Kazuo Neriishi

Circulating sex hormones and breast cancer risk factors in postmenopausal women: reanalysis of 13 studies.

Background:Breast cancer risk for postmenopausal women is positively associated with circulating concentrations of oestrogens and androgens, but the determinants of these hormones are not well understood.Methods:Cross-sectional analyses of breast cancer risk factors and circulating hormone concentrations in more than 6000 postmenopausal women controls in 13 prospective studies.Results:Concentrations of all hormones were lower in older than younger women, with the largest difference for dehydroepiandrosterone sulphate (DHEAS), whereas sex hormone-binding globulin (SHBG) was higher in the older women. Androgens were lower in women with bilateral ovariectomy than in naturally postmenopausal women, with the largest difference for free testosterone. All hormones were higher in obese than lean women, with the largest difference for free oestradiol, whereas SHBG was lower in obese women. Smokers of 15+ cigarettes per day had higher levels of all hormones than non-smokers, with the largest difference for testosterone. Drinkers of 20+ g alcohol per day had higher levels of all hormones, but lower SHBG, than non-drinkers, with the largest difference for DHEAS. Hormone concentrations were not strongly related to age at menarche, parity, age at first full-term pregnancy or family history of breast cancer.Conclusion:Sex hormone concentrations were strongly associated with several established or suspected risk factors for breast cancer, and may mediate the effects of these factors on breast cancer risk.

Postoperative Cataract Cases among Atomic Bomb Survivors: Radiation Dose Response and Threshold

Abstract Neriishi, K., Nakashima, E., Minamoto, A., Fujiwara, S., Akahoshi, M., Mishima, H. K., Kitaoka, K. and Shore, R. E. Postoperative Cataract Cases among Atomic Bomb Survivors: Radiation Dose Response and Threshold. Radiat. Res. 168, 404–408 (2007). Recent evidence argues against a high threshold dose for vision-impairing radiation-induced cataractogenesis. We conducted logistic regression analysis to estimate the dose response and used a likelihood profile procedure to determine the best-fitting threshold model among 3761 A-bomb survivors who underwent medical examinations during 2000–2002 for whom radiation dose estimates were available, including 479 postoperative cataract cases. The analyses indicated a statistically significant dose–response increase in the prevalence of postoperative cataracts [odds ratio (OR), 1.39; 95% confidence interval (CI), 1.24–1.55] at 1 Gy, with no indication of upward curvature in the dose response. The dose response was suggestive when the restricted dose range of 0 to 1 Gy was examined. A nonsignificant dose threshold of 0.1 Gy (95% CI, <0–0.8) was found. The prevalence of postoperative cataracts in A-bomb survivors increased significantly with A-bomb radiation dose. The estimate (0.1 Gy) and upper bound (0.8 Gy) of the dose threshold for operative cataract prevalence was much lower than the threshold of 2–5 Gy usually assumed by the radiation protection community and was statistically compatible with no threshold at all.

A Reanalysis Of Atomic-bomb Cataract Data, 2000–2002: A Threshold Analysis

To obtain the best statistical model for a previous study of cataract prevalence in atomic-bomb survivors, we tested the fitness of the threshold model in an updated dataset of the study, utilizing re-diagnosis by a single ophthalmologist, use of the DS02 dosimetry system, and separation of the in utero group. The results suggest that, in 730 atomic-bomb survivors, we cannot conclude thresholds are greater than 0 Sv in cortical cataract and posterior sub-capsular opacity since the lower 90% confidence limits of the thresholds were 0 Sv. Threshold dose point estimates were 0.6 Sv (90% CI, <0.0–1.2 Sv) and 0.7 Sv (90% CI, <0.0–2.8 Sv) for cortical cataract and posterior sub-capsular opacity, respectively. Detailed regression analyses with no threshold model showed that nuclear color and nuclear opacity have no dose responses (p > 0.40). Cortical cataract showed a significant dose effect (p = 0.002), with an odds ratio (OR)/Sv of 1.30 (95% CI, 1.10–1.53) and no dose-effect modifiers. Posterior sub-capsular opacity showed a significant dose effect (p < 0.001), with an OR/Sv of 1.44 at age of exposure of 10 y (95% CI, 1.19–1.73). The dose effect decreased significantly with increasing age at exposure (p = 0.022). No dose response was observed for in utero survivors (p > 0.20).

