1. Prevalence of Thyroid Nodules in Residents of Ukraine Exposed as Children or Adolescents to Iodine-131 from the Chornobyl Accident.
- Author
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Cahoon EK, Grimm E, Mabuchi K, Mai JZ, Zhang R, Drozdovitch V, Hatch M, Little MP, Peters KO, Bogdanova TI, Shelkovoy E, Shpak VM, Terekhova G, Zamotayeva G, Pasteur IP, Masiuk SV, Chepurny M, Zablotska LB, McConnell R, O'Kane P, Tronko MD, and Brenner AV
- Subjects
- Humans, Ukraine epidemiology, Adolescent, Child, Male, Prevalence, Female, Cross-Sectional Studies, Young Adult, Radiation Exposure adverse effects, Child, Preschool, Thyroid Neoplasms epidemiology, Thyroid Neoplasms etiology, Thyroid Neoplasms diagnostic imaging, Ultrasonography, Radiation Dosage, Neoplasms, Radiation-Induced epidemiology, Risk Factors, Thyroid Nodule epidemiology, Thyroid Nodule diagnostic imaging, Chernobyl Nuclear Accident, Iodine Radioisotopes adverse effects
- Abstract
Background: Although childhood exposure to radioactive iodine-131 (I-131) is an established risk factor for thyroid cancer, evidence for an association with thyroid nodules is less clear. The objective of this study is to evaluate the association between childhood I-131 exposure and prevalence of ultrasound-detected thyroid nodules overall and by nodule histology/cytology (neoplastic/suspicious/non-neoplastic), size (<10 mm/≥10 mm), and number (single/multiple). Methods: This is a cross-sectional study of radiation dose (mean = 0.53 gray, range: 0.0003-31 gray) and screen-detected thyroid nodules conducted in 1998-2000 (median population age 21.5 years) in a cohort of 13,243 residents of Ukraine who were under 18 years at the time of the Chornobyl accident on April 26, 1986. Excess odds ratios per gray (excess odds ratio [EOR]/Gy) and confidence intervals (CIs) were estimated using logistic regression. Results: Among 13,078 eligible individuals, we identified 358 (2.7%) with at least one thyroid nodule. Significantly increased dose-response associations were found for all nodules and nodule groups with doses <5 Gy except individuals with non-neoplastic nodules. Among individuals with doses <5 Gy, the EOR/Gy for neoplastic nodules (5.35; CI: 2.19-15.5) was significantly higher than for non-neoplastic nodules (0.24; CI: 0.07-0.74), but the EOR/Gy did not vary by nodule size or number. Conclusions: Childhood exposure to I-131 is associated with an increased risk of thyroid nodules detected 12-14 years following exposure, and the risk for neoplastic nodules is higher than for non-neoplastic nodules. Analyses of incident thyroid nodules may help clarify dose-response patterns by nodule characteristics and provide insights into thyroid nodule etiology.
- Published
- 2024
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