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      Radiation exposure and thyroid cancer: a review

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          ABSTRACT

          The association between radiation exposure and the occurrence of thyroid cancer has been well documented, and the two main risk factors for the development of a thyroid cancer are the radiation dose delivered to the thyroid gland and the age at exposure. The risk increases after exposure to a mean dose of more than 0.05-0.1 Gy (50-100mGy). The risk is more important during childhood and decreases with increased age at exposure, being low in adults. After exposure, the minimum latency period before the appearance of thyroid cancers is 5 to 10 years. Papillary carcinoma (PTC) is the most frequent form of thyroid carcinoma diagnosed after radiation exposure, with a higher prevalence of the solid subtype in young children with a short latency period and of the classical subtype in cases with a longer latency period after exposure. Molecular alterations, including intra-chromosomal rearrangements, are frequently found. Among them, RET/PTC rearrangements are the most frequent. Current research is directed on the mechanism of genetic alterations induced by radiation and on a molecular signature that can identify the origin of thyroid carcinoma after a known or suspected exposure to radiation.

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          Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis

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            Risk of thyroid cancer after exposure to 131I in childhood.

            After the Chernobyl nuclear power plant accident in April 1986, a large increase in the incidence of childhood thyroid cancer was reported in contaminated areas. Most of the radiation exposure to the thyroid was from iodine isotopes, especially 131I. We carried out a population-based case-control study of thyroid cancer in Belarus and the Russian Federation to evaluate the risk of thyroid cancer after exposure to radioactive iodine in childhood and to investigate environmental and host factors that may modify this risk. We studied 276 case patients with thyroid cancer through 1998 and 1300 matched control subjects, all aged younger than 15 years at the time of the accident. Individual doses were estimated for each subject based on their whereabouts and dietary habits at the time of the accident and in following days, weeks, and years; their likely stable iodine status at the time of the accident was also evaluated. Data were analyzed by conditional logistic regression using several different models. All statistical tests were two-sided. A strong dose-response relationship was observed between radiation dose to the thyroid received in childhood and thyroid cancer risk (P<.001). For a dose of 1 Gy, the estimated odds ratio of thyroid cancer varied from 5.5 (95% confidence interval [CI] = 3.1 to 9.5) to 8.4 (95% CI = 4.1 to 17.3), depending on the risk model. A linear dose-response relationship was observed up to 1.5-2 Gy. The risk of radiation-related thyroid cancer was three times higher in iodine-deficient areas (relative risk [RR]= 3.2, 95% CI = 1.9 to 5.5) than elsewhere. Administration of potassium iodide as a dietary supplement reduced this risk of radiation-related thyroid cancer by a factor of 3 (RR = 0.34, 95% CI = 0.1 to 0.9, for consumption of potassium iodide versus no consumption). Exposure to (131)I in childhood is associated with an increased risk of thyroid cancer. Both iodine deficiency and iodine supplementation appear to modify this risk. These results have important public health implications: stable iodine supplementation in iodine-deficient populations may substantially reduce the risk of thyroid cancer related to radioactive iodines in case of exposure to radioactive iodines in childhood that may occur after radiation accidents or during medical diagnostic and therapeutic procedures.
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              Thyroid cancer after Chernobyl.

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                Author and article information

                Journal
                Arch Endocrinol Metab
                Arch Endocrinol Metab
                aem
                Archives of Endocrinology and Metabolism
                Sociedade Brasileira de Endocrinologia e Metabologia
                2359-3997
                2359-4292
                01 February 2017
                Mar-Apr 2017
                : 61
                : 2
                : 180-187
                Affiliations
                [1 ] orgdiv1Institut Gustave Roussy orgnameUniversité Paris-Sud Villejuif France originalInstitut Gustave Roussy, Université Paris-Sud, Villejuif, France
                [2 ] orgdiv1Hospital de Clínicas orgnameUniversity of Buenos Aires Buenos Aires Argentina original Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires. Buenos Aires, Argentina
                [3 ] Villejuif France original Cancer and Radiation Team, INSERM Unit 1018, Villejuif, France
                [4 ] orgnameInstitute of Cellular and Molecular Radiobiology orgdiv1Laboratory of Experimental Cancerology Fontenay-aux-Roses France original CEA, Institute of Cellular and Molecular Radiobiology, Laboratory of Experimental Cancerology, CEA, Fontenay-aux-Roses, France
                Author notes
                Correspondence to: Maria Laura Iglesias. Institut Gustave Roussy, 114 Rue Edouard Vaillant 94800 – Villejuif, France. maria.iglesias@ 123456gustaveroussy.fr

                Disclosure: no potential conflict of interest relevant to this article was reported.

                Article
                2359-3997000000257
                10.1590/2359-3997000000257
                10118869
                28225863
                cdd18045-8db0-4440-b729-8d494958db97

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 August 2016
                : 31 October 2016
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 54, Pages: 1
                Categories
                Articles

                differentiated thyroid carcinoma,radiation-induced thyroid cancer,radiation exposure,chernobyl accident

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