Persistent subclinical inflammation among A-bomb survivors.

Purpose : To investigate the associations between inflammation tests and radiation dose in A-bomb survivors. Subjects and methods : Subjects were A-bomb survivors who underwent inflammation tests of leukocyte counts, neutrophil counts, erythrocyte sedimentation rate, corrected erythrocyte sedimentation rate, α -1 globulin, α -2 globulin and sialic acid between 1988 and 1992. Associations with radiation dose (DS86) were analyzed by regression analysis and heterogeneity among inflammatory diseases, anaemia at examination, or history of cancer was also tested. Results : The associations with radiation dose were statistically significant for leukocyte counts (71.0mm -3 Gy -1, p =0.015), erythrocyte sedimentation rate (1.58mm h -1 Gy -1, p =0.0001), corrected erythrocyte sedimentation rate (1.14 mm h -1 Gy -1, p =0.0001), α -1 globulin (0.0057 g dl -1 Gy -1, p =0.0001), α -2 globulin (0.0128 g dl -1 Gy -1, p =0.0001), and sialic acid (1.2711 mg dl -1 Gy -1, p =0.0001) but not for neutrophil counts (29.9mm -3 Gy -1, p =0.17). Heterogeneity was not statistically significant. Among inflammatory diseases, associations were the strongest for chronic thyroiditis and chronic liver diseases. Conclusions : This study suggests statistically significant association between inflammation in A-bomb survivors and radiation dose of during 1988-1992. The association might contribute, as an epigenetic and/or bystander effect, to development of several radiation-induced disorders.

Epidemiological studies of cataract risk at low to moderate radiation doses: (not) seeing is believing.

Abstract The prevailing belief for some decades has been that human radiation-related cataract occurs only after relatively high doses; for instance, the ICRP estimates that brief exposures of at least 0.5–2 Sv are required to cause detectable lens opacities and 5 Sv for vision-impairing cataracts. For protracted exposures, the ICRP estimates the corresponding dose thresholds as 5 Sv and 8 Sv, respectively. However, several studies, especially in the last decade, indicate that radiation-associated opacities occur at much lower doses. Several studies suggest that medical or environmental radiation exposure to the lens confers risk of opacities at doses well under 1 Sv. Among Japanese A-bomb survivors, risks for cataracts necessitating lens surgery were seen at doses under 1 Gy. The confidence interval on the A-bomb dose threshold for cataract surgery prevalence indicated that the data are compatible with a dose threshold ranging from none up to only 0.8 Gy, similar to the dose threshold for minor opacities seen among Chernobyl clean-up workers with primarily protracted exposures. Findings from various studies indicate that radiation risk estimates are probably not due to confounding by other cataract risk factors and that risk is seen after both childhood and adult exposures. The recent data are instigating reassessments of guidelines by various radiation protection bodies regarding permissible levels of radiation to the eye. Among the future epidemiological research directions, the most important research need is for adequate studies of vision-impairing cataract after protracted radiation exposure.

Hyperparathyroidism among Atomic Bomb Survivors in Hiroshima

To determine the effect of exposure to atomic bomb radiation on the occurrence of hyperparathyroidism, the prevalence was determined among a population of 3,948 atomic bomb survivors and their controls in Hiroshima. The diagnosis of hyperparathyroidism was based upon histopathological findings or the presence of consistent hypercalcemia and elevated levels of serum parathyroid hormone. Primary hyperparathyroidism was diagnosed in 19 persons (3 males, 16 females). Females had approximately a threefold higher overall prevalence of hyperparathyroidism than males (P less than 0.05). The prevalence rates of hyperparathyroidism increased with radiation dose (chi2(1) = 12, P less than 0.001) after adjusting for sex and age at the time of the bombing. The estimated relative risk was 4.1 at 1 Gy (95% confidence limits 1.7 to 14). There was some evidence that the effect of radiation was greater for individuals who were younger at the time of the bombing. In conclusion, exposure to atomic bomb radiation affected the occurrence of hyperparathyroidism, suggesting that doses of radiation lower than those used in radiotherapy may also induce this disorder.

