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Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

Appendix D
Thyroid Cancer in Idaho 1970-1996

Christopher J. Johnson, MPH, Epidemiologist

Stacey L. Carson, ART, CTR, Director

Cancer Data Registry of Idaho

PO Box 1278

Boise, Idaho 83701-1278

(208) 338-5100 ext. 213 (phone)

(208) 338-7800 (FAX)

Following release of the National Cancer Institute's report of its study to assess Americans' exposure to radioactive iodine-131 from atmospheric nuclear bomb testing in the 1950s and 1960s at the Nevada Test Site, and pursuant to requests from the public, media, and health officials, staff at the Cancer Data Registry of Idaho (CDRI) conducted several analyses of thyroid cancer. This report describes the analyses of thyroid cancer incidence rates in Idaho, 1970-1996, and the ratio of female-to-male thyroid cancer cases by age group. Because four of the five counties in the United States with highest estimated exposure to iodine-131 from atmospheric nuclear bomb tests at the Nevada Test Site are located in Idaho (Blaine, Custer, Gem, and Lemhi), and public health services are delivered at the health district level, analyses were conducted at both the county and health district levels of geography (see Appendix for listing of counties by health district).

METHODS

Established in 1969, CDRI is a population-based cancer registry that collects incidence and survival data on cancer patients who reside in the state of Idaho at the time of diagnosis or who are diagnosed and/or treated for cancer in the state of Idaho. All cases of invasive thyroid cancer diagnosed among residents of the state of Idaho between January 1, 1970, and December 31, 1996, were included in these analyses.

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

Thyroid Cancer Incidence in Idaho, 1970-1996, by Birth Cohort and Overall

A combination of direct and indirect age adjustment was used to compare the incidence rates of thyroid cancer among geographic areas and by birth cohort. The following provides an overview of the steps taken in the analysis.

Step 1. The number of invasive cases of thyroid cancer diagnosed among residents of the state of Idaho, 1970-1996, were summed by sex, 5-year age group, county of residence, and year of diagnosis. The age groups were: 0-4, 5-9, 10-14, …, 85+. Cases with missing information on sex, age at diagnosis, or county were not included in the analysis. If birth year was unknown, it was imputed from diagnosis date and estimated age at diagnosis. Birth cohort was defined by birth year: before 1948, 1948-1958, and after 1958. Given the years that atmospheric nuclear bomb tests were conducted at the Nevada Test Site, and the fact that children aged 0-5 are biologically most sensitive to iodine-131, persons born during the time period 1948-1958 are thought to have been at the risk of highest exposure. The other birth cohorts were chosen for comparison purposes.

Step 2. Population data were obtained from the U.S. Bureau of the Census. Data for 1970-1989 were available by sex and 5-year age-group. Data for 1990-1996 were available by sex and single-year age group. Single-year age group estimates were derived from 1970-1989 data by dividing the population in each 5-year age group into 5 equal parts. For example, if 1,000 persons were in the 5-year age group 15-19, 200 persons each were assigned to ages 15, 16, 17, 18, and 19. Separating the population data into single-year age groups was necessary to calculate age-adjusted rates by birth cohort.

Step 3. Three birth cohorts were defined, again based upon differences due to age in estimated exposure to iodine-131 from atmospheric nuclear bomb tests at the Nevada Test Site: before 1948, 1948-1958, and after 1958. Population data were estimated for each of the birth cohorts, by county, sex, and 5-year age group. Two age breaks were defined and incremented by year of study. The lower age break was defined as: AGELOW = YEAR - 1958, and year was varied from 1970-1996, the years for which CDRI has reliable statewide case information. The upper age break was defined as: AGEHIGH = YEAR - 1948, and year was again varied from 1970-1996. AGELOW and AGEHIGH give the (truncated) ages a person would have been in each year, 1970-1996, given that they were born in the period 1948-1958. Thus, a person born from 1948-1958 would have been assigned ages 12-22 in 1970, and between 32 and 42 in 1990, etc. Population data were assigned to birth cohorts depending on single-year age group and year (1970-1996). For example, for the year 1970, persons aged 10 were assigned to the after-1958 birth cohort; persons aged 20 were assigned to the 1948-1958 birth cohort; and persons aged 30 were assigned to the before-1948 birth

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

cohort. Finally, population data were collapsed over age to yield estimates by birth cohort, county, sex, and 5-year age group.

Step 4. The age-adjusted rate of invasive thyroid cancer for the state of Idaho, 1970-1996, was calculated by the direct method, using the 1970 U.S. population as standard. Age-specific rates for the state of Idaho were calculated for use in direct age adjustment. The result was an age-adjusted incidence rate of thyroid cancer for the state of Idaho, 1970-1996, of 4.22 cases per 100,000 person-years.

Step 5. Age- and sex-specific rates for the state of Idaho for the time period 1970-1996 were calculated for use as standard rates in indirect age and sex adjustment.

Step 6. For all birth cohorts combined, the numbers of observed and expected cases were calculated for each health district and county. Expected cases were calculated by applying the age- and sex-specific rates for the state of Idaho to the population by age and sex in each health district and county. Two-tailed p-values comparing the number of observed and expected cases were calculated using the Poisson probability distribution. Observed and expected cases, and p-values, were calculated separately for males, females, and both sexes combined.

