阳江高本底地区恶性肿瘤死亡调查1987～1995年资料分析

Analysis of data (1987-1995) from investigation of cancer mortality in high background radiation area of Yangjiang,China\

目的本项研究是高本底辐射研究组的一项专题，始于１９７２年，旨在探索平均年有效剂量为６４ｍＳｖ的阳江天然放射性高本底辐射照射的致癌危险。１９９１年起中日两国科学家合作继续研究，以累积更多观察人年数，提高统计学精度，并检验以往研究的可重复性。方法合作研究后所获１９８７～１９９５年恶性肿瘤死亡资料是通过回顾性调查或／和前瞻性调查从定群队列中获得。恶性肿瘤死亡现场调查分为队列成员追踪和死因确认两步骤。按外照射年剂量水平，将高本底人群分为高、中、低剂量３个组，以进行内比较。高本底地区３个剂量组与对照组之间的比较采用相对危险（ＲＲ）。ＲＲ和超额相对危险（ＥＲＲ）系数及其９５％置信区间（ＣＩ）计算应用Ｅｐｉｃｕｒｅ中ＡＭＦＩＴ程序。结果１９８７年１月１日定群观察起点人口为１０６５１７人，至１９９５年共累积观察９２６２３８人年，期间共死亡５１６１人，其中恶性肿瘤死亡５５７例。整个高本底地区经性别年龄组调整的全部恶性肿瘤的ＲＲ（９５％ＣＩ）为０９６（０８０，１１５）。就部位别恶性肿瘤而论，白血病、鼻咽癌、食管癌和小肠癌的ＲＲ大于１，而胃癌、肝癌、肺癌、女性乳腺癌、甲状腺癌和淋巴肉瘤的ＲＲ小于１，但差异均无显著性。对全?

Objective\ This investigation is a special project of High Background Radiation Research Group.The objective of the cancer mortality study in the high background radiation area (HBRA) of Yangjiang,China,which was started in 1972,was to estimate cancer risk associated with the low level radiation exposure of average annual effective dose of 6.4 mSv in HBRA.Since 1991,the study has been conducted collaboratively by Chinese and Japanese scientists with the purpose of accumulating further person years (Pyr) of observation for improving the statistical precision and seeing the reproducibility of the previous results. Methods The cancer mortality data of 1987 1995 covered in the current cooperative study were collected by a retrospective and/or prospective survey from a fixed cohort.The mortality investigation on the spot consisted of two steps,i.e.the follow up of members in the cohort and the ascertainment of the death causes.Based on the hamlet specific average annual external dose,the members of the cohort in HBRA were classified into three groups:high,medial and low dose groups.Risk comparisons between each of the three dose groups with the control group from control area (CA) were conducted by means of relative risk (RR).The RR and the excess relative risk coefficient (ERR per sievert) and their 95% confidence interval (CI) were estimated using AMFIT program in Epicure. Results During the period 1987 1995,there were 5161 total deaths and 557 cancer deaths among 926238 Pyr at risk in the cohort of 106517 subjects.The RR (95% CI) adjusted for sex and age group for all cancers of whole HBRA was 0.96 ( 0.80- 1.15).As for the site specific cancer of whole HBRA,the RRs for leukemia,cancers of nasopharynx,esophagus and intestine were larger than one,while the RRs for cancers of stomach,liver,lungs,female breast,thyroid and lymphoma were less than one.However,all of them were not statistically different from one ( P >0.05 for all).The homogeneity tests of RRs for all cancers and for site specific cancer among the three dose groups in HBRA revealed that the RRs among the dose groups were not different statistically ( P >0.05 for all).The results of RR estimation based on the combined data of 1979 1995,which included 125079 subjects,and total deaths of 10415 and cancer deaths of 1003 among 1698350 Pyr at risk,were generally consistent with those based on the data of 1987 1995 mentioned above.The RR (95%CI) for all cancers of whole HBRA was 0.99 (0.87 1.14) and the ERR (95%CI)/Sv of all cancers for both sexes and all ages was 0.10(-0.67,0.69) resulting from the combined data. Conclusion The results from data of different periods demonstrated that an increased cancer risk associated with the high levels of natural radiation in HBRA was not found;on the contrary,there was a trend that the mortality of all cancers in HBRA was generally lower than that in CA,but not significantly different statistically.