Thyroid cancer incidence in Chornobyl liquidators in Ukraine: SIR analysis, 1986-2010.

We studied thyroid cancer incidence in a cohort of 150,813 male Chornobyl clean-up workers ("liquidators") from Ukraine by calculating standardized incidence ratio (SIR) using national cancer statistics. Follow-up began on the liquidator's registration date with the Chornobyl State Registry of Ukraine (the earliest date was 05. 05. 1986) and continued through December 31, 2010, date of thyroid cancer diagnosis, date of death, or date of last known vital status, whichever came first. There were 196 incident thyroid cancers in the study cohort with an overall SIR of 3.50 [95 % confidence interval (CI) 3.04-4.03]. A significantly elevated SIR estimate of 3.86 (95 % CI 3.26-4.57) was observed for liquidators who had their first clean-up mission in the Chornobyl zone in 1986, when levels of external and internal exposure to radiation were highest; the SIR estimates for later calendar years of first clean-up mission, while significantly elevated, were lower. The SIR estimates were elevated throughout the entire follow-up period but were especially high 10-18 years after the accident: 4.62 (95 % CI 3.47-6.15) and 4.80 (95 % CI 3.78-6.10) for the period 1995-1999 and 2000-2004, respectively. Our findings support the growing evidence of increased thyroid cancer rates among Chornobyl liquidators. Although this could be partially attributed to increased medical surveillance, the observed pattern of SIR increase warrants further investigation of a potential contribution of radiation exposure to the elevated thyroid cancer rates in this large population.