Step 7. The adjusted incidence rates for each health district and county were calculated as the standardized incidence ratio (observed/expected) multiplied by the age-adjusted rate from Step 4. For example, there were 314 cases observed, and 254.6 cases expected in Health District 4, yielding an adjusted incidence rate of (314/254.6) * 4.22 = 5.20 cases per 100,000 person-years.

Step 8. Age- and sex-specific rates for the state of Idaho, 1970-1996, were calculated by birth cohort for use in indirect age and sex adjustment by birth cohort. (Step 5 was repeated by birth cohort.)

Step 9. For each birth cohort, the number of observed and expected cases were calculated for each health district and county. Expected cases were calculated by applying the age- and sex-specific rates for the state of Idaho, by birth cohort (from Step 8), to the population by age and sex in each health district and county. Two-tailed p-values comparing the number of observed and expected cases were calculated using the Poisson probability distribution. Observed and expected cases, and p-values, were calculated separately for males, females, and both sexes combined, by birth cohort. Statistical significance was set at α = .05.

Step 10. The adjusted rates for each health district and county were calculated by birth cohort as the standardized incidence ratio for that birth cohort (observed/expected) multiplied by the age-adjusted rate for all birth cohorts (from Step 4). For example, there were 87 cases observed and 69.4 expected in Health District 4

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

for the birth cohort 1948-1958, yielding an adjusted incidence rate of (87/69.4) * 4.22 = 5.29. The overall rate from Step 4 was used as the reference rate in order to facilitate comparisons across birth cohort for individual health districts and counties, and to allow comparisons among health districts and counties within birth cohort. See Box D.1 for a description of the Idaho population by health districts.

Step 11. The adjusted rates for the state of Idaho were calculated by birth cohort using the standardized incidence ratio for that birth cohort (observed/expected), with expected cases based upon age- and sex-specific rates for all birth cohorts

BOX D.1 Description of Idaho Population

The population of the state of Idaho in 1996 was estimated to be 1,189,251, made up of 594,604 males and 594,647 females (U.S. Bureau of the Census). Idaho comprises 44 counties grouped into seven health districts. The composition of the health districts and population estimates by sex are shown below:

District

Counties

Males

Females

District 1

Benewah, Bonner, Boundary, Kootenai, Shoshone

80,792

81,548

District 2

Clearwater, Idaho, Latah, Lewis, Nez Perce

49,574

48,568

District 3

Adams, Canyon, Gem, Owyhee, Payette, Washington

84,753

85,602

District 4

Ada, Boise, Elmore, Valley

147,684

149,119

District 5

Blaine, Camas, Cassia, Gooding, Jerome, Lincoln, Minidoka, Twin Falls

77,788

77,139

District 6

Bannock, Bear Lake, Bingham, Butte, Caribou, Franklin, Oneida, Power

77,425

77,227

District 7

Bonneville, Clark, Custer, Fremont, Jefferson, Lemhi, Madison, Teton 

76,588

75,444

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

(from Step 5). For example, there were 271 cases observed and 256.9 expected in the state of Idaho, 1970-1996, among the 1948-1958 cohort, yielding an adjusted incidence rate of (271/256.9) * 4.22 = 4.45 cases per 100,000 person-years. The state of Idaho rates by birth cohort were designed to be compared to each other, and to the overall state of Idaho rate of 4.22 cases per 100,000 person-years.

Ratio of Female-to-Male Thyroid Cancer Cases by Age Group and Birth Cohort

The overall ratio of thyroid cancer cases among females versus males differed by birth cohort, with a ratio of 2.7 in the before-1948 cohort, 5.2 in the 1948-1958 cohort, and 5.3 in the after-1958 cohort. In order to examine if the differences in female-to-male ratios by birth cohort were an artifact of differing age-specific rates by sex, cumulative ratios of female-to-male cases were calculated by age group. For all invasive cases of thyroid cancer diagnosed among Idaho residents, 1970-1996, the numbers of cases were summed separately for males and females by 5-year age group and birth cohort. The cumulative ratios of female-to-male cases were calculated by 5-year age group and birth cohort. For example, for the age group 35-39, the cumulative female-to-male ratio in the before-1948 birth cohort was 5.0 (75 cases among females aged 39 years and younger, and 15 cases among males aged 39 years and younger).

RESULTS

The overall age-adjusted incidence rate of invasive thyroid cancer in Idaho, 1970-1996, was 4.22 cases per 100,000 person-years (see Table D.1). Incidence rates varied by geographic location, ranging from 3.28 cases per 100,000 person-years in Health District 2 to 5.20 cases per 100,000 person-years in Health District 4. There were significantly more cases of invasive thyroid cancer diagnosed among residents of Health District 4 than expected based upon rates in the state of Idaho (314 observed, 254.6 expected, p<.001), and the number of observed cases was higher than expected for both males and females. Ada County had significantly more cases of invasive thyroid cancer than expected based upon rates in the state of Idaho (276 observed, 221.4 expected, p<.001). None of the four Idaho counties with highest estimated exposure to iodine-131 showed an elevation in thyroid cancer cases from 1970-1996.

