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August 2, 1995, Vol 274, No. 5 >
ARTICLE | August 2, 1995

Studies of Cancer and Radiation Dose Among Atomic Bomb Survivors: Title and subTitle BreakThe Example of Breast Cancer FREE

Charles E. Land, PhD
[+] Author Affiliations

Reprint requests to Radiation Epidemiology Branch, National Cancer Institute, EPN 408, 6130 Executive Blvd, MS 7362, Bethesda, MD 20892-7362 (Dr Land).


JAMA. 1995;274(5):402-407. doi:10.1001/jama.1995.03530050050031
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References

A comprehensive program of medical follow-up of survivors of the atomic bombings of Hiroshima and Nagasaki, Japan, by the Radiation Effects Research Foundation (RERF) has produced quantitative estimates of cancer risk from exposure to ionizing radiation. For breast cancer in women, in particular, the strength of the radiation dose response and the generally low level of population risk in the absence of radiation exposure have led to a clear description of excess risk and its variation by age at exposure and over time following exposure. Comparisons of RERF data with data from medically irradiated populations have yielded additional information on the influence of population and underlying breast cancer rates on radiation-related risk. Epidemiological investigations of breast cancer cases and matched controls among atomic bomb survivors have clarified the role of reproductive history as a modifier of the carcinogenic effects of radiation exposure. Finally, a pattern of radiation-related risk by attained age among the survivors exposed during childhood or adolescence suggests the possible existence of a radiation-susceptible subgroup. The hypothetical existence of such a group is lent plausibility by the results of recent family studies suggesting that heritable mutations in certain genes are associated with familial aggregations of breast cancer. The recent isolation and cloning of one such gene, BRCA1, makes it likely that the hypothesis can be tested using molecular assays of archival and other tissue obtained from atomic bomb survivor cases and controls.

(JAMA. 1995;274:402-407)

