Problems of Radiation Medicine and Radiobiology

A. Ye. Prysyazhnyuk¹, D. А. Bаzyка¹, А. Yu. Romanenko¹, Z. P. Fedorenko², M. M. Fuzik¹,
N. A. Gudzenko¹, N. K.Trotsyuk¹, L. O. Gulak², E. L. Gorokh², A. Yu. Ryzhov³,
O. M. Khuryanskaya¹, S. А. Danevich¹

¹State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
²National Cancer Institute, 33/43 Lomonosova St., Kyiv, 03022, Ukraine
³Taras Shevchenko National University of Kyiv, 60 Volodymyrska St., Kyiv, 01033, Ukraine

EPIDEMIOLOGY OF BREAST CANCER IN UKRAINE WITH CONSIDERATION OF THE FACTORS OF THE CHORNOBYL ACCIDENT

Objective. Assessment of the possible impact of the Chornobyl accident on the incidence of breast cancer in the female population of Ukraine as a whole and in some affected groups.
Object of the study. The female population of Ukraine as a whole and in separate groups of victims – women participating in the clean-up works in 1986–1987, evacuaees from the exclusion zone and inhabitants of the territories most contaminated with radionuclides.
Methods. Statistical, mathematical, cartographic.
Results. This study, covering a significant period of time (1976–2016), revealed a steady temporal and territorial agglomeration of regions with a higher incidence of breast cancer in the southern and south-eastern regions of Ukraine. Lower – in the western and northern regions. There is a steady increase in the incidence rate, but in recent years this growth has slowed down. The epidemiological situation regarding the incidence of breast cancer in the female population of Ukraine during the 30 years after the Chornobyl accident is generally stable. At the same time, a marked increase in the frequency of this pathology in the groups of the affected population, especially in women, participated in clean-up works in 1986–1987.
Conclusions. A stable agglomeration of regions with high levels of incidence in the south and south-east, and low in the west and north of the country is determined. The dynamics of breast cancer in Ukraine as a whole is characterized by steady growth, although in recent years its pace has slightly decreased. Among the individual population groups affected by the Chornobyl catastrophe (female liquidators, evacuated women from the exclusion zone, residents of the most contaminated with radionuclides territories) only among female liquidators of 1986–1987 the significant increase was observed in the incidence of breast cancer, which exceeds the national indicators at 1.3–1.6 times.
Key words: breast cancer incidence, inhabitants of the territories most contaminated by radionuclides, female liquidators, evacuees, age-specific incidence rate, standardized incidence rate, standardized incidence ratio.

Problems of Radiation Medicine and Radiobiology.
2019;24:150-168. doi: 10.33145/2304-8336-2019-24-150-168

full text

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin Nov. 2018;68(6):394-424. DOI: https://doi.org/10.3322/caac.21492.

2. Brinton LA, Gaudet MM, Gierach GL. Breast cancer. In: MJ Thun, MS Linet, JR Cerhan, CA Haiman, D, Schottenfeld, editors. Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press; 2018. p. 861-88.

3. Craig ZR, Wang W, Flaws JA. Endocrine-disrupting chemicals in ovarian function: effects on steroidogenesis, metabolism and nuclear receptor signaling. Reproduction. 2011;142(5):633-46. DOI: https://doi.org/10.1530/REP-11-0136.

4. Boon WC, Chow JD, Simpson ER. The multiple roles of estrogens and the enzyme aromatase. Prog Brain Res. 2010;181:209-232. DOI: https://doi.org/10.1016/S0079-6123(08)81012-6.

5. Lichtenstein P, Holm NV, Verkasalo PK, Iliadou A, Kaprio J, Koskenvuo M, et al. Environmental and heritable factors in the causation of cancer-analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med. 2000;343:78-85. DOI: 10.1056/NEJM200007133430201.

6. Pesatori AC, Consonni D, Rubagotti M, Grillo P, Bertazzi PA. Cancer incidence in the population exposed to dioxin after the "Seveso accident": twenty years of follow-up. Environ Health. 2009;8:39. DOI: https://doi.org/10.1186/1476-069X-8-39

7. Revich BA, Avaliani SL, Tikhonova GI; Revich BA, editor. [Ecological epidemiology]. Moscow, Publishing center “Academiya”. 2004. 384 p. Russian.

8. Bonefeld-Jorgensen EC, Long M, Bossi R, Ayotte P, Asmund G, Kruger T, et al. Perfluorinated compounds are related to breast cancer risk in Greenlandic Inuit: a case control study. Environ Health. 2011;10:88. DOI: https://doi.org/10.1186/1476-069X-10-88.

9. Bray F, McCarron P, Parkin DM. The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res. 2004; 6: 229-239. DOI: https://doi.org/10.1186/bcr932.

10. J. Ferlay, M. Colombet, I. Soerjomataram, T. Dyba, G. Randi, M. Bettio, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 2018;103:356-87. DOI: https://doi.org/10.1016/j.ejca.2018.07.005.

11. Carioli G, Malvezzi M, Rodriguez T, Bertuccio P, Negri E, La Vecchia C. Trends and predictions to 2020 in breast cancer mortality in Europe. Breast. 2017;36:89-95. DOI: https: //doi.org/10.1016/j.breast.2017.06.003.

12. Mackenzie J. Breast cancer following multiple fluoroscopies. Br J Cancer. 1965;19(1):1-8. doi:10.1038/bjc.1965.1.

13. Myrden JA, Hiltz JE: Breast cancer following multiple fluoroscopes during artificial pneumo- thorax treatment of pulmonary tuberculosis. Can Med Ass J. 1969;100:1032-4.

