in 83 (P=.01)" later (1972 through
1980), when
seven cases were ex-
pected. Leukemia was most important
in the early period (9/0.2, P=.01)."
The classes of cancer in excess in the
early period also included cancer of
the stomach (3/0.2, P=.01),"° melanoma (2/10, P=.01)," and brain tumor
(2/0.1, P=.01)."* In the later period,
cancer of the breast (8/0.7, P=.01)"
and lymphoma (5/0.3, P=.01)'* were
most important. Cancer of the colon
was also higher (8/0.7, P=.034).
The ratio of cancer of more radiosensitive organs (Table 1) to all other
cancers in the high-fallout area was
24.0% higher in the period 1958
through 1966 than that for al) Utah
Mormons, and for the later period,
1972 through 1980, the ratio was
53.5% higher. Among the fallouteffects group, this ratio was 29.6%
higher than for Utah Mormonsin the
early period and about 300% higher
in the later period.
Differences in the incidence of cancer by sex are given in Table 3.
Although both sexes had an excess of
leukemia, males had more cases.
Males did not have an excess of
lymphoma, as females did later (6/
1.9, P=.05). Females had a larger
excess of cancer of the thyroid gland
(6/1.0 [P=.01}* early and 9/1.3
{[P=.01}"* later) than males, who had
no cases in the early study period but
had an excess (5/0.4, P=.01)" later.
Females had a greater excess of stomach cancer early (6/0.6, P=.01)" that
did not persist later (2/0.9). There
were an excessive numberof cases of
cancer of the colon later among
females
(11/3.7,
P=.01),"
but
not
among males. Both males and females _
had an excess of melanoma later
(4/12, P34, and 5/1.4, P=.05;
respectively).
Females
had
more
brain tumors (3/0.7, P=.34, early; and
3/1.1 later), and males had more bone
cancer (2/0.2 [P=.05] early and 4/0.8
[P=.05} later). Females had two more
cases of bone cancer than expected
throughout the study periods.
COMMENT
There was an excess of 109 cases of
cancer (288 cases observed [P*.01]",
179 expected) in this southwestern
Utah population of 4,125 during the
period of the study in this report
(1958 through 1966 and 1972 through
1980), a total of about 72,000 person234
years. Leukemia was preponderant
early and persisted later, compatible
with a prolonged period of exposure
to radioactive fallout during 1951
through 1962 and afterward from the
venting of 11 of the underground
nuclear bomb tests (1962 through
1979). This is in contrast to the peak
of leukemia deaths in about five years
among the Hiroshima-Nagasaki sur-
vivors after one exposure in 1945.
There was an increase of lymphoma
in females of marginal significance
(P=.05) in 1972 through 1980. There
was only one case identified as multiple myeloma, in a 15-year-old boy.
One person was reported to have had
aplastic anemia (woman, aged 23
years), another was reported to have
Table 3.—Age-Adjusted Cancer incidence by
Typet
A+6
A: Cancer of more
radioeensitive
organs
, Peepiratory
(162, 160, 183)
Upper Gi tract
(141-180)
Stomach (161)
Coton (153)
Breast (174)
Thyroid (193)
Leukemia
Lymphoma
Total
B: Other cancer
Melanoma (172)
Brain, CNS (101, 182)
Bone, joint (170)
polycythemia (man, aged 73 years),
and one death was attributed to
radiation sickness. Major classes of
cancer (chiefly breast, colon, and
jung) in the early period (1958
through 1966) had virtually the same
incidence as that for all Utah Mormons, consistent with the longer
latency period for these cancers.
Clase
(international
Claseification of
Diseses No.,
Revision 8)
All ates (140-207)
Other
Total
A/B
(42 Keuppopviston)+)» 100
A/‘B (Utah)
Cancer of the thyroid gland was
prominent in the exposed group. A
significant (P=.01) excess was noted
early in females, and a notable excess
was found in both sexes in 1972
through 1980. Many others in the
study group complained of thyroid
problems.
There was not an excess of cancer
of the breast until the later period
(1972 through 1980). There was a
slight excess of cancer of the upper GI
tract, the stomach, and of the colon
occurring later in females. The incidence of lung cancer was not higher
in the study population than for all!
Utah Mormons. Theiow prevalence of
smoking in this group would decrease
retention of inhaled radioactive parti-
cles of respiratory size. Moreover,
most Utah Mormons live in urban
areas with greater air pollution than
in southwestern Utah, and so lung
cancer rates here similar to those for
all Utah Mormons mayactually represent an increase. Females seemed to
have no advantage over males with
regard to lung cancer risk. Considering the excess incidence of other
classes of cancer associated with
radiation in this area, a larger study
population may demonstrate an excess incidence of jung cancer.
A significant (P=.01) excess of mel-
JAMA, Jan 13, 1984—Vo!l 251, No. 2
anoma was found in the later period
(1972 through 1980), about equally in
males and females. An excess inci-
dence of melanoma has been reported
in plutonium workers, and a possible
mechanism for induction of melano-
ma by actinides has been described.”
The actinides are chemically similar,
mostly synthetic, radioactive elements such as actinium, thorium,
uranium, and plutonium. Of the
radionuclides of potential importance
in routine releases from nuclear facilities, 47 are actinides.’ Tests of plutonium dispersion devices at the NTS,
as well as the detonation of weapons
with plutonium components, have
scattered plutonium over a wide area
and this may be related to the excess
cases of melanoma found there.
Plutonium workers have been reported to have a proportional morbidity ratio sf brain tumors (gliomas)
eight times greater than expected,”
and a significant (P=.05) excess of
Cancer and Radioactive Fallout— Johnson