Among the birth cohort born before 1948, the incidence rate of invasive thyroid cancer, 1970-1996, was 4.10 cases per 100,000 person-years (see Table D.2). There were significantly more cases observed than expected in Health District 4 and Ada County. None of the four Idaho counties with highest estimated exposure to iodine-131 showed an elevation in thyroid cancer cases from 1970-1996 in the birth cohort born before 1948.

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

Among the birth cohort born 1948-1958, the incidence rate of invasive thyroid cancer, 1970-1996, was 4.45 cases per 100,000 person-years (see Table D.3). There were significantly more cases observed than expected in Health District 4 and Ada County. None of the four Idaho counties with highest estimated exposure to iodine-131 showed an elevation in thyroid cancer cases from 1970-1996 in the birth cohort born 1948-1958. Although the incidence rate of invasive thyroid cancer, 1970-1996, was highest for the birth cohort born 1948-1958, the number of cases observed was not statistically significantly different from that expected based upon rates for all birth cohorts.

Among the birth cohort born after 1958, the incidence rate of invasive thyroid cancer, 1970-1996, was 4.35 cases per 100,000 person-years (see Table D.4). There were significantly more cases observed than expected in Elmore County. None of the four counties with highest estimated exposure to iodine-131 showed an elevation in thyroid cancer cases from 1970-1996 in the birth cohort born after 1958.

Regarding the female-to-male ratios for invasive thyroid cancer cases, the differences in the overall female-to-male ratios by birth cohort (see Table D.5) appear to be due to the higher age-specific thyroid cancer incidence rates in younger females as compared with younger males. In all three birth cohorts, the cumulative age-specific ratios were similar for the age groups 25-29, 30-34, and 35-39 (the only age groups for which comparisons are available across all three birth cohorts, as CDRI has reliable statewide cancer incidence data since 1970).

SUMMARY AND CONCLUSIONS

Thyroid cancer is relatively rare among all cancers, accounting for less than 2% of invasive cases in Idaho in 1996. The age-adjusted incidence rate of invasive thyroid cancer in Idaho, 1970-1996, was 4.22 cases per 100,000 person-years. In comparison, the Surveillance, Epidemiology, and End Results (SEER) rate for whites, 1973-1995, was 4.39 cases per 100,000 person-years. CDRI investigated thyroid cancer incidence in three birth cohorts to explore the relationship between age at the time of iodine-131 release from atmospheric nuclear bomb tests at the Nevada Test Site and thyroid cancer incidence. The number of invasive thyroid cancer cases in the state of Idaho, 1970-1996, was not statistically significantly higher than expected, based upon overall rates, for any of the three birth cohorts. Within each birth cohort, and for all cohorts combined, variation existed among health districts and counties in the incidence of thyroid cancer, with more marked variation observed among geographic areas with smaller populations.

There are several limitations of the data that may have influenced the results of the analyses. The accuracy of the estimated incidence rates assumes similar case

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

TABLE D.1  Invasive Thyroid Cancer in Idaho, 1970-1996, Among All Birth Cohorts

 

 