14. Mettler FA, Hempelmann LH, Dutton AM, Pifer JW, Toyooka ET, Ames WR. Breast neoplasms in women treated with X-rays for acute postpartum mastitis. A pilot study. J Nat Cancer Inst. 1969;43:803-11.

15. Wanebo CK, Jonson KG, Sato K, Thorslund TW. Breast cancer after exposure to the atomic bombing of Hiroshima and Nagasaki. N Engl J Med. 1968;279:667-71. DOI: 10.1056/NEJM196809262791301.

16. Tokunaga M, Land C, Tokuoka S, Nishimori I, Soda M, Akiba S. Incidence of female breast cancer among survivors of atomic bombing, 1950-1985. Radiat. Res. 1994;138:209-23.

17. Preston DL, Ron E, Tokuoka S, Funamoto S, Nishi N, Soda M, et al. Solid cancer incidence in the atom bomb survivors: 1958-1998. Radiat Res. 2007;168(1):1-64. DOI: https://doi.org/10.1667/RR0763.1.

18. Acquavella JF, Wilkinson GS, Wiggs LD, Tietjen GL, Key CR. An evaluation of cancer incidence among employees at the Los Alamos National Laboratory. Los Alamos, NM: Los Alamos National Laboratory; 1983 January. Report No.: LA-UR-83-62.

19. Loomis DP, Wolf SH. Mortality of workers at a nuclear materials manufacturing plant in Oak Ridge, Tennessee, 1947-1990. Am J Ind Med. 1996;29:131-41. DOI:10.1002/(SICI)1097-0274(199602)29:2<131::AID-AJIM3>3.0.CO;2-V.

20. Wilkinson GS, Trieff N, Graham R, Priore RL. Final Report: Study of Mortality Among the Nuclear Weapons Workers. Buffalo, New York: State University of New York; 2000 May 19.

21. Prysyazhnyuk A, Grischenko V, Zakordonets V et al. Risk of development of malignant tumors in Ukraine after the Chernobyl accident. In: Proceedings of the New Risk Frontiers, Annual Meeting of the Society for Risk Analysis-Europe; Stockholm, 1997. Stockholm; 1997. p. 790-9.

22. Prysyazhnyuk AE, Grishchenko VG, Fedorenko ZP, Zakordonets VA, Gulak LO, Fuzik NN, Slipenyuk EM. [Epidemiological study of malignant neoplasms in the victims of the Chernobyl accident. Results, problems and prospects]. International Journal of Radiation Medicine. 1999;(2):42-50. Russian.

23. Prysyazhnyuk A, Gulak L, Grischenko V, Fedorenko Z. Cancer incidence in Ukraine after the Chernobyl accident. In: Yamashita S et al., editors. Chernobyl: Message for the 21st Century. Ed. by (Excerpta Medica, International Congress Series 1234). Amsterdam: Elsevier; 2002. p. 281-91.

24. Prysyazhnyuk A, Grischenko V, Fedorenko Z, Gulak L, Fuzik M, Slipenyuk K, Tirmarche M. Twenty years after the Chernobyl accident: a solid incidence of cancer in the Ukrainian population. Radiat Environ Biophys. 2007;46:43-51.

25. Prisyazhnyuk AE, Romanenko AYu, Fuzik MM, Slypenyuk KM, Trotsyuk NK, Hudzenko NA, Polischuk JM, Fedorenko ZN, Gulak LO, Gorokh EL. [The incidence of breast cancer in the female population of Ukraine before and after the Chornobyl accident]. Journal of Academy of the Medical Sciences of Ukraine. 2007;13(4):676-87. Ukrainian.

26. Islamova AR. [The incidence of malignant neoplasms of participants in the liquidation of the consequences of the Chernobyl accident] [author's abstract of dissertation]. Obninsk; 2004. 19 p. Russian.

27. Ostapenko VA, Dainiak EJ, Hunting HL et al. Breast cancer rates among women in Belarus, before and after the Chernobyl catastrophe. Presented at the International Conference on Diagnosis and Treatment of Radiation Injury, Rotterdam, August 1998, p. 304-7.

28. Pukkala E., Polyakov S., Ryzhov A., Ryzhov A, Drozdovitch V, Kovgan L, et al. Breast cancer in Belarus and Ukraine after the Chernobyl accident. Int J Cancer. 2006;119:651-8. DOI: https://doi.org/10.1002/ijc.21885.

29. [15 years of Chornobyl catastrophe. Experience Overcoming: National Report of Ukraine]. Kyiv: Chornobyl Radio Ecological Center of the Ministry of Emergencies of Ukraine; 2001. p. 81. Ukrainian.

30. [Stochastic effects]. In: [20 years of the Chernobyl disaster. Looking to the future: National report of Ukraine]. Kyiv: Atika; 2006. p. 72-4. Ukrainian.

31. [Twenty-five years of the Chernobyl disaster. Safety of the future]. Kyiv: KIM; 2011. 356 p. ISBN 978-966-1547-62. Ukrainian.

32. Prysyazhnyuk AYe, Fuzik MM, Gudzenko NA, et al. Experience of study of the incidence of malignant neoplasms population in small areas of Ukraine, which suffered contamination with radionuclides due to the Chornobyl accident. Probl Radiac Med Radiobiol. 2015;20:229-40.