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Radiation Dose and Second Cancer Risk in Patients Treated for Cancer of the Cervix
Abstract
The risk of cancer associated with a broad range of organ doses was estimated in an international study of women with cervical cancer. Among 150,000 patients reported to one of 19 population-based cancer registries or treated in any of 20 oncology clinics, 4188 women with second cancers and 6880 matched controls were selected for detailed study. Radiation doses for selected organs were reconstructed for each patient on the basis of her original radiotherapy records. Very high doses, on the order of several hundred gray, were found to increase the risk of cancers of the bladder [relative risk (RR) = 4.0], rectum (RR = 1.8), vagina (RR = 2.7), and possibly bone (RR = 1.3), uterine corpus (RR = 1.3), cecum (RR = 1.5), and non-Hodgkin's lymphoma (RR = 2.5). For all female genital cancers taken together, a sharp dose-response gradient was observed, reaching fivefold for doses more than 150 Gy. Several gray increased the risk of stomach cancer (RR = 2.1) and leukemia (RR = 2.0). Although cancer of the pancreas was elevated, there was no evidence of a dose-dependent risk. Cancer of the kidney was significantly increased among 15-year survivors. A nonsignificant twofold risk of radiogenic thyroid cancer was observed following an average dose of only 0.11 Gy. Breast cancer was not increased overall, despite an average dose of 0.31 Gy and 953 cases available for evaluation (RR = 0.9); there was, however, a weak suggestion of a dose response among women whose ovaries had been surgically removed. Doses greater than 6 Gy to the ovaries reduced breast cancer risk by 44%. A significant deficit of ovarian cancer was observed within 5 years of radiotherapy; in contrast, a dose response was suggested among 10-year survivors. Radiation was not found to increase the overall risk of cancers of the small intestine, colon, ovary, vulva, connective tissue, breast, Hodgkin's disease, multiple myeloma, or chronic lymphocytic leukemia. For most cancers associated with radiation, risks were highest among long-term survivors and appeared concentrated among women irradiated at relatively younger ages.
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Citations
Cited by
Thyroid Cancer after Exposure to External Radiation: A Pooled Analysis of Seven Studies
Ron, E., Lubin, J. H., Shore, R. E., Mabuchi, K., Modan, B., Pottern, L. M., Schneider, A. B., Tucker, M. A., & Boice, J. D. (2012) · Radiation Research · doi:10.1667/rrav05.1 · Cited by 1,124
Self-citationPreston, D. L., Kusumi, S., Tomonaga, M., Izumi, S., Ron, E., Kuramoto, A., Kamada, N., Dohy, H., Matsui, T., Nonaka, H., et al. (1994) · Radiation Research · doi:10.2307/3578893 · Cited by 803
CANCER RISKS FROM MEDICAL RADIATION
Ron, E. (2003) · Health Physics · doi:10.1097/00004032-200307000-00011 · Cited by 382
Issues and Epidemiological Evidence regarding Radiation-Induced Thyroid Cancer
Shore, R. E. (1992) · Radiation Research · doi:10.2307/3578322 · Cited by 263
Metadata
- Authors
- Boice, J. D., Engholm, G., Kleinerman, R. A., Blettner, M., Stovall, M., Lisco, H., Moloney, W. C., Austin, D. F., Bosch, A., Cookfair, D. L., Krementz, E. T., Latourette, H. B., Merrill, J. A., Peters, L. J., Schulz, M. D., Storm, H. H., Björkholm, E., Pettersson, F., Bell, C. M. J., Coleman, M. P., Fraser, P., Neal, F. E., Prior, P., Choi, N. W., Hislop, T. G., Koch, M., Kreiger, N., Robb, D., Robson, D., Thomson, D. H., Lochmüller, H., von Fournier, D., Frischkorn, R., Kjørstad, K. E., Rimpela, A., Pejovic, M.-H., Kirn, V. P., Stankusova, H., Berrino, F., Sigurdsson, K., Hutchison, G. B., MacMahon, B., Engholm, G., Bjorkholm, E., Lochmuller, H., Kjorstad, K. E., & Pejovic, M.-H.
- Venue
- Radiation Research
- Publisher
- JSTOR
- Published
- 1988-10
- Volume
- 116
- Issue
- 1
- Pages
- 3
- ISSN
- 0033-7587 (ISSN-L)
- OpenAlex
- W1971713603
- Cited by
- 394
- References
- 0
- FWCI
- 9.04
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Radiation Dose and Second Cancer Risk in Patients Treated for Cancer of the Cervix. https://app.cochat.ai/papers/10.2307/3577477
- The paper
- Boice, J. D., Engholm, G., Kleinerman, R. A., Blettner, M., Stovall, M., Lisco, H., Moloney, W. C., Austin, D. F., Bosch, A., Cookfair, D. L., Krementz, E. T., Latourette, H. B., Merrill, J. A., Peters, L. J., Schulz, M. D., Storm, H. H., Björkholm, E., Pettersson, F., Bell, C. M. J., . . . Pejovic, M.-H. (1988). Radiation Dose and Second Cancer Risk in Patients Treated for Cancer of the Cervix. Radiation Research. https://doi.org/10.2307/3577477
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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