PO.PS01.12 · 人群科学
钻孔水中天然放射性核素与癌症风险之间的关联：一项来自芬兰的基于人群的综合研究
Associations between natural radionuclides in borehole water and cancer risks: A comprehensive population-based study from Finland
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作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：
环境本底中放射性元素对所有癌症类型的致癌作用尚未得到充分研究。
方法：
本文基于芬兰全体人口，评估钻孔水中放射性元素与所有癌症类型之间的关联。将 1987-2016 年间连续居住在芬兰的普通人群国家登记数据与钻孔水中铀（Ur）和氡（Rn）的年度市级浓度相链接。基于每年的居住地点，为每个个体计算了 30 年间的平均辐射暴露。基于国家癌症登记，从 2017 年至 2021 年随访新诊断的癌症。通过 Cox 比例风险模型评估暴露与癌症发病率之间的关联，并对既有健康状况和社会经济因素进行校正。使用 Bonferroni 校正对多重性进行调整。
结果：
共纳入 1,013,054 名男性和 1,101,589 名女性（市级暴露数据无缺失）。在随访期内，男性共诊断出 70 个亚型的 62,085 例癌症病例，女性共诊断出 73 个亚型的 57,627 例癌症病例。在男性（Ur：风险比 [HR] 1.05，95% 置信区间 [CI] 1.03-1.07；Rn：1.04，1.02-1.05）和女性（Ur：1.07，1.05-1.09；Rn：1.05，1.03-1.07）中均观察到环境辐射暴露与癌症风险升高之间的显著关联。经多重性校正后，在 Ur 暴露较高的男性中观察到以下癌症风险显著升高：淋巴和造血组织性质未定的癌症（1.66，1.39-1.97）、间皮瘤（1.48，1.18-1.86）、骨髓瘤（1.36，1.18-1.57）、黑色素瘤（1.31，1.22-1.40）、淋巴细胞白血病（1.28，1.12-1.48）；在 Rn 暴露较高者中观察到真性红细胞增多症（1.79，1.30-2.45）、淋巴和造血组织性质未定的癌症（1.61，1.36-1.91）、骨髓瘤（1.52，1.32-1.75）、黑色素瘤（1.22，1.14-1.31）和膀胱癌（1.20，1.08-1.32）风险升高。在 Ur 暴露较高的女性中观察到以下风险显著升高：淋巴和造血组织性质未定的癌症（1.78，1.52-2.08）、淋巴细胞白血病（1.48，1.24-1.77）、黑色素瘤（1.33，1.24-1.44）、肺癌（1.26，1.19-1.34）和乳腺癌（1.07，1.04-1.10）；在 Rn 暴露较高者中观察到淋巴和造血组织性质未定的癌症（1.73，1.48-2.03）、真性红细胞增多症（1.72，1.26-2.35）、骨髓瘤（1.51，1.30-1.75）、黑色素瘤（1.28，1.19-1.38）和肺癌（1.21，1.14-1.29）风险升高。在敏感性分析中，在 1987-2016 年间仅居住于独栋房屋的样本中观察到类似模式。在男性和女性中分别观察到总癌症风险的剂量-反应趋势。
解读：
高环境辐射暴露与普通人群总癌症风险及若干亚型风险升高显著相关。
查看英文原文 English abstract
Background:
Carcinogenic effects of radioactive elements in environmental background for all cancer types have not been fully investigated.
Methods:
This paper assesses the associations between radioactive elements in borehole water and all cancer types based on total Finnish population. National registries of the general population living continuously in Finland during 1987-2016 were linked to annual municipality-level concentrations of uranium (Ur) and radon (Rn) in borehole water. Average radiation exposures over 30 years were calculated individually based on residential location annually. Newly diagnosed cancers were followed from 2017 until 2021 based on national cancer registry. Associations between exposures and cancer incidences were assessed via Cox proportional hazards models, adjusted for pre-existing health conditions and socio-economic factors. Multiplicity was adjusted using Bonferroni correction.
Results:
Totally 1,013,054 men and 1,101,589 women with non-missing municipality-level exposures were included. During follow-up period, totally 62,085 cancer cases of 70 sub-types were diagnosed in men and 57,627 cancer cases of 73 sub-types were diagnosed in women respectively. Significant associations between environmental radiation exposures and elevated risks of cancer were observed in men (Ur: hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.03-1.07; Rn: 1.04, 1.02-1.05) and women (Ur: 1.07, 1.05-1.09; Rn: 1.05, 1.03-1.07). After correction of multiplicity, significantly elevated risks were observed for cancers of uncertain lymphoid and hematopoietic tissue (1.66, 1.39-1.97), mesothelioma (1.48, 1.18-1.86), myeloma (1.36, 1.18-1.57), melanoma (1.31, 1.22-1.40), leukemia lymphoid (1.28, 1.12-1.48) in men with higher exposure to Ur; and Polycythemia vera (1.79, 1.30-2.45), uncertain lymphoid and hematopoietic tissue (1.61, 1.36-1.91), myeloma (1.52, 1.32-1.75), melanoma (1.22, 1.14-1.31) and bladder (1.20, 1.08-1.32) with higher exposure to Rn. Significantly elevated risks were observed for uncertain lymphoid and hematopoietic tissue (1.78, 1.52-2.08), leukemia lymphoid (1.48, 1.24-1.77), melanoma (1.33, 1.24-1.44), lung (1.26, 1.19-1.34) and breast (1.07, 1.04-1.10) in women with higher exposure to Ur; and uncertain lymphoid and hematopoietic tissue (1.73, 1.48-2.03), Polycythemia vera (1.72, 1.26-2.35), myeloma (1.51, 1.30-1.75), melanoma (1.28, 1.19-1.38) and lung (1.21, 1.14-1.29) with higher exposure to Rn. In sensitivity analysis, similar patterns were observed in samples who only lived in houses during 1987-2016. Dosage-response trends were observed for total cancer risks in men and women respectively.
Interpretation:
High environmental radiation exposures were significantly associated with elevated total cancer risks and several sub-types in the general population.
利益披露 Disclosure
P. Li, None.