engleski

Possible effects of Chernobyl accident (1986) and war aggression on Croatia (1991-1995) on thyroid and breast cancer epidemiology

Aim of the study was to analyze possible changes in the period 1980-1999 on thyroid and breast cancer epidemiology in the Department of Pathology Cancer Registry related to Chernobyl accident (1986) and war aggression on Croatia (1991-1995). It is very well-known that war trauma influence on hormone levels and immunologic parameters in Croatian population. Also, there is no doubt about an influence of ionizing radiation on cancer risk, especially on thyroid cancer incidence in children. There are numerous data about different incidence of some histological types of breast cancer in different population as a result of probably different genetic and environmental influence. Patients and methods. All relevant disposable Clinical Department of Pathology biopsy reports data, clinical data and data from National Cancer Registry in the period 1980-1999 were used in this study. During this period the recent WHO- tumour classifications for thyroid and breast cancers were used in the routine biopsy diagnostic procedure. Results. Total of 461 thyroid cancer patients was analysed in 20-year period (1980- 1999) in our Department Cancer Registry, which is almost one-fifth of all thyroid cancers in Croatia at that time. There was a significant decrease of follicular thyroid carcinoma from 22% in 1980 to almost 0% in 1999, probably due to better iodine uptake in the population. We did not find significant difference in the average age distribution and 5-year survival rates of all primary thyroid cancer histological types among pre-Chernobyl and post-Chernobyl periods as well as pre-war and post-war periods. There was a slight increase of thyroid cancer pTNM stage in post-war and post-Chernobyl periods. We did not find an increasing number of thyroid cancers among children in post-Chernobyl as well as in post-war periods. In our Breast Cancer Registry we found 2032 female (99, 2%) and 18 male patients (0, 8%) of total 2050 cases investigated. In this study an increasing average age (from 56, 0 in pre-war period to 60, 7 in post-war period) at the diagnosis of primary breast cancer patients was found in the post-war period as well as in the post-Chernobyl period. The most impressive finding was an increase of the percentage of invasive lobular carcinoma among these patients (from 1.0% in pre-war and pre-Chernobyl periods to 5.4% in post-war and post-Chernobyl periods). The decreasing of F/M ratio from 133:1 in pre-war period to 92:1 in post-war period was found. All analyzed patients with ductal invasive breast carcinoma and lobular invasive breast carcinoma presented in an advanced pTNM stage in post-war as well as in post-Chernobyl periods. The 5-year survival rates of the patients with breast carcinomas did not show significant difference in comparison with those in west countries. Discussion and conclusion. These findings of an increasing average age of patients at the time of diagnosis as well as the finding of an increase of pTNM stage of both, thyroid cancers and breast cancers, was probably result of the general war influence (1991-1995) on Croatian population. The better iodine uptake among Croatian population probably resulted with dramatic decrease of follicular thyroid carcinomas as well as lack of an increasing of thyroid carcinomas in young population. The increasing number of breast lobular invasive carcinomas in post-war and post- Chernobyl periods has been probably the result of the war trauma on Croatian population rather than an influence of the Chernobyl catastrophe.

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