the exposed and control groups was ascertained by means of record linkage with the Canadian Mortality Data Base. Survival analysis with life-table techniques did not reveal any difference in overall mortality between the exposed and control groups. Analysis of cause-specific mortality showed similar mortality patterns in the two groups; there was no elevation in the exposed group in the frequency of death from leukemia or thyroid cancer, the causes of death most often associated with radiation exposure. Analysis of survival by recorded gamma radiation dose also did not show any effect of radiation dose on mortality. The findings are in agreement with the current scientific literature on the risk of death from exposure to low-dose radiation.
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PMID:Mortality among Canadian military personnel exposed to low-dose radiation. 356 65

Second malignancies were observed in 181 cases after treatment of antecedent breast cancer, among 5,302 primary breast cancer cases. The accumulated incidence of double cancer was as follows: 2.8% for 5 years, 5.2% for 10 years, 7.6% for 15 years, and 10.0% for 20 years. The observed incidence of second malignancy for all sites was 1.58 times as frequent as in the normal group. Statistically significant increased risks were observed for opposite breast cancer (O/E ratio 5.92), ovarian cancer (O/E ratio 4.47), corpus uterine cancer (O/E ratio 5.97) and thyroid cancer (O/E ratio 5.07). Among 5,302 cases, 2,431 (45.9%) underwent adjuvant chemotherapy. In chemotherapy groups, significantly increased risk of stomach cancer, thyroid cancer, leukemia and hepatoma was observed, but there were no remarkable differences between the MMC group and the CPA group. However, in the MMC + CPA combination treatment group, the risk of stomach cancer and leukemia was higher than in the single drug treatment groups. When multiple drugs were administered in large doses as long-term adjuvants, the risk of second malignancy seemed to become greater.
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PMID:[Effects of surgery and adjuvant chemotherapy of breast cancer on the incidence of a second malignancy]. 372 65


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