All Cases                                    

Male Cases                                  

Female Cases                                

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

STATE OF IDAHO

4.22

1,119

n/a

n/a

256

n/a

n/a

863

n/a

n/a

HEALTH DISTRICT 1

3.60

127

148.9

0.074

26

35.2

0.132

101

113.7

0.250

HEALTH DISTRICT 2

3.28

85

109.4

0.018

18

25.8

0.141

67

83.6

0.072

HEALTH DISTRICT 3

4.34

165

160.6

0.751

39

37.4

0.838

126

123.2

0.826

HEALTH DISTRICT 4

5.20

314

254.6

0.000

70

55.5

0.067

244

199.2

0.002

HEALTH DISTRICT 5

4.59

171

157.2

0.291

37

36.9

1.000

134

120.3

0.232

HEALTH DISTRICT 6

3.52

126

151.0

0.042

34

34.3

1.000

92

116.7

0.021

HEALTH DISTRICT 7

4.03

131

137.2

0.631

32

30.9

0.897

99

106.3

0.515

ADA

5.26

276

221.4

0.000

63

47.7

0.039

213

173.7

0.004

ADAMS

4.13

4

4.1

1.000

2

1.1

0.570

2

3.0

0.834

BANNOCK

4.19

72

72.5

1.000

17

15.8

0.828

55

56.7

0.894

BEAR LAKE

4.64

8

7.3

0.887

2

1.8

1.000

6

5.5

0.949

BENEWAH

2.67

6

9.5

0.333

1

2.4

0.624

5

7.1

0.578

BINGHAM

3.29

30

38.5

0.190

11

8.9

0.553

19

29.7

0.050

BLAINE

4.80

16

14.1

0.674

4

3.2

0.783

12

10.9

0.815

BOISE

4.42

4

3.8

1.000

2

1.0

0.510

2

2.8

0.916

BONNER

3.40

25

31.0

0.322

6

7.6

0.733

19

23.4

0.424

BONNEVILLE

4.31

75

73.5

0.888

14

16.3

0.685

61

57.2

0.648

BOUNDARY

5.13

11

9.0

0.598

4

2.2

0.362

7

6.8

1.000

BUTTE

2.38

2

3.5

0.626

1

0.9

1.000

1

2.6

0.519

CAMAS

0.00

0.9

0.793

0.2

1.000

0.7

1.000

CANYON

4.67

113

102.1

0.305

28

23.1

0.354

85

79.0

0.532

CARIBOU

2.08

4

8.1

0.184

1.9

0.299

4

6.2

0.510

CASSIA

3.37

17

21.3

0.421

5

5.0

1.000

12

16.3

0.348

CLARK

0.00

0.9

0.821

0.3

1.000

0.6

1.000

CLEARWATER

3.93

11

11.8

0.969

2

3.0

0.843

9

8.8

1.000

CUSTER

7.91

9

4.8

0.112

5

1.2

0.017

4

3.6

0.957

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

 

 

All Cases                                    

Male Cases

Female Cases                                

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

ELMORE

4.40

23

22.0

0.894

2

5.0

0.251

21

17.1

0.396

FRANKLIN

0.88

2

9.6

0.008

1

2.3

0.641

1

7.3

0.012

FREMONT

3.34

9

11.4

0.600

2.7

0.130

9

8.7

0.996

GEM

4.66

16

14.5

0.757

3

3.5

1.000

13

10.9

0.607

GOODING

3.87

13

14.2

0.888

3

3.6

1.000

10

10.6

1.000

IDAHO

2.47

10

17.1

0.094

1

4.3

0.140

9

12.8

0.363

JEFFERSON

2.90

11

16.0

0.255

4

3.8

1.000

7

12.2

0.164

JEROME

4.85

20

17.4

0.594

4

4.1

1.000

16

13.3

0.519

KOOTENAI

3.53

66

78.9

0.156

11

18.1

0.105

55

60.8

0.501

LATAH

3.40

27

33.5

0.295

6

7.4

0.771

21

26.1

0.372

LEMHI

4.29

9

8.9

1.000

2

2.2

1.000

7

6.6

0.989

LEWIS

0.87

1

4.8

0.092

1.2

0.580

1

3.6

0.249

LINCOLN

3.13

3

4.0

0.850

1.0

0.713

3

3.0

1.000

MADISON

4.17

18

18.2

1.000

7

3.5

0.134

11

14.7

0.409

MINIDOKA

4.51

23

21.5

0.806

1

5.1

0.074

22

16.4

0.216

NEZ PERCE

3.61

36

42.1

0.394

9

9.7

0.980

27

32.3

0.400

ONEIDA

3.21

3

3.9

0.889

1.0

0.749

3

3.0

1.000

OWYHEE

2.76

6

9.2

0.381

1

2.3

0.647

5

6.9

0.639

PAYETTE

3.21

15

19.7

0.344

1

4.7

0.106

14

15.0

0.924

POWER

2.82

5

7.5

0.486

2

1.7

1.000

3

5.7

0.352

SHOSHONE

3.92

19

20.4

0.863

4

4.9

0.902

15

15.5

1.000

TETON

0.00

3.6

0.053

0.9

0.808

2.7

0.131

TWIN FALLS

5.22

79

63.8

0.073

20

14.7

0.216

59

49.1

0.187

VALLEY

6.33

11

7.3

0.248

3

1.8

0.531

8

5.5

0.393

WASHINGTON

4.20

11

11.0

1.000

4

2.7

0.581

7

8.3

0.817

NOTES: The incidence rate for the state of Idaho is age adjusted to the standard 1970 U.S. population using the direct method. The incidence rates for the other geographic areas are the products of the standardized incidence ratios and the state age-adjusted rate. Expected cases are based upon age- and sex-specific rates for the state of Idaho. P-values compare observed and expected cases, are two-tailed, based upon the Poisson probability distribution.

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

TABLE D.2 Invasive Thyroid Cancer in Idaho, 1970-1996, Among Birth Cohort Born Before 1948

 

 

