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Submitted on March 6, 2006
Accepted on August 9, 2006
Institute of Endocrinology and Metabolism, Kyiv, Ukraine; Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, MD, USA; Clinical Endocrinology Branch, NIDDK, NIH, DHHS, Bethesda, MD, USA; Department of Medicine, The Thyroid Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Scientific Center for Radiation Medicine, Academy of Medical Sciences, Kyiv, Ukraine; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Radiation and Radiological Sciences, School of Medicine, Vanderbilt University, Nashville, TN, USA
* To whom correspondence should be addressed. E-mail: brennera{at}mail.nih.gov.
Context: Due to the Chornobyl accident, millions were exposed to radioactive isotopes of iodine and some received appreciable 131I doses. A subsequent increase in thyroid cancer has been largely attributed to this exposure, but evidence concerning autoimmune thyroiditis (AIT) remains inconclusive.
Objective: To quantify risk of AIT following 131I exposure.
Design/Setting/Participants: Baseline data were collected from the first screening cycle (1998-2000) of a large cohort of radiation-exposed individuals (n = 12,240), residents of contaminated, iodine deficient territories of Ukraine. Study individuals were under the age of 18 yr on April 26, 1986 and had thyroid radioactivity measurements made shortly after the accident.
Outcomes: AIT was defined a priori based on various combinations of elevated antibodies to thyroid peroxidase (ATPO), TSH, and clinical findings; elevated ATPO were considered to be an indicator of thyroid autoimmunity.
Results: No significant association was found between 131I thyroid dose estimates and AIT, but prevalence of elevated ATPO demonstrated a modest, significant association with 131I that was well described by several concave models. This relationship was apparent in individuals with moderately elevated ATPO and euthyroid, thyroid disease-free individuals.
Conclusions: Twelve to fourteen years after the Chornobyl accident, no radiation-related increase in prevalence of AIT was found in a large cohort study, the first in which 131I thyroid doses were estimated using individual radioactivity measurements. However, a dose-response relationship with ATPO prevalence raises the possibility that clinically important changes may occur over time. Thus, further follow up and analysis of prospective data in this cohort are necessary.
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