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Life Span Study Report 10. Part 1

Technical Report No. 1-86
Life span study report 10. Part 1. Cancer mortality among A-bomb survivors in Hiroshima and Nagasaki, 1950-82

Preston DL, Kato H, Kopecky KJ, Fujita S
Editor's note: The following journal articles, based on this ABCC technical report, were published in the scientific literature:
  • Preston DL, Kato H, Kopecky KJ, Fujita S: Studies of the mortality of A-bomb survivors. 8. Cancer mortality, 1950-1982. Radiat Res 111:151-78, 1987
  • Preston DL, Kato H, Kopecky KJ, Fujita S: Studies of the mortality of A-bomb survivors. 8. Cancer mortality, 1950-1982. Hiroshima Igaku [J Hiroshima Med Assoc] 41:1377-97, 1988 (in Japanese)
  • Summary
    The present study extends the previous report on cancer mortality among atomic bomb survivors by adding data from four additional years of follow-up (1979-1982) and by expanding the cohort (now designated LSS-E85) to include 11,393 Nagasaki survivors located between 2,500-9,999 m from the hypocenter at the time of the bombing (ATB). Among 91,231 exposed survivors with tentative 1965 (T65DR) dose estimates, there were 6,270 cancer deaths during 1950-1982. Among the 54,058 persons with T65DR dose estimates greater than 0.5 rad, there were 3,832 cancer deaths during 1950-1982, an estimated 8% of which are excess deaths attributable to A-bomb radiation.

    The results of analyses of mortality from specific cancers, in relation to T65DR dose estimates, are generally consistent with the previous findings. Significant dose responses were observed for leukemia, for cancers of the lung, female breast, stomach, colon, esophagus, and urinary bladder, and for multiple myeloma. Four new categories of cancer were also investigated: the results for cancers of the liver and intrahepatic bile ducts and of the ovary and other uterine adnexa were suggestive of significant radiation effects, but the positive dose responses for cancers of the gallbladder and prostate were not significant. Due to diagnostic difficulties and the lack of evidence for radiogenic effects at these sites, the results for liver and ovarian cancers do not provide convincing evidence for radiogenic effects.

    With the exception of multiple myeloma, the relative risk (RR) of radiation-induced cancer mortality was greater for women than for men, for each nonleukemic cancer with a significant overall dose response. These differences can be attributed in large measure to differences in the background cancer mortality rates, which are generally much higher for men than women. For leukemia there was no significant sex difference in the RR, while for multiple myeloma women had a slightly, though nonsignificantly, lower RR than males.

    The rate at which the excess RR of leukemia mortality has decreased with age varies significantly with age ATB (p = .03); the excess risk among young ATB groups has declined more rapidly and from larger initial levels, compared to those who were older ATB. The present analyses also suggest that the occurrence of radiation-induced leukemia death has persisted as late as 1979-1982.

    A statistically significant interaction (p = .008) between the effects of age ATB and attained age on radiation-related mortality was also observed for cancers other than leukemia. In particular, the initially large RRs seen in those who were young ATB have decreased with time, while the smaller RRs for those who were older ATB tended to increase. While this pattern was statistically significant only for all nonleukemic cancers combined, a similar pattern was seen in separate analyses for cancers of the stomach, lung, and female breast. The absolute risk of radiation-induced nonleukemic cancer mortality has increased with time for all age ATB groups.
    Editor's note: The following components of this report contain data on communicable diseased frequencies, allergies, malignancies, and many other symptoms that may be of interest from a public health standpoint.

    List of Tables

    1. Number of exposed subjects with T65DR dose estimates and mean doses, by city and T65DR dose category; both sexes, all ages ATB (LSS-E85 cohort)
    2. Distribution of deaths by cause and exposure status; both cities, both sexes, all ages ATB, 1950-1982 (LSS-E85 cohort, T65DR doses)
    3. Summary measures of radiation dose response for mortality from selected causes; both cities, both sexes, all ages ATB, 1950-1982 (LSS-E85 cohort, T65DR doses)
    4. Variation of radiation dose response by sex; both cities, all ages ATB, 1950-1982 (LSS-E85 cohort, T65DR doses)
    5. Trends in radiation dose response with attained age by age ATB; both cities, both sexes, 1950-1982 (LSS-E85 cohort, T65DR doses)
    6. Variation of radiation dose response by age ATB; both cities, both sexes, 1950-1982 (LSS-E85 cohort, T65DR doses)
    List of Appendix Tables
      Appendix 1
      1. Definitions of categories of cause of death in terms of ICD rubrics
      2. Covariates used for investigation of dose-response modification
      3. Dose-response models used in analyses for the present report
      4. Selection criteria for method of significance level computation: Dose trend tests

      Appendix 2

      1. Comparison of death rates by cause of death

      Appendix 3

      1. Numbers of persons and person-years at risk
      2. All causes of death
      3. All diseases
      4. All neoplasms
      5. All malignant neoplasms
      6. Leukemia
      7. All cancers except leukemia
      8. Cancers of the digestive organs and peritoneum
      9. Cancer of the esophagus
      10. Cancer of the stomach
      11. Cancer of the colon
      12. Cancers of the rectum, rectosigmoid, and anus
      13. Cancers of the liver and intrahepatic bile ducts
      14. Cancers of the gallbladder and extrahepatic bile ducts
      15. Cancer of the pancreas
      16. Cancers of the digestive organs and peritoneum other than those of tables Appendix 3-9 through Appendix 3-15
      17. Cancers of the respiratory system and intrathoracic organs
      18. Cancers of the trachea, bronchus, and lung
      19. Cancer of the female breast
      20. Cancers of the cervix uteri, uterus, and placenta
      21. Cancer of the cervix uteri
      22. Cancers of the ovary and other uterine adnexa
      23. Cancer of the prostate
      24. Cancers of the bladder, kidney, and other or unspecified urinary organs
      25. Malignant lymphoma
      26. Multiple myeloma
      27. Cancers other than those of tables Appendix 3-6 through Appendix 3-26