Serum ferritin and stomach cancer risk among a Japanese population.

Using stored serum samples collected during from 1970 to 1972 and/or 1977 to 1979 from a fixed population in Hiroshima and Nagasaki, Japan, serum ferritin, transferrin, and ceruloplasmin levels were determined immunologically for persons in whom stomach (233 cases) or lung cancer (84 cases) subsequently developed as well as for their controls. An elevated stomach cancer risk was associated with low antecedent serum ferritin levels, with more than a threefold excess among those in the lowest compared with the highest ferritin quintile. The risk did not vary with the time between blood collection and stomach cancer onset, remaining high among those with low ferritin levels 5 or more years before cancer diagnosis. Achlorhydria, diagnosed in a sample of the population about 10 years before the 1970‐to‐1972 blood collection and up to 25 years before cancer, was an independent marker of stomach cancer risk. In combination, low serum ferritin and achlorhydria were associated with a tenfold increase in the subsequent risk. No effect of transferrin or ceruloplasmin, independent of ferritin, was observed in the gastric cancer risk, and the risk of lung cancer was not related to these three serum proteins. These prospective findings indicate that biologic markers of an increased risk of stomach cancer can be detected long before cancer onset.

The observed relationship between the occurrence of acute radiation effects and leukemia mortality among A-bomb survivors.

In an analysis of a follow-up study of a fixed population of 73,330 atomic bomb survivors in Hiroshima and Nagasaki, the slope of an estimated dose response between ionizing radiation and leukemia mortality was found to be steeper (P less than 0.002), by a factor of 2.4, among those who reported epilation within 60 days of the bombings, compared to those who did not experience this sign of acute radiation exposure. The strength of this empirical finding as evidence of biological association in individual radiosensitivity for these two end points is studied here. The major factor complicating the interpretation of this finding as evidence of such an association is the degree of imprecision of the radiation dosimetry system used in assignment of radiation doses to the A-bomb survivors. Using models recently suggested for dealing with dosimetry errors in epidemiological analysis of the A-bomb survivor data, the sensitivity of the apparent association between leukemia mortality and severe epilation to the assumed level of dosimetry error is investigated.

Metabolic cardiovascular disease risk factors and their clustering in subclinical hypothyroidism

Objective  A possible association between subclinical hypothyroidism and cardiovascular disease (CVD) has been reported. Monitoring of atomic‐bomb survivors for late effects of radiation exposure at the Radiation Effects Research Foundation has provided the opportunity to examine associations between subclinical hypothyroidism and metabolic CVD risk factors. The objective of the study was to evaluate associations between subclinical hypothyroidism and metabolic CVD risk factors, and a cluster of these factors.

Cataract in atomic bomb survivors based on a threshold model and the occurrence of severe epilation

This report re-examines the relationship of radiation dose to the occurrence of cataracts among 1742 atomic bomb survivors seen in the years 1963-1964 for whom the degree of epilation and Dosimetry System 1986 (DS86) doses are known. Of these individuals, 67 had cataracts. A relative risk model with two thresholds, one for the epilation group and the other for the no-epilation group, has been fitted to the data using a binomial odds regression approach and a constant relative biological effectiveness (RBE) for neutrons of 10. Among these models, a linear-linear (L-L) dose-response relationship with two thresholds presents the best fit. Under the L-L threshold model based on DS86 eye organ dose estimates for the epilation and no-epilation groups, the slope estimate for the epilation group was 1.6-2.0 times greater than that for the no-epilation group, but no statistical difference between the two slope estimates was noted. The estimated threshold for the epilation group was 0.86 Sv and 1.54 Sv for the no-epilation group, but again the difference between the two threshold estimates is not statistically significant. When an L-L relative risk model with two thresholds was fitted to the data assuming the dose estimates to be in error by 35%, or when the data were restricted to the 1105 individuals exposed in Japanese houses at distances of less than 2500 m, where the DS86 doses are thought to be most reliable, the results were almost the same as those for the individuals for whom unadjusted DS86 eye organ dose estimates were used.