Keywords
benign thyroid pathology
morbidity
How to Cite
Abstract
The accident at the Chornobyl Nuclear Power Plant
(ChNPP) resulted in widespread radioactive contamination, with
the the main factor for the population, particularly children and
adolescents, being radioactive iodine isotopes (mainly 131I), which
target is the thyroid gland (TG). Assessment of the long-term consequences
of such exposure remains an urgent scientific problem.
Aim of the study. To assess the incidence rates of benign thyroid
morbidity among participants of the Ukrainian-American project
«Scientific Project to Study Cancer and Other Thyroid Diseases in
Ukraine Following the Chornobyl Accident» (UAP) in the remote periods
after the accident and to conduct a comparative analysis with
official epidemiological data for the relevant regions and Ukraine as
a whole. Material and methods. In 1998-2000, as part of a classical
prospective cohort study, implemented in cooperation between
the State Institution «V.P. Komisarenko Institute of Endocrinology and
Metabolism of the National Academy of Medical Sciences of Ukraine»
and the National Cancer Institute, USA, a cohort of individuals was
formed who: a) at the time of the accident permanently resided or
were temporarily stayed in the most radiation-contaminated areas
of Zhytomyr, Kyiv and Chernihiv regions; b) were under 18 years of
age at the time of the accident; c) underwent thyroid radiometry in
the first week after the accident; d) were selected randomly. The examination
program included registration, thyroid ultrasound, laboratory
tests (thyroid-stimulating hormone, free thyroxine, thyroglobulin,
ionized calcium, thyroperoxidase and thyroglobulin antibodies),
urine iodine determination, an endocrinologist consultation, and
questionnaires for reconstruction of the thyroid radiation dose. When
indicated, more in-depth examinations were performed, including
fine-needle aspiration biopsy of the thyroid gland, and appropriate
treatment was prescribed. Clinical diagnoses established based on
the final endocrinological conclusions were used for the analysis. Five
active screening cycles were conducted: 1st (1998-2000), 2nd (2001-
2003), 3rd (2003-2005), 4th (2005-2008) and 5th (2012-2015). Incidence
rates in cycles 2-5 were calculated taking into account the average
duration between examinations and expressed as the number of
cases per 1000 person-years. Statistical analysis was performed using
appropriate software packages. All participants (or parents of minors)
provided written informed consent. Results. Significantly higher incidence
rates of follicular adenoma, diffuse non-toxic and toxic goiter,
nodular non-toxic goiter, autoimmune thyroiditis, postoperative andacquired hypothyroidism were found among UAP participants compared
to official data of the Ministry of Health of Ukraine for the relevant
regions and country as a whole. in general. These elevated rates
are largely due to the specific implementation features of UAP, which
are inherent to mass screening programs: active medical examination
regardless of complaints, highly qualified staff, better logistics, and a
wider range of diagnostic procedures. Additional factors that could
be influenced by different diagnostic criteria, iodine deficiency in
the northern regions of Ukraine and the radiation factor, the study of
which is the main purpose of UAP. Conclusions. The incidence rates
of the main types of benign thyroid pathology among UAP participants
12-29 years after the Chornobyl accident significantly exceed
the corresponding official data of the Ministry of Health of Ukraine for
the northern regions and Ukraine for the same period.
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