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Epidemiology and Biostatistics Program, Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland 20892 [M. A. T., J. D. B., B. J. S., J. H. L., R. N. H., J. F. F.]; Royal Manchester Children's Hospital, Pendlebury, England M27 1HA [P. H. M. J.]; University of Minnesota Hospital, Minneapolis, Minnesota 55404 [L. L. R.]; University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030 [M. S.]; Sunnybrook Medical Centre, Toronto, Ontario, Canada M4N 3M5 [R. D. T. J.]; Children's Memorial Hospital, Chicago, Illinois 60614 [E. S. B.]; Children's Hospital of Los Angeles, Los Angeles, California 90027 [S. E. S.]; and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104 [A. T. M.]
We estimated the risk of thyroid cancer among 9170 patients who had survived 2 or more years after the diagnosis of a cancer in childhood. As compared with the general population, patients had a 53-fold increased risk (95% confidence interval, 34–80). Risk increased significantly with time since treatment for the initial cancer (P = 0.03). Detailed treatment data were obtained for 23 cases and 89 matched controls from the childhood cancer cohort. Sixty-eight % of the thyroid cancers arose within the field of radiation. Radiation doses to the thyroid of > 200 cGy were associated with a 13-fold increased risk (95% confidence interval, 1.7–104). The risk of thyroid cancer rose with increasing dose (P < 0.001), but this was derived almost entirely from the increase from <200 to >200 cGy. The risk of thyroid cancer did not decrease, however, at radiation doses as high as 6000 cGy.
1 Supported in part by Public Health Service Contract N01CP-91049 from the Division of Cancer Etiology, National Cancer Institute.
2 To whom requests for reprints should be addressed, at EPN 439, 6130 Executive Blvd., Rockville, MD 20892.
Received 8/16/90. Accepted 3/14/91.
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