rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.18821/0044-197Х-2017-61-5-269-275rfhealth-54Research ArticleПРОФЕССИЯ И ЗДОРОВЬЕPROFESSION AND HEALTHПОКАЗАТЕЛИ ЗАБОЛЕВАЕМОСТИ РАКОМ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ У РАБОТНИКОВ РАДИАЦИОННО ОПАСНОГО ПРЕДПРИЯТИЯTHE INDICES OF MORBIDITY OF PANCREAS CANCER IN WORKERS OF RADIATION DANGEROUS ENTERPRISEЖунтоваГ. В.ZhuntovaG. V.noemail@neicon.ruАзизоваТ. В.AzizovaT. V.clinic@subi.suГригорьеваЕ. С.Grigor’EvaE. S.noemail@neicon.ruЗаварухинаТ. П.ZavarukhinaT. P.noemail@neicon.ruФоминЕ. П.FominE. P.noemail@neicon.ruФГУП «Южно-Уральский институт биофизики» ФМБА РоссииSouthern Ural Institute of BiophysicsФГБУЗ «Центральная медико-санитарная часть № 71» ФМБА РоссииThe central medical sanitary unit №71201716062020615269275Copyright © Жунтова Г.В., Азизова Т.В., Григорьева Е.С., Заварухина Т.П., Фомин Е.П., 20202020Жунтова Г.В., Азизова Т.В., Григорьева Е.С., Заварухина Т.П., Фомин Е.П.Zhuntova G.V., Azizova T.V., Grigor’Eva E.S., Zavarukhina T.P., Fomin E.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/54

В последние десятилетия в Российской Федерации отмечается рост заболеваемости раком поджелудочной железы (ПЖ). Рак ПЖ входит в число ведущих причин в структуре смертности от злокачественных новообразований. Данные о влиянии ионизирующего излучения на возникновение рака ПЖ неоднозначны. Исследованы показатели заболеваемости раком ПЖ в когорте работников, впервые нанятых на предприятие атомной промышленности «Производственное объединение "Маяк"» в 1948-1982 гг., подвергшихся пролонгированному общему внешнему гамма-облучению и внутреннему альфа-облучению инкорпорированным плутонием. Установлено, что в изучаемой когорте, как и в общей популяции, показатели заболеваемости раком ПЖ зависели от нерадиационных факторов: достигнутый возраст, пол, календарный период наблюдения, курение и величина индекса курения, злоупотребление алкоголем. Обнаружено увеличение стандартизованных по возрасту показателей заболеваемости раком ПЖ у работников, подвергшихся пролонгированному внешнему гамма-облучению в дозах 0,5 Гр и более. Влияния внутреннего альфа-облучения на показатели заболеваемости раком ПЖ в изучаемой когорте не выявлено.

In Russia, during last decades increasing of morbidity of pancreas cancer is observed. This disease is among leading causes in the structure of mortality of malignant neoplasms. The data concerning effect of ionizing irradiation on development of pancreas cancer is ambiguous. The analysis was carried out concerning indices of morbidity of pancreas cancer in cohort of workers for the first time hired to enterprise of nuclear industry production association «Mayak» in 1948-1982 exposed to prolonged total external gamma-irradiation and internal alpha-irradiation by incorporated plutonium. It is established that in both considered cohort and total population, indices of morbidity of pancreas cancer depended on such non-radiation factors as attained age, gender, calendar period of observation, smoking and value of smoking index, alcohol abuse. The study established increasing of standardized by age indices of morbidity of pancreas cancer in workers exposed to prolonged external gamma-irradiation in doses 0.5 Gy and higher. The effect of internal alpha-irradiation on indices of morbidity of pancreas cancer was absent in examined cohort.