All Cases                                    

Male Cases                                  

Female Cases                                 

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

STATE OF IDAHO

4.10

679

698.3

0.480

185

186.5

0.953

494

511.8

0.447

HEALTH DISTRICT 1

3.55

79

93.8

0.133

21

26.4

0.346

58

67.5

0.273

HEALTH DISTRICT 2

3.08

50

68.5

0.024

13

19.1

0.190

37

49.4

0.082

HEALTH DISTRICT 3

4.32

106

103.6

0.841

31

28.4

0.669

75

75.3

1.000

HEALTH DISTRICT 4

5.13

173

142.3

0.014

44

37.3

0.306

129

105.0

0.026

HEALTH DISTRICT 5

4.54

108

100.3

0.468

25

27.6

0.716

83

72.8

0.255

HEALTH DISTRICT 6

3.77

81

90.7

0.334

27

24.6

0.682

54

66.1

0.147

HEALTH DISTRICT 7

4.34

82

79.8

0.837

24

21.8

0.688

58

58.0

1.000

ADA

5.35

157

123.9

0.005

40

32.2

0.201

117

91.8

0.013

ADAMS

6.22

4

2.7

0.578

2

0.8

0.403

2

1.9

1.000

BANNOCK

4.41

43

41.2

0.815

13

10.9

0.595

30

30.3

1.000

BEAR LAKE

5.10

6

5.0

0.755

2

1.4

0.805

4

3.6

0.960

BENEWAH

3.45

5

6.1

0.854

1

1.8

0.915

4

4.3

1.000

BINGHAM

4.13

23

23.5

1.000

10

6.4

0.230

13

17.1

0.393

BLAINE

3.60

6

7.0

0.888

1.9

0.288

6

5.1

0.803

BOISE

5.52

3

2.3

0.805

2

0.7

0.319

1

1.6

1.000

BONNER

3.20

15

19.8

0.339

5

5.7

0.983

10

14.0

0.347

BONNEVILLE

4.35

44

42.7

0.882

8

11.3

0.420

36

31.4

0.459

BOUNDARY

6.62

9

5.7

0.254

3

1.6

0.458

6

4.1

0.459

BUTTE

0.00

2.4

0.187

0.7

0.990

1.7

0.377

CAMAS

0.00

0.6

1.000

0.2

1.000

0.4

1.000

CANYON

4.63

70

63.8

0.472

21

17.1

0.397

49

46.8

0.783

CARIBOU

1.65

2

5.1

0.232

1.4

0.494

2

3.7

0.567

CASSIA

3.13

10

13.5

0.422

4

3.7

1.000

6

9.8

0.286

CLARK

0.00

0.6

1.000

0.2

1.000

0.4

1.000

CLEARWATER

3.72

7

7.9

0.922

2

2.3

1.000

5

5.6

1.000

CUSTER

6.79

5

3.1

0.406

3

0.9

0.140

2

2.2

1.000

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

 

 

All Cases                                    

Male Cases                                  

Female Cases                                 

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

ELMORE

2.56

7

11.6

0.222

3.1

0.091

7

8.5

0.781

FRANKLIN

0.00

6.4

0.003

1.8

0.330

4.6

0.021

FREMONT

2.92

5

7.2

0.543

2.0

0.261

5

5.2

1.000

GEM

3.82

9

9.9

0.930

3

2.8

1.000

6

7.1

0.864

GOODING

4.28

10

9.9

1.000

3

2.8

1.000

7

7.0

1.000

IDAHO

2.55

7

11.6

0.216

1

3.4

0.298

6

8.2

0.573

JEFFERSON

3.48

8

9.7

0.735

4

2.8

0.598

4

6.9

0.357

JEROME

5.63

15

11.2

0.329

4

3.1

0.770

11

8.1

0.389

KOOTENAI

3.32

38

48.4

0.148

8

13.3

0.176

30

35.1

0.446

LATAH

2.83

12

17.9

0.192

3

4.9

0.562

9

13.0

0.333

LEMHI

4.20

6

6.0

1.000

2

1.8

1.000

4

4.3

1.000

LEWIS

1.24

1

3.4

0.292

1.0

0.741

1

2.4

0.610

LINCOLN

1.55

1

2.7

0.490

0.8

0.898

1

1.9

0.856

MADISON

7.13

14

8.3

0.087

7

2.2

0.014

7

6.1

0.821

MINIDOKA

3.71

12

13.6

0.790

3.8

0.044

12

9.8

0.568

NEZ PERCE

3.51

23

27.6

0.440

7

7.5

1.000

16

20.1

0.425

ONEIDA

3.02

2

2.8

0.943

0.8

0.908

2

2.0

1.000

OWYHEE

3.55

5

6.0

0.907

1

1.8

0.948

4

4.2

1.000

PAYETTE

3.18

10

13.3

0.457

1

3.7

0.237

9

9.6

1.000

POWER

4.73

5

4.5

0.923

2

1.2

0.709

3

3.2

1.000

SHOSHONE

3.66

12

13.9

0.746

4

3.9

1.000

8

10.0

0.673

TETON

0.00

2.2

0.225

0.6

1.000

1.5

0.429

TWIN FALLS

5.47

54

41.7

0.076

14

11.2

0.467

40

30.5

0.114

VALLEY

5.66

6

4.5

0.584

2

1.3

0.743

4

3.2

0.784

WASHINGTON

4.27

8

7.9

1.000

3

2.2

0.766

5

5.7

0.997

NOTES: The incidence rate for the state of Idaho is the product of the age adjusted rate for all birth cohorts using the 1970 standard U.S. population (direct age adjustment) and the standardized incidence ratio for this birth cohort compared with all birth cohorts (indirect age adjustment). The incidence rates for the other geographic areas are the products of the standardized incidence ratios for this cohort and the state age-adjusted rate. Expected cases for geography other than state are based upon age- and sex-specific rates for the state of Idaho for this cohort. P-values compare observed and expected cases, are two-tailed, based upon the Poisson probability distribution.

