A pooled analysis of thyroid cancer incidence following radiotherapy for childhood cancer

Lene H S Veiga, Jay H Lubin, Harald Anderson, Florent de Vathaire, Margaret Tucker, Parveen Bhatti, Arthur Schneider, Robert Johansson, Peter Inskip, Ruth Kleinerman, Roy Shore, Linda Pottern, Erik Holmberg, Michael M Hawkins, M Jacob Adams, Siegal Sadetzki, Marie Lundell, Ritsu Sakata, Lena Damber, Gila NetaElaine Ron

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    84 Citations (Scopus)


    Childhood cancer five-year survival now exceeds 70-80%. Childhood exposure to radiation is a known thyroid carcinogen; however, data are limited for the evaluation of radiation dose-response at high doses, modifiers of the dose-response relationship and joint effects of radiotherapy and chemotherapy. To address these issues, we pooled two cohort and two nested case-control studies of childhood cancer survivors including 16,757 patients, with 187 developing primary thyroid cancer. Relative risks (RR) with 95% confidence intervals (CI) for thyroid cancer by treatment with alkylating agents, anthracyclines or bleomycin were 3.25 (0.9-14.9), 4.5 (1.4-17.8) and 3.2 (0.8-10.4), respectively, in patients without radiotherapy, and declined with greater radiation dose (RR trends, P = 0.02, 0.12 and 0.01, respectively). Radiation dose-related RRs increased approximately linearly for 50 Gy. The fitted RR at 10 Gy was 13.7 (95% CI: 8.0-24.0). Dose-related excess RRs increased with decreasing age at exposure (P
    Original languageEnglish
    Pages (from-to)365-76
    JournalRadiation Research
    Issue number4
    Publication statusPublished - Oct 2012


    • Adolescent
    • Adult
    • Case-Control Studies
    • Child
    • Child, Preschool
    • Dose-Response Relationship, Radiation
    • Female
    • Humans
    • Incidence
    • Infant
    • Male
    • Neoplasms
    • Neoplasms, Radiation-Induced
    • Neoplasms, Second Primary
    • Radiotherapy
    • Thyroid Neoplasms


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