BMJ public health · 2026
Tracing echoes from the past: a district-level analysis of thyroid cancer incidence and radiation exposure in post-Chornobyl Ukraine.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Levchuk Nataliia, Schöley Jonas, Cilek Laura, Jasilionis Domantas
Аннотация
INTRODUCTION: Increases in thyroid cancer have been reported as one of the major public health consequences of the Chornobyl accident. Using an excess relative risk (ERR) model and detailed district-level data across Ukraine, we aimed to estimate the association between iodine-131 exposure and thyroid cancer risk while accounting for spatial confounding.
METHODS: This ecological study used data on all diagnosed thyroid cancer cases in 2001 among individuals aged 15 years or older and settlement-level iodine-131 thyroid doses from 1986, covering the entire territory of Ukraine and encompassing 627 spatial units (districts and cities). District doses were estimated by sex and age using areal-weighted interpolation. District-level standardised incidence ratios (SIRs) were calculated and smoothed with negative binomial regression and spatial P-splines. The ERR was assessed using an intrinsic conditional autoregressive negative binomial (ICAR-NB) model adjusting for sex, age at exposure and district-specific effects.
RESULTS: Excess thyroid cancer incidence was observed not only in northern districts near the Chornobyl plant but also in several central districts. The ICAR-NB model produced lower ERR estimates than the corresponding model without district-level adjustment, suggesting that risks may be overestimated when spatial dependencies are ignored (ages at exposure 0-4: 24.85 (95% CI 7.78 to 41.78) vs 48.09 (95% CI 17.05 to 79.11)). ERRs were significant for both sexes although sex differences were not statistically significant. Risk decreased strongly with age at exposure.
CONCLUSIONS: This study underscores the value of small-area data analysis and spatial modelling for assessing radiation-related health risks and offers methodological guidance for future studies following nuclear accidents.
METHODS: This ecological study used data on all diagnosed thyroid cancer cases in 2001 among individuals aged 15 years or older and settlement-level iodine-131 thyroid doses from 1986, covering the entire territory of Ukraine and encompassing 627 spatial units (districts and cities). District doses were estimated by sex and age using areal-weighted interpolation. District-level standardised incidence ratios (SIRs) were calculated and smoothed with negative binomial regression and spatial P-splines. The ERR was assessed using an intrinsic conditional autoregressive negative binomial (ICAR-NB) model adjusting for sex, age at exposure and district-specific effects.
RESULTS: Excess thyroid cancer incidence was observed not only in northern districts near the Chornobyl plant but also in several central districts. The ICAR-NB model produced lower ERR estimates than the corresponding model without district-level adjustment, suggesting that risks may be overestimated when spatial dependencies are ignored (ages at exposure 0-4: 24.85 (95% CI 7.78 to 41.78) vs 48.09 (95% CI 17.05 to 79.11)). ERRs were significant for both sexes although sex differences were not statistically significant. Risk decreased strongly with age at exposure.
CONCLUSIONS: This study underscores the value of small-area data analysis and spatial modelling for assessing radiation-related health risks and offers methodological guidance for future studies following nuclear accidents.