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

TABLE D.3  Invasive Thyroid Cancer in Idaho, 1970-1996, Among Birth Cohort Born 1948-1958

 

 

All Cases                                    

Male Cases                                  

Female Cases                                 

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

STATE OF IDAHO

4.45

271

256.9

0.394

44

45.2

0.932

227

211.6

0.307

HEALTH DISTRICT 1

3.18

27

35.8

0.156

4

5.7

0.654

23

30.1

0.223

HEALTH DISTRICT 2

4.10

24

24.7

0.992

3

4.2

0.804

21

20.6

0.980

HEALTH DISTRICT 3

4.35

36

35.0

0.905

6

5.5

0.950

30

29.4

0.966

HEALTH DISTRICT 4

5.29

87

69.4

0.046

16

11.4

0.227

71

58.0

0.109

HEALTH DISTRICT 5

4.38

37

35.6

0.865

5

5.8

0.948

32

29.8

0.737

HEALTH DISTRICT 6

3.44

30

36.8

0.297

7

6.0

0.775

23

30.8

0.177

HEALTH DISTRICT 7

3.76

30

33.7

0.599

3

5.5

0.413

27

28.2

0.919

ADA

5.39

77

60.3

0.043

13

9.7

0.361

64

50.6

0.078

ADAMS

0.00

0.9

0.824

0.1

1.000

0.7

0.953

BANNOCK

4.20

19

19.1

1.000

4

3.1

0.741

15

16.0

0.930

BEAR LAKE

2.94

1

1.4

1.000

0.2

1.000

1

1.2

1.000

BENEWAH

0.00

2.2

0.228

0.4

1.000

1.8

0.329

BINGHAM

1.39

3

9.1

0.040

1

1.5

1.000

2

7.6

0.036

BLAINE

3.59

4

4.7

0.987

0.8

0.887

4

3.9

1.000

BOISE

4.15

1

1.0

1.000

0.2

1.000

1

0.8

1.000

BONNER

3.90

7

7.6

1.000

1

1.2

1.000

6

6.3

1.000

BONNEVILLE

4.28

19

18.7

1.000

3

3.0

1.000

16

15.7

1.000

BOUNDARY

3.96

2

2.1

1.000

1

0.4

0.594

1

1.8

0.940

BUTTE

11.27

2

0.7

0.346

1

0.1

0.240

1

0.6

0.925

CAMAS

0.00

0.2

1.000

0.0

1.000

0.2

1.000

CANYON

4.53

25

23.3

0.774

5

3.7

0.613

20

19.6

0.988

CARIBOU

4.43

2

1.9

1.000

0.3

1.000

2

1.6

0.946

CASSIA

4.46

5

4.7

1.000

1

0.8

1.000

4

4.0

1.000

CLARK

0.00

0.2

1.000

0.0

1.000

0.1

1.000

CLEARWATER

6.78

4

2.5

0.480

0.4

1.000

4

2.1

0.311

CUSTER

7.50

2

1.1

0.621

0.2

1.000

2

0.9

0.480

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

 

 

All Cases                                    

Male Cases                                  

Female Cases                                 

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

ELMORE

3.46

5

6.1

0.862

2

1.2

0.645

3

4.9

0.549

FRANKLIN

4.42

2

1.9

1.000

1

0.3

0.550

1

1.6

1.000

FREMONT

3.37

2

2.5

1.000

0.4

1.000

2

2.1

1.000

GEM

7.37

5

2.9

0.325

0.4

1.000

5

2.4

0.196

GOODING

4.64

3

2.7

1.000

0.5

1.000

3

2.3

0.793

IDAHO

2.38

2

3.5

0.626

0.6

1.000

2

2.9

0.879

JEFFERSON

2.23

2

3.8

0.541

0.6

1.000

2

3.2

0.777

JEROME

4.39

4

3.8

1.000

0.6

1.000

4

3.2

0.805

KOOTENAI

3.01

14

19.6

0.240

2

3.1

0.818

12

16.6

0.316

LATAH

5.28

11

8.8

0.541

2

1.6

0.918

9

7.2

0.608

LEMHI

2.25

1

1.9

0.880

0.3

1.000

1

1.6

1.000

LEWIS

0.00

0.9

0.803

0.2

1.000

0.8

0.939

LINCOLN

0.00

0.8

0.858

0.1

1.000

0.7

0.997

MADISON

3.70

4

4.6

1.000

0.7

0.983

4

3.9

1.000

MINIDOKA

7.05

8

4.8

0.224

0.8

0.900

8

4.0

0.101

NEZ PERCE

3.29

7

9.0

0.654

1

1.4

1.000

6

7.6

0.742

ONEIDA

5.84

1

0.7

1.000

0.1

1.000

1

0.6

0.909

OWYHEE

2.14

1

2.0

0.829

0.3

1.000

1

1.6

1.000

PAYETTE

2.11

2

4.0

0.477

0.6

1.000

2

3.4

0.686

POWER

0.00

1.9

0.301

0.3

1.000

1.6

0.411

SHOSHONE

3.94

4

4.3

1.000

0.7

1.000

4

3.6

0.970

TETON

0.00

0.9

0.821

0.2

1.000

0.7

0.960

TWIN FALLS

3.98

13

13.8

0.971

4

2.2

0.358

9

11.6

0.556

VALLEY

8.51

4

2.0

0.280

1

0.3

0.569

3

1.6

0.458

WASHINGTON

6.40

3

2.0

0.635

1

0.3

0.544

2

1.7

0.990

NOTES: The incidence rate for the state of Idaho is the product of the age adjusted rate for all birth cohorts using the 1970 standard U.S. population (direct age adjustment) and the standardized incidence ratio for this birth cohort compared with all birth cohorts (indirect age adjustment). The incidence rates for the other geographic areas are the products of the standardized incidence ratios for this cohort and the state age-adjusted rate. Expected cases for geography other than state are based upon age- and sex-specific rates for the state of Idaho for this cohort. P-values compare observed and expected cases, are two-tailed, based upon the Poisson probability distribution.

