Table 1.—Cancer incidence in a Mormon Population Residing in Southwestern Utah Exposed to Radioactive Faliout Compared
With Cancer incidence for All Utah Mormons *
Class
Utah
High-Faliout Area"’
(international Mormons
Classification of
Typet
A+B
A: Cancer of
more radio-
sensitive
organs
B: Other
cancer
A/B
Diseases No.,
Revision 8) —
Ail sites
(140-207)
Lung, raspiratory (162,
160, 163)
Upper Gi tract
(141-150)
Stomach (161)
Coton (153)
Breast (174)
Thyroid (193)
Leukemia
Lymphoma
Total
Melanoma (172)
Brain, CNS
(191, 192)
Bone,joint (170)
Other
Total
(Apoplar1)x100
A/B (Utah)
1958-1966
19671975,
Ratet
228
Rate
354
Cb
Ex-
1184,
76.0
served§ pected§
a
Faltout-Effects Group
1972-1980
Rate
377
1958-1968
Ob-
Ex
170
1028
1,922
21
served pected
16.8
20.0
?
6.8
12.8
6
7.7
4.4
11.4
4
1.5
ao
4
2.0
7.0
19.7
31.9
3.7
74
10.7
101.8
5.7
34.6
14.0
20.1
16.3
417
10.1
177.1
9.0
9G
5
8
e{
194
4
62
3
1.8
7.0
8.8
1.4
3.6
4.2
4.1
1.9
12.8
34.1
60.7
30.8
28.1
20,7
208.6
19.5
4.7
15.0
5#
1.6
8.2
a3
34
144.6
46
176.9
56%
1001...
0.3
36.8
39.6
Lae
10.1
130.6
168.4
1230
oo
459.5%
0.8
115.0
126.2
0.807
es)
ee
.
Rate
1972-1980
-
Ob-
Ex-
319
6.3
1,064
1
0.8
served pected
0
Ob-
Ex-
339
7.1
22
1
0.8
26
1
0.2
38
87
347
26
70
199
813.
13
2
3
Bg
1
1
5
224
1
04
0.7
0.7
0.1
0.1
0.3
3.3
0.4
Rate
served pected
§
14
274
14]
124
10
o2G
9g
2.8
8.1
14.2
1.7
3.4
5.2
45.1
2.68
138
86
@6
Lan
307
48
676
85
34
2
2
0
9g
1
189
2g
0.2
0.6
0.7
ae
0.2
0.2.
27
0.1
4
2.3
131
2¢
0.1
70
1
0.1
Q.4
62.8
58.1
_
Lan
430
e4g
1046
0
oq
134
=~,
Lae
2.4
2.6
bee
.e
168
251
3.239
0
9
11
0.1
6.2
6.8
54
60
78
=.
6...
2B.
#801A
" Radioactive tallout occurring trom atrnospheric detonations of nuclear weapons at the Nevadae Test Site between 1951 and 1062. Data have been adjusted for age
and sex: age adjustment for the three populationa by the direct method with the 1970 US white population as the standard (JNC/ 1980;65: 1 169).
tA” classes of cancer (of the more radicsensitive organs) are those found in exceas among the survivors of the nuciear bomb detonations at Hiroshima and
Nagasaki: leukemia, lymphoma, cancer of thyroid gland, lung, esophagus (included here are other cancers of the upper gastromiestinal [GI] tract 141-150}, stomach,
coton, and breast.
¢All rates are average annual age-adjusted incidence of cancer per 100,000.
§The number of cases observed is compared with the number expected. Expected case numbers were calculated by the following approach: the number of cases in
each class times the average annual age-adjusted cancer incidence rate for Utah Mormona divided by the everage age-adjusted cancer mcidence rate tor the study
population (Environ Res 1981;25:86).
\itigh-falout areas consiat of the St George ares, Parowan, Paragonah, and Kanab, Utah: Fradonia, Ariz, and Bunkerville, Nev, For some cases, dates of
diagnosis of Cancer were not recalled with certainty. These were ailocated to the broad time periods indicated in the table above. Those not clearty falling in a time
period were aasigned to a time period in the sequence in which they appeared, with conservative effect, ie, assigned equally to the early (1958 through 1966), interim
(1987 through 1971), and intermediate (1972 through 1980) time periods. The interim period was not studied because the design is to compare an early period with a
later period.
Gindicates significant at P=.01.
#indicates significant at P=.05 (two-tailed teat '*).
each household, including children born to
these families during the period 1951
through 1962 and those who died in 19620r
after. The period 1951 through 1962 was
chosen to define the study population
because the major exposures to fallout
occurred in this time. However, the choice
of 1962 as the end of this period is not
intended to imply that fallout-induced
neoplastic diseases of short latency such
as leukemia could not have appeared
before 1962.
Volunteers were trained in the smaller
towns to carry out a survey of this population between April and December 1981.In
St George, trained volunteers were augmented with persons hired for this purpose. The survey form was completed by
the surveyor and the head of the family
and included an inquiry about church
membership. Other questions concerned
effects felt immediately after fallout (skin
burns, eye burns, hair loss, change in hair
232
coloration, nausea, and diarrhea), smoking
experience, employment, and diagnosis of
cancer. Those who had a medical diagnosis
of cancer were asked to supply information for a supplementary form: diagnosis,
date of diagnosis, date of death if
deceased, hospital where iast treated,
nameof physician, and current address of
the cancer patient or surviving relative.
Cancer is a major life-threatening event
that will be remembered by a person and
by members of the family. The treating
physician will inform the patient and/or
the family of the diagnosis of the disease.
A recent study reports that diagnosis in
life correlated with death certificate cause
and with unpublished data from the Utah
Cancer Registry more than 90% of the
time.”
Information was also requested about
spontaneous abortions, stillbirths, and
malformations, to be included in later
reports. When necessary, telephone inter-
JAMA, Jan 13, 1984—Vol 251, No. 2
views were conducted. Telephone companies reported that about 2.5% of residents
in this area did not have telephones. About
40% of the defined population could not be
located in 1981. Loss of this portion of the
population was thought to have a conservative effect on the data, ie, to be more
likely to understate any association present. Less than 1% refused to cooperate.
The year of diagnosis of cancer could not
be recalled with certainty in about 18% of
cases occurring between 1958 through
1980. These were assigned at random to
periods 1958 through 1966, 1967 through
1971, or 1972 through 1980. Skin cancers
not melanoma and benign tumors werenot
considered, although a high rate of the
former was reported, and an increase of
benign tumors could be expected in a
population with radiation effects.”
The 1951 cohort at high risk was identified by 1962 telephone directories and
availability for this study in 1981. The
Cancer and Radioactive Fallout—Johnson