рак поджелудочной железывнешнее гамма-облучениевнутреннее альфа-облучениекурениеупотребление алкоголяpancreas cancerexternal gamma-irradiationinternal alpha-irradiationsmokingalcohol consumptionReferencesJemal A., Siegel R., Ward E., Hao Y., Xu J., Murray T. et al. Cancer statistics, 2008. CA Cancer J. Clin. 2008; 58(2): 71-96.Jemal A., Siegel R., Ward E., Hao Y., Xu J., Murray T. et al. Cancer statistics, 2008. CA Cancer J. Clin. 2008; 58(2): 71-96.Iovanna J., Mallmann M.C., Gonçalves A., Turrini O., Dagorn J.C. Current knowledge on pancreatic cancer. Front. Oncol. 2012; 2: 6.Iovanna J., Mallmann M.C., Gonçalves A., Turrini O., Dagorn J.C. Current knowledge on pancreatic cancer. Front. Oncol. 2012; 2: 6.Каприн А.Д., Старинский В.В., Петрова Г.В., ред. Злокачественные новообразования в России в 2013 году (Заболеваемость и смертность). М: МНИОИ им. П.А. Герцена; 2015Каприн А.Д., Старинский В.В., Петрова Г.В., ред. Злокачественные новообразования в России в 2013 году (Заболеваемость и смертность). М: МНИОИ им. П.А. Герцена; 2015Vincent A., Herman J., Schulick R., Hruban R.H., Goggins M. Pancreatic cancer. Lancet. 2011; 378(9791): 607-20.Vincent A., Herman J., Schulick R., Hruban R.H., Goggins M. Pancreatic cancer. Lancet. 2011; 378(9791): 607-20.Bosetti C., Lucenteforte E., Silverman D.T, Petersen G., Bracci P.M., Ji B.T. et al. Cigarette smoking and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (Panc4). Ann. Oncol. 2012; 23(7): 1880-8.Bosetti C., Lucenteforte E., Silverman D.T, Petersen G., Bracci P.M., Ji B.T. et al. Cigarette smoking and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (Panc4). Ann. Oncol. 2012; 23(7): 1880-8.Tramacere I., Scotti L., Jenab M., Bagnardi V., Bellocco R., Rota M. et al. Alcohol drinking and pancreatic cancer risk: a meta-analysis of the dose-risk relation. Int. J. Cancer. 2010; 126(6): 1474-86.Tramacere I., Scotti L., Jenab M., Bagnardi V., Bellocco R., Rota M. et al. Alcohol drinking and pancreatic cancer risk: a meta-analysis of the dose-risk relation. Int. J. Cancer. 2010; 126(6): 1474-86.Bosetti C., Rosato V., Li D., Silverman D., Petersen G.M., Bracci P.M. et al. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-control Consortium. Ann. Oncol. 2014; 25(10): 2065-72.Bosetti C., Rosato V., Li D., Silverman D., Petersen G.M., Bracci P.M. et al. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-control Consortium. Ann. Oncol. 2014; 25(10): 2065-72.Maisonneuve P., Lowenfels A.B. Risk factors for pancreatic cancer: a summary review of meta-analytical studies. Int. J. Epidemiol. 2015; 44(1): 186-98.Maisonneuve P., Lowenfels A.B. Risk factors for pancreatic cancer: a summary review of meta-analytical studies. Int. J. Epidemiol. 2015; 44(1): 186-98.Klein A.P. Genetic susceptibility to pancreatic cancer. Mol. Carcinog. 2012; 51(1): 14-24.Klein A.P. Genetic susceptibility to pancreatic cancer. Mol. Carcinog. 2012; 51(1): 14-24.Ojajärvi I.A., Partanen T.J., Ahlbom A., Boffetta P., Hakulinen T., Jourenkova N. et al. Occupational exposures and pancreatic cancer: a meta-analysis. Occup. Environ. Med. 2000; 57(5): 316-24.Ojajärvi I.A., Partanen T.J., Ahlbom A., Boffetta P., Hakulinen T., Jourenkova N. et al. Occupational exposures and pancreatic cancer: a meta-analysis. Occup. Environ. Med. 2000; 57(5): 316-24.Ozasa K., Shimizu Y., Suyama A., Kasagi F., Soda M., Grant E.J. et al. Studies of the mortality of atomic bomb survivors, Report 14, 1950-2003: an overview of cancer and noncancer diseases. Radiat. Res. 2012; 177(3): 229-43.Ozasa K., Shimizu Y., Suyama A., Kasagi F., Soda M., Grant E.J. et al. Studies of the mortality of atomic bomb survivors, Report 14, 1950-2003: an overview of cancer and noncancer diseases. Radiat. Res. 2012; 177(3): 229-43.Preston D., Ron E., Tokuoka S., Funamoto S., Nishi N., Soda M. et al. Solid cancer incidence in atomic bomb survivors: 1958-1998. Radiat. Res. 2007; 168(1): 1-64.Preston D., Ron E., Tokuoka S., Funamoto S., Nishi N., Soda M. et al. Solid cancer incidence in atomic bomb survivors: 1958-1998. Radiat. Res. 2007; 168(1): 1-64.Dropkin G. Reanalysis of cancer mortality in Japanese A-bomb survivors exposed to low doses of radiation: bootstrap and simulation methods. Environ. Health. 