REFERENCES

1 +
Putnam FW.  Hiroshima and Nagasaki revisited: the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation. Perspect Biol Med . 1994;;37:515-545.
2 +
Neel JV, Schull WJ, eds. The Children of the Atomic Bomb Survivors: A Genetic Study . Washington, DC: National Academy Press; 1991;.
3 +
Roesch WC, ed. US-Japan Joint Reassessment of Atomic Bomb Radiation Dosimetry in Hiroshima and Nagasaki: Final Report . Hiroshima, Japan: Radiation Effects Research Foundation; 1987;.
4 +
Shimizu Y, Kato S, Schull WJ.  Studies of the mortality of A-bomb survivors: mortality, 1950-1985, part 2: cancer mortality based on the recently revised doses (DS86). Radiat Res . 1990;;121:120-141.
5 +
Mabuchi K, Soda M, Ron E, et al.  Cancer incidence in atomic bomb survivors, part I: use of the tumor registries in Hiroshima and Nagasaki for incidence studies. Radiat Res . 1994;;137:51-516.
6 +
Tokunaga M, Land CE, Tokuoka S, Nishimori I, Soda M, Akiba S.  Incidence of female breast-cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950-1985. Radiat Res . 1994;;138:209-223.
7 +
Thompson DE, Mabuchi K, Ron E, et al.  Cancer incidence in atomic bomb survivors, part II: solid tumors, 1958-1987. Radiat Res . 1994;;137:517-567.
8 +
Tokunaga M, Land CE, Yamamoto T, et al.  Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950-1980. Radiat Res . 1987;;112:243-272.
9 +
Land CE.  Cancer risks from low doses of ionizing radiation. Science . 1980;;209:1197-1203.
10 +
Land CE, Boice JD Jr, Shore RE, Norman JE, Tokunaga M.  Breast cancer risk from low-dose exposures to ionizing radiation: results of a parallel analysis of three exposed populations of women. J Natl Cancer Inst . 1980;;65:353-375.
11 +
United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and Effects of Ionizing Radiation: UNSCEAR 1994 Report to the General Assembly With Scientific Annexes . New York, NY: United Nations; 1994;:115, 155.
12 +
Parkin DM, Muir CS, Waterhouse J, et al. Cancer Incidence in Five Continents, Vol VI . Lyon, France: International Agency for Research on Cancer; 1992;. IARC Scientific Publications No. 120.
13 +
Boice JD Jr, Preston DL, Davis FG, Monson RR.  Frequent chest x-ray fluoroscopy and breast cancer incidence among tuberculosis patients in Massachusetts. Radiat Res . 1990;;125:214-222.
14 +
Hildreth NG, Shore RE, Dvoretsky PM.  The risk of breast cancer after irradiation of the thymus in infancy. N Engl J Med . 1989;;321:1281-1284.
15 +
Hancock SL, Tucker MA, Hoppe RT.  Breast cancer after treatment of Hodgkin's disease. J Natl Cancer Inst . 1993;;181:25-31.
16 +
Shore RE, Hildreth N, Woodard E, Dvoretsky P, Hempelmann L, Pasternack B.  Breast cancer among women given x-ray therapy for acute postpartum mastitis. J Natl Cancer Inst . 1986;;77:689-696.
17 +
Mattson A, Ruden B, Hall P, Wilking N, Rutqvist LE.  Radiation-induced breast cancer: long-term follow-up of radiation therapy for benign breast disease. J Natl Cancer Inst . 1993;;85:1679-1685.
18 +
Ziegler RG, Hoover RN, Pike NC, et al.  Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst . 1993;;22:1819-1827.
19 +
Kelsey JL, Gammon MD, John EM.  Reproductive factors and breast cancer. Epidemiol Rev . 1993;; 15:36-47.
20 +
Land CE, Hayakawa N, Machado S, et al.  A case-control interview study of breast cancer among Japanese A-bomb survivors, I: main effects. Cancer Causes Control . 1994;;5:157-165.
21 +
Land CE, Hayakawa N, Machado S, et al.  A case-control interview study of breast cancer among Japanese A-bomb survivors, II: interactions between epidemiological factors and radiation dose. Cancer Causes Control . 1994;;5:167-176.
22 +
Clifton KH, Sridharan BN, Douple EB.  Mammary carcinogenesis-enhancing effect in irradiated rats with pituitary tumor MtT-F4. J Natl Cancer Inst . 1975;;55:485-487.
23 +
Clifton KH, Crowley J.  Effects of radiation type and role of glucocorticoids, gonadectomy and thyroidectomy in mammary tumor induction in MtT-grafted rats. Cancer Res . 1978;;38:1507-1513.
24 +
Land CE, Tokunaga M, Tokuoka S, Nakamura N.  Early-onset breast cancer in A-bomb survivors. Lancet . 1993;;342:237.
25 +
Wooster R, Neuhausen SL, Mangion J, et al.  Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12-13. Science . 1994;; 265:2088-2090.
26 +
Malkin D, Jolly KW, Barbier N, et al.  Germline mutations of the p53 tumor-suppressor gene in children and young adults with second malignant neoplasms. N Engl J Med . 1992;;326:1309-1315.
27 +
Swift M, Morrell D, Massey RB, Chase CL.  Incidence of cancer in 161 families affected by ataxia telangiectasia. N Engl J Med . 1991;;325:1831-1836.
28 +
Eng C, Li FP, Abramson DH, et al.  Mortality from second tumors among long-term survivors of retinoblastoma. J Natl Cancer Inst . 1993;;85:1121-1128.
29 +
Rall JE, Beebe GW, Hoel DG, et al. Report of the National Institutes of Health Ad Hoc Working Group to Develop Radioepidemiological Tables . Bethesda, Md: National Institutes of Health; 1985;. NIH publication 85-2748.
30 +
Ford D, Easton DF, Bishop DT, Narod SA, Goldgar DE, and the Breast Cancer Linkage Consortium.  Risks of cancer in BRCA1 mutation carriers. Lancet . 1994;;343:692-695.
31 +
Miki Y, Swenson J, Shattuck-Eidens D, et al.  A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science . 1994;;266:66-71.
32 +
Shattuck-Eidens D, McClure M, Simard J, et al.  A collaborative survey of 80 mutations in the BRCA1 breast and ovarian cancer susceptibility gene: implications for presymptomatic testing and screening. JAMA . 1995;;273:535-541.
33 +
Savitsky K, Bar-Shira A, Gilad S, et al.  A single ataxia telangiectasia gene with a product similar to pl-3 kinase. Science . 1995;;268:1749-1753.