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

TABLE D.4 Invasive Thyroid Cancer in Idaho, 1970-1996, Among Birth Cohort Born After 1958

 

 

All Cases                                    

Male Cases                                  

Female Cases                                 

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

STATE OF IDAHO

4.35

169

163.9

0.708

27

24.3

0.634

142

139.6

0.859

HEALTH DISTRICT 1

4.57

21

19.4

0.774

1

3.1

0.367

20

16.3

0.416

HEALTH DISTRICT 2

2.92

11

15.9

0.265

2

2.5

1.000

9

13.4

0.282

HEALTH DISTRICT 3

4.41

23

22.0

0.887

2

3.5

0.631

21

18.5

0.615

HEALTH DISTRICT 4

5.20

54

43.8

0.152

10

6.9

0.329

44

36.9

0.279

HEALTH DISTRICT 5

5.20

26

21.1

0.336

7

3.5

0.137

19

17.6

0.793

HEALTH DISTRICT 6

2.74

15

23.1

0.099

3.7

0.050

15

19.4

0.375

HEALTH DISTRICT 7

3.39

19

23.6

0.398

5

3.7

0.621

14

20.0

0.213

ADA

4.66

42

38.1

0.565

10

5.9

0.159

32

32.1

1.000

ADAMS

0.00

0.5

1.000

0.1

1.000

0.4

1.000

BANNOCK

3.49

10

12.1

0.678

1.8

0.321

10

10.2

1.000

BEAR LAKE

4.92

1

0.9

1.000

0.1

1.000

1

0.7

1.000

BENEWAH

3.60

1

1.2

1.000

0.2

1.000

1

1.0

1.000

BINGHAM

2.89

4

5.9

0.611

1.0

0.747

4

4.9

0.928

BLAINE

10.53

6

2.4

0.072

4

0.4

0.002

2

2.0

1.000

BOISE

0.00

0.5

1.000

0.1

1.000

0.4

1.000

BONNER

3.41

3

3.7

0.984

0.6

1.000

3

3.1

1.000

BONNEVILLE

4.23

12

12.0

1.000

3

2.0

0.648

9

10.0

0.922

BOUNDARY

0.00

1.2

0.621

0.2

1.000

1.0

0.759

BUTTE

0.00

0.4

1.000

0.1

1.000

0.3

1.000

CAMAS

0.00

0.1

1.000

0.0

1.000

0.1

1.000

CANYON

5.04

18

15.1

0.514

2

2.4

1.000

16

12.7

0.420

CARIBOU

0.00

1.1

0.693

0.2

1.000

0.9

0.828

CASSIA

2.86

2

3.0

0.867

0.5

1.000

2

2.5

1.000

CLARK

0.00

0.1

1.000

0.0

1.000

0.1

1.000

CLEARWATER

0.00

1.3

0.566

0.2

1.000

1.0

0.713

CUSTER

14.82

2

0.6

0.224

2

0.1

0.009

0.5

1.000

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

 

 

