leukemia were not a chance occurrence, the SMOKY participants may have
received higher radiation doses than supposed (perhaps from neutrons or
inhaled radioactive material not detected by film badges) or radiation was
more carcinogenic at low doses than previously assumed.
The CDC published a preliminary report of these findings in the 3 October
1980 edition of the Journal of the American Medical Association (4).

The CDC

continued to study the incidence of all forms of cancer as well as causes of
death among the cohort, which was eventually refined to 3,217 veterans.
Disease incidence and mortality data were collected through 1979 on over
95 percent of the cohort.
The followup study identified a total of 112 cancer cases, which is below
the expected number of 117.5 cases.

The incidence of some specific cancer

types was slightly higher than expected, but the increase was not considered
statistically significant with the exception of leukemia (one additional case
was identified).

Cancers of the digestive system, respiratory, genital, and

urinary systems occurred less often than expected.

No cancers of the bone/

joints, soft tissue, endocrine system, or multiple myeloma were found.
With regard to mortality, the cohort had considerably fewer total deaths
than expected.

The number of deaths increased in only three categories--

infectious and parasitic diseases, accidents, and killed in action.

Deaths

from individual types of cancer exceeded the norm in five categories-leukemia, brain and nervous system, eye and orbit, genital system, and skin
melanoma.

Again, only the increased incidence of leukemia deaths was found

statistically significant.
An analysis of the film badge dosimetry available for the cohort showed
that, in general, radiation doses were well within current occupational
exposure standards.

The analysis also showed that the mean dose received by

participants engaged in the military maneuver was higher than the mean dose
received by support units.

However, the frequency of cancer was higher among

the participants assigned to support units. Assuming that the dosimetry is
correct, at least in a relative sense, the opposite would be expected if
radiation were the cause.

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