江苏省医用诊断X射线工作者肿瘤流行病学调查

An epidemiologic investigation of cancers among medical diagnostic X-ray workers of 1950-1996 in Jiangsu Province

目的 医用诊断X射线工作者是小剂量长期照射的特定人群 ,调查旨在研究辐射诱发恶性肿瘤在这一人群中的表现及特点。方法 收集定群队列 195 0～ 1996年间恶性肿瘤发病资料 ,其相对危险 (RR)计算采用Epicure(HirosoftInternationalCorp .1988～ 1992 )中的AMFIT程序。结果该定群队列来自江苏省各医院医用诊断X射线工作者和同所医院其他科室医务工作者共 770 1人 ,累计观察了 2 15 35 5人年 ,期间发生恶性肿瘤 312例 ,经性别、年龄调整 ,照射组全部恶性肿瘤的相对危险RR >1;妇女乳腺癌的发病率显著增高 (RR =3.3,95 %置信区间为 1 39～ 8 0 7) ;实体癌及白血病RR达 1 2和 2 6 ;恶性肿瘤的平均发病年龄由对照组的 5 5 0提前至 5 1 3岁 ;照射组全死因RR为1 2。结论 医用诊断X射线工作者这一群体显现出辐射致癌效应。但要得出全面的结论仍需继续追踪观察。

Objective\ To research the phenomenon and characteristic of radiation oncogenesis among medical diagnostic X\|ray workers. Methods\ The cancer incidence data of the fixed cohort from the beginning of 1950 to the end of 1996 were collected.The estimates of relative risk(RR)were calculated by AMFIT in Epicure(Hirosoft International Corp,1988-1992). Results\ During the period of 1950-1996 there were 312 cancers among 215 355 person\|years at risk in a cohort of 7 701 subjects,including,medical diagnostic X\|ray workers and workers of other departments in the same hospitals.The RR adjusted for sex and age for overall cancers was more than 1.The incidence of female breast cancer increased significantly(RR=3.3,95%,CI=1.39-8.07),and the relative risks for solid cancer and leukemia were 1.2 and 2.6,respectively.The average age of occurrence of malignant tumors was moved up from 55.0 years in the controls to 51.3 years in the X\|ray workers. Conclusions There is a positive effect of radiation oncogenesis on medical diagnostic X\|ray workers,although our sample size is not large enough to make a definite overall conclusion statistically.Further follow\|up is needed.