All Cases                                    

Male Cases                                  

Female Cases                                 

Residence

Incidence Rate

Observed

Expected

P-Value

Observed

Expected

P-Value

Observed

Expected

P-Value

ELMORE

10.58

11

4.4

0.011

0.8

0.918

11

3.6

0.003

FRANKLIN

0.00

1.3

0.538

0.2

1.000

1.1

0.671

FREMONT

5.22

2

1.6

0.961

0.3

1.000

2

1.3

0.767

GEM

5.11

2

1.7

0.984

0.3

1.000

2

1.4

0.796

GOODING

0.00

1.6

0.405

0.3

1.000

1.3

0.539

IDAHO

2.23

1

1.9

0.870

0.3

1.000

1

1.6

1.000

JEFFERSON

1.69

1

2.5

0.574

0.4

1.000

1

2.1

0.771

JEROME

1.83

1

2.3

0.659

0.4

1.000

1

1.9

0.858

KOOTENAI

5.26

14

11.2

0.480

1

1.8

0.950

13

9.5

0.321

LATAH

2.47

4

6.8

0.376

1

1.0

1.000

3

5.8

0.332

LEMHI

9.16

2

0.9

0.471

0.1

1.000

2

0.8

0.365

LEWIS

0.00

0.5

1.000

0.1

1.000

0.4

1.000

LINCOLN

18.17

2

0.5

0.159

0.1

1.000

2

0.4

0.115

MADISON

0.00

5.4

0.009

0.6

1.000

4.8

0.017

MINIDOKA

4.16

3

3.0

1.000

1

0.5

0.797

2

2.5

1.000

NEZ PERCE

4.69

6

5.4

0.906

1

0.8

1.000

5

4.6

0.957

ONEIDA

0.00

0.4

1.000

0.1

1.000

0.4

1.000

OWYHEE

0.00

1.3

0.572

0.2

1.000

1.0

0.723

PAYETTE

5.22

3

2.4

0.873

0.4

1.000

3

2.0

0.668

POWER

0.00

1.1

0.643

0.2

1.000

0.9

0.775

SHOSHONE

5.98

3

2.1

0.710

0.3

1.000

3

1.8

0.525

TETON

0.00

0.6

1.000

0.1

1.000

0.5

1.000

TWIN FALLS

6.16

12

8.2

0.258

2

1.3

0.771

10

6.9

0.318

VALLEY

4.82

1

0.9

1.000

0.1

1.000

1

0.7

1.000

WASHINGTON

0.00

1.1

0.645

0.2

1.000

1.0

0.772

NOTES: The incidence rate for the state of Idaho is the product of the age adjusted rate for all birth cohorts using the 1970 standard U.S. population (direct age adjustment) and the standardized incidence ratio for this birth cohort compared with all birth cohorts (indirect age adjustment). The incidence rates for the other geographic areas are the products of the standardized incidence ratios for this cohort and the state age-adjusted rate. Expected cases for geography other than state are based upon age- and sex-specific rates for the state of Idaho for this cohort. P-values compare observed and expected cases, are two-tailed, based upon the Poisson probability distribution.

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

TABLE D.5 Ratio of Female-to-Male Invasive Thyroid Cancer Cases by Age Group and Birth Cohort

 

Birth Cohort Born Before 1948   

Birth Cohort Born 1948-1958        

Birth Cohort Born After 1958           

Age

Group

Female Cases

Male Cases

Cumulative F:M Ratio

Female Cases

Male Cases

Cumulative F:M Ratio

Female Cases

Male Cases

Cumulative F:M Ratio

0- 4

 

 

 

 

 

 

0

1

0.0

5- 9

 

 

 

 

 

 

2

0

2.0

10-14

 

 

 

 

 

 

5

3

1.8

15-19

 

 

 

7

2

3.5

21

3

4.0

20-24

 

 

 

22

5

4.1

42

3

7.0

25-29

8

1

8.0

37

3

6.6

44

9

6.0

30-34

33

4

8.2

58

9

6.5

25

5

5.8

35-39

34

10

5.0

50

14

5.3

3

3

5.3

40-44

52

20

3.6

42

11

4.9

 

 

 

45-49

70

15

3.9

11

0

5.2

 

 

 

50-54

55

23

3.5

 

 

 

 

 

 

55-59

60

20

3.4

 

 

 

 

 

 

60-64

50

29

3.0

 

 

 

 

 

 

65-69

37

17

2.9

 

 

 

 

 

 

70-74

37

22

2.7

 

 

 

 

 

 

75-79

30

12

2.7

 

 

 

 

 

 

80-84

16

10

2.6

 

 

 

 

 

 

85+

12

2

2.7

 

 

 

 

 

 

Total

494

185

2.7

227

44

5.2

142

27

5.3

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×

ascertainment rates across geographic areas, and depends upon the accuracy of the population estimates generated by the U.S. Bureau of the Census and apportionment of 5-year age group data into five equal single-year groups. The analyses did not account for in- or out-migration of cases. Cases among previous Idaho residents who moved to another state prior to diagnosis were not accounted for, but cases among persons who previously resided in other states, but moved to Idaho prior to diagnosis, were counted as Idaho cases. This same limitation exists at the county level for county-specific analyses. Many of the statistics, particularly for the county analyses by birth cohort, are based upon small numbers of cases. Incidence rates based upon 10 or fewer cases (numerator) should be interpreted with caution.

None of the four Idaho counties with highest estimated exposure to iodine-131 showed an elevation in thyroid cancer cases from 1970-1996 in the birth cohort born during 1948-1958, which was estimated to have received the highest exposure to iodine-131. Although the overall female-to-male thyroid case ratios differed by birth cohort, this result was confounded by age, as the cumulative age-specific ratios are similar in each birth cohort.

Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 198
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 199
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 200
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 201
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 202
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 203
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 204
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 205
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 206
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 207
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 208
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 209
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 210
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 211
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 212
Suggested Citation:"Appendix D. Thyroid Cancer in Idaho, 1970-1996." Institute of Medicine and National Research Council. 1999. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, DC: The National Academies Press. doi: 10.17226/6283.
×
Page 213
Next: Appendix E. Applicable Radiation Exposure Standards and Guides: Past and Present »
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In 1997, after more than a decade of research, the National Cancer Institute (NCI) released a report which provided their assessment of radiation exposures that Americans may have received from radioactive iodine released from the atomic bomb tests conducted in Nevada during the 1950s and early 1960s. This book provides an evaluation of the soundness of the methodology used by the NCI study to estimate:

  • Past radiation doses.
  • Possible health consequences of exposure to iodine-131.
  • Implications for clinical practice.
  • Possible public health strategies--such as systematic screening for thyroid cancer--to respond to the exposures.

In addition, the book provides an evaluation of the NCI estimates of the number of thyroid cancers that might result from the nuclear testing program and provides guidance on approaches the U.S. government might use to communicate with the public about Iodine-131 exposures and health risks.

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