Figures

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Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Putnam FW.  Hiroshima and Nagasaki revisited: the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation. Perspect Biol Med . 1994;;37:515-545.
2 +
Neel JV, Schull WJ, eds. The Children of the Atomic Bomb Survivors: A Genetic Study . Washington, DC: National Academy Press; 1991;.
3 +
Roesch WC, ed. US-Japan Joint Reassessment of Atomic Bomb Radiation Dosimetry in Hiroshima and Nagasaki: Final Report . Hiroshima, Japan: Radiation Effects Research Foundation; 1987;.
4 +
Shimizu Y, Kato S, Schull WJ.  Studies of the mortality of A-bomb survivors: mortality, 1950-1985, part 2: cancer mortality based on the recently revised doses (DS86). Radiat Res . 1990;;121:120-141.
5 +
Mabuchi K, Soda M, Ron E, et al.  Cancer incidence in atomic bomb survivors, part I: use of the tumor registries in Hiroshima and Nagasaki for incidence studies. Radiat Res . 1994;;137:51-516.
6 +
Tokunaga M, Land CE, Tokuoka S, Nishimori I, Soda M, Akiba S.  Incidence of female breast-cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950-1985. Radiat Res . 1994;;138:209-223.
7 +
Thompson DE, Mabuchi K, Ron E, et al.  Cancer incidence in atomic bomb survivors, part II: solid tumors, 1958-1987. Radiat Res . 1994;;137:517-567.
8 +
Tokunaga M, Land CE, Yamamoto T, et al.  Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950-1980. Radiat Res . 1987;;112:243-272.
9 +
Land CE.  Cancer risks from low doses of ionizing radiation. Science . 1980;;209:1197-1203.
10 +
Land CE, Boice JD Jr, Shore RE, Norman JE, Tokunaga M.  Breast cancer risk from low-dose exposures to ionizing radiation: results of a parallel analysis of three exposed populations of women. J Natl Cancer Inst . 1980;;65:353-375.
11 +
United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and Effects of Ionizing Radiation: UNSCEAR 1994 Report to the General Assembly With Scientific Annexes . New York, NY: United Nations; 1994;:115, 155.
12 +
Parkin DM, Muir CS, Waterhouse J, et al. Cancer Incidence in Five Continents, Vol VI . Lyon, France: International Agency for Research on Cancer; 1992;. IARC Scientific Publications No. 120.
13 +
Boice JD Jr, Preston DL, Davis FG, Monson RR.  Frequent chest x-ray fluoroscopy and breast cancer incidence among tuberculosis patients in Massachusetts. Radiat Res . 1990;;125:214-222.
14 +
Hildreth NG, Shore RE, Dvoretsky PM.  The risk of breast cancer after irradiation of the thymus in infancy. N Engl J Med . 1989;;321:1281-1284.
15 +
Hancock SL, Tucker MA, Hoppe RT.  Breast cancer after treatment of Hodgkin's disease. J Natl Cancer Inst . 1993;;181:25-31.
16 +
Shore RE, Hildreth N, Woodard E, Dvoretsky P, Hempelmann L, Pasternack B.  Breast cancer among women given x-ray therapy for acute postpartum mastitis. J Natl Cancer Inst . 1986;;77:689-696.
17 +
Mattson A, Ruden B, Hall P, Wilking N, Rutqvist LE.  Radiation-induced breast cancer: long-term follow-up of radiation therapy for benign breast disease. J Natl Cancer Inst . 1993;;85:1679-1685.
18 +
Ziegler RG, Hoover RN, Pike NC, et al.  Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst . 1993;;22:1819-1827.
19 +
Kelsey JL, Gammon MD, John EM.  Reproductive factors and breast cancer. Epidemiol Rev . 1993;; 15:36-47.
20 +
Land CE, Hayakawa N, Machado S, et al.  A case-control interview study of breast cancer among Japanese A-bomb survivors, I: main effects. Cancer Causes Control . 1994;;5:157-165.
21 +
Land CE, Hayakawa N, Machado S, et al.  A case-control interview study of breast cancer among Japanese A-bomb survivors, II: interactions between epidemiological factors and radiation dose. Cancer Causes Control . 1994;;5:167-176.
22 +
Clifton KH, Sridharan BN, Douple EB.  Mammary carcinogenesis-enhancing effect in irradiated rats with pituitary tumor MtT-F4. J Natl Cancer Inst . 1975;;55:485-487.
23 +
Clifton KH, Crowley J.  Effects of radiation type and role of glucocorticoids, gonadectomy and thyroidectomy in mammary tumor induction in MtT-grafted rats. Cancer Res . 1978;;38:1507-1513.
24 +
Land CE, Tokunaga M, Tokuoka S, Nakamura N.  Early-onset breast cancer in A-bomb survivors. Lancet . 1993;;342:237.
25 +
Wooster R, Neuhausen SL, Mangion J, et al.  Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12-13. Science . 1994;; 265:2088-2090.
26 +
Malkin D, Jolly KW, Barbier N, et al.  Germline mutations of the p53 tumor-suppressor gene in children and young adults with second malignant neoplasms. N Engl J Med . 1992;;326:1309-1315.
27 +
Swift M, Morrell D, Massey RB, Chase CL.  Incidence of cancer in 161 families affected by ataxia telangiectasia. N Engl J Med . 1991;;325:1831-1836.
28 +
Eng C, Li FP, Abramson DH, et al.  Mortality from second tumors among long-term survivors of retinoblastoma. J Natl Cancer Inst . 1993;;85:1121-1128.
29 +
Rall JE, Beebe GW, Hoel DG, et al. Report of the National Institutes of Health Ad Hoc Working Group to Develop Radioepidemiological Tables . Bethesda, Md: National Institutes of Health; 1985;. NIH publication 85-2748.
30 +
Ford D, Easton DF, Bishop DT, Narod SA, Goldgar DE, and the Breast Cancer Linkage Consortium.  Risks of cancer in BRCA1 mutation carriers. Lancet . 1994;;343:692-695.
31 +
Miki Y, Swenson J, Shattuck-Eidens D, et al.  A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science . 1994;;266:66-71.
32 +
Shattuck-Eidens D, McClure M, Simard J, et al.  A collaborative survey of 80 mutations in the BRCA1 breast and ovarian cancer susceptibility gene: implications for presymptomatic testing and screening. JAMA . 1995;;273:535-541.
33 +
Savitsky K, Bar-Shira A, Gilad S, et al.  A single ataxia telangiectasia gene with a product similar to pl-3 kinase. Science . 1995;;268:1749-1753.

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