2009; 8: 56.Dropkin G. Reanalysis of cancer mortality in Japanese A-bomb survivors exposed to low doses of radiation: bootstrap and simulation methods. Environ. Health. 2009; 8: 56.Carr Z.A., Kleinerman R.A., Stovall M., Weinstock R.M., Griem M.L., Land С.E. Malignant neoplasms after radiation therapy for peptic ulcer. Radiat. Res. 2002; 157(6): 668-77.Carr Z.A., Kleinerman R.A., Stovall M., Weinstock R.M., Griem M.L., Land С.E. Malignant neoplasms after radiation therapy for peptic ulcer. Radiat. Res. 2002; 157(6): 668-77.Boice J.D. Jr., Engholm G., Kleinerman R.A., Blettner M., Stovall M., Lisco H. et al. Radiation dose and second cancer risk in patients treated for cancer of the cervix. Radiat. Res. 1988; 116(1): 3-55.Boice J.D. Jr., Engholm G., Kleinerman R.A., Blettner M., Stovall M., Lisco H. et al. Radiation dose and second cancer risk in patients treated for cancer of the cervix. Radiat. Res. 1988; 116(1): 3-55.Little M.P., Stovall M., Smith S.A., Kleinerman R.A. A reanalysis of curvature in the dose response for cancer and modifications by age at exposure following radiotherapy for benign disease. Int. J. Radiat. Oncol. Biol. Phys. 2013; 85(2): 451-9.Little M.P., Stovall M., Smith S.A., Kleinerman R.A. A reanalysis of curvature in the dose response for cancer and modifications by age at exposure following radiotherapy for benign disease. Int. J. Radiat. Oncol. Biol. Phys. 2013; 85(2): 451-9.Travis L.B., Hauptmann M., Gaul L.K., Storm H.H., Goldman M.B., Nyberg U., et al. Site-specific cancer incidence and mortality after cerebral angiography with radioactive Thorotrast. Radiat. Res. 2003; 160(6): 691-706.Travis L.B., Hauptmann M., Gaul L.K., Storm H.H., Goldman M.B., Nyberg U., et al. Site-specific cancer incidence and mortality after cerebral angiography with radioactive Thorotrast. Radiat. Res. 2003; 160(6): 691-706.Nyberg U., Nilsson B., Travis L.B., Holm L.E., Hall P. Cancer incidence among Swedish patients exposed to radioactive thorotrast: a forty-year follow-up survey. Radiat. Res. 2002; 157(4): 419-25.Nyberg U., Nilsson B., Travis L.B., Holm L.E., Hall P. Cancer incidence among Swedish patients exposed to radioactive thorotrast: a forty-year follow-up survey. Radiat. Res. 2002; 157(4): 419-25.Polednak A.P., Stehney A.F., Lucas H.F. Mortality among male workers at a thorium processing plant. Health Phys. 1983; 4(Suppl. 1): 239-51.Polednak A.P., Stehney A.F., Lucas H.F. Mortality among male workers at a thorium processing plant. Health Phys. 1983; 4(Suppl. 1): 239-51.Cardis E., Vrijheid M., Blettner M., Gilbert E., Hakama M., Hill C. et al. The 15-country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: estimates of radiation-related cancer risks. Radiat. Res. 2007; 167(4): 396-416.Cardis E., Vrijheid M., Blettner M., Gilbert E., Hakama M., Hill C. et al. The 15-country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: estimates of radiation-related cancer risks. Radiat. Res. 2007; 167(4): 396-416.Sokolnikov M.E., Gilbert E.S., Preston D.L., Ron E., Shilnikova N.S., Khokhryakov V.V. et al. Lung, liver and bone cancer mortality in Mayak workers. Int. J. Cancer. 2008; 123(4): 905-11.Sokolnikov M.E., Gilbert E.S., Preston D.L., Ron E., Shilnikova N.S., Khokhryakov V.V. et al. Lung, liver and bone cancer mortality in Mayak workers. Int. J. Cancer. 2008; 123(4): 905-11.Azizova T.V., Day R.D., Wald N., Muirhead C.R., O'Hagan J.A., Sumina M.V. et al. The «clinic» medical-dosimetric database of Mayak production association workers: structure, characteristics and prospects of utilization. Health. Phys. 2008; 94: 449-58.Azizova T.V., Day R.D., Wald N., Muirhead C.R., O'Hagan J.A., Sumina M.V. et al. The «clinic» medical-dosimetric database of Mayak production association workers: structure, characteristics and prospects of utilization. Health. Phys. 2008; 94: 449-58.Vasilenko E.K., Scherpelz R.I., Gorelov M.V., Stram D.J., Smetanin M.Y. External dosimetry reconstruction for Mayak workers. AAHP Special Session Health Physics Society Annual Meeting Paper. Salt Lake City; 2010. Available at: http://www.hps1.org/aahp/public/AAHP_Special_Sessions/2010_Salt_Lake_City/pm-1.pdfVasilenko E.K., Scherpelz R.I., Gorelov M.V., Stram D.J., Smetanin M.Y. External dosimetry reconstruction for Mayak workers. AAHP Special Session Health Physics Society Annual Meeting Paper. Salt Lake City; 2010. Available at: http://www.hps1.org/aahp/public/AAHP_Special_Sessions/2010_Salt_Lake_City/pm-1.pdfDorrian M.D., Birchall A., Vostrotin V.V. Mayak Worker Dosimetry System (MWDS-2013): Phase I - Quality Assurance of Organ Doses and Excretion Rates from Internal Exposures of Plutonium-239 for the Mayak Worker Cohort. Radiat. Prot. Dosimetry. 2016; 1-16.Dorrian M.D., Birchall A., Vostrotin V.V. Mayak Worker Dosimetry System (MWDS-2013): Phase I - Quality Assurance of Organ Doses and Excretion Rates from Internal Exposures of Plutonium-239 for the Mayak Worker Cohort. Radiat. Prot. Dosimetry. 2016; 1-16.Мерков А.М., Поляков Л.Е. Санитарная статистика (Пособие для врачей). М.: Атомиздат; 1975Мерков А.М., Поляков Л.Е. Санитарная статистика (Пособие для врачей). М.: Атомиздат; 1975Blackford A., Parmigiani G., Kensler T.W., Wolfgang C., Jones S., Zhang X. et al. Genetic mutations associated with cigarette smoking in pancreatic cancer. Cancer Res. 2009; 69(8): 3681-8.Blackford A., Parmigiani G., Kensler T.W., Wolfgang C., Jones S., Zhang X. et al. Genetic mutations associated with cigarette smoking in pancreatic cancer. Cancer Res. 2009; 69(8): 3681-8.Herreros-Villanueva M., Hijona E., Bañales J.M., Cosme A., Bujanda L. Alcohol consumption on pancreatic diseases. World J. Gastroenterol. 2013; 19(5): 638-47.Herreros-Villanueva M., Hijona E., Bañales J.M., Cosme A., Bujanda L. Alcohol consumption on pancreatic diseases. World J. Gastroenterol. 2013; 19(5): 638-47.Shuryak I., Hahnfeldt P., Hlatky L., Sachs R.K., Brenner D.J. A new view of radiation-induced cancer: integrating short- and long-term processes. Part II: second cancer risk estimation. Radiat. Environ. Biophys. 2009; 48(3): 275-86.Shuryak I., Hahnfeldt P., Hlatky L., Sachs R.K., Brenner D.J. A new view of radiation-induced cancer: integrating short- and long-term processes. Part II: second cancer risk estimation. Radiat. Environ. Biophys. 2009; 48(3): 275-86.Hunter N., Kuznetsova I.S., Labutina E.V., Harrison J.D. Solid cancer incidence other than lung, liver and bone in Mayak workers: 1948-2004. Br. J. Cancer. 2013; 109(7): 1989-96.Hunter N., Kuznetsova I.S., Labutina E.V., Harrison J.D. Solid cancer incidence other than lung, liver and bone in Mayak workers: 1948-2004. Br. J. Cancer. 2013; 109(7): 1989-96.Sokolnikov M., Preston D., Gilbert E., Schonfeld S., Koshurnikova N. Radiation Effects on Mortality from Solid Cancers Other than Lung, Liver, and Bone Cancer in the Mayak Worker Cohort: 1948-2008. PLoS One. 2015; 10(2): e0117784.Sokolnikov M., Preston D., Gilbert E., Schonfeld S., Koshurnikova N. Radiation Effects on Mortality from Solid Cancers Other than Lung, Liver, and Bone Cancer in the Mayak Worker Cohort: 1948-2008. PLoS One. 2015; 10(2): e0117784.

The authors declare that there are no conflicts of interest present.