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Health Physics

separately estimated risks for leukemia, thyroid cancer,
stomach cancer, and colon cancer. For the residual group

of all solid cancers except thyroid, stomach, and colon,

we subtracted the estimates for stomach and colon
cancer from the estimate for the combination of all
solid cancers excepting thyroid cancer and non-melanoma
skin cancer (obtained using weights 0.7 and 0.3 for multiplicative and additive transfer, respectively).
For thyroid cancer, the estimated ERR (ERR,<s)
obtained above for thyroid cancer is directly applicable
to the MI population (i.e., ERR, = ERR,ss). Thus,

ERR, has a lognormal uncertainty distribution with
GM = 0.0805 and GSD = 3.40 (mean = 0.170) (Fig. 5).

Life tables
Until this point, the narrative has concerned only
estimates of ERR at specific ages. Projected lifetimerisk,
however, is calculated as a differentially-weighted sum
of age-specific absolute risks in which the weightsreflect
the inverse relationship between the likelihood of reaching a given age and the numerical value of that age. For
this purpose, we used a 1989-1991 life table for the U.S.
(NCHS 1997) (Fig. 6) to adjust for competing, agespecific mortality in estimating cumulative baseline and
radiation-related excess risk for exposure to a given
radiation dose at a given age. This life table, based on
sex- and age-specific mortality rates for the U.S. in
1989-1991, provides one-year survival data for persons
alive at any given age during that period, Le., the
proportion of persons of a given age that survived until
the next year oflife. However,it is often used, as in Fig.
6, to show the average likelihood that a newborn person
would survive until one, two, three, etc. years of age

100

a

N

a

\

provided that the age-specific mortality rates observed in
1989-1991 also were to hold for every other calendar
year (which, of course, may not be the case). If we
multiply age-specific baseline rates by the life table
survival probability for that age, and sum over the
different ages, the “life-table-weighted sum” is an estimate of lifetime cancer risk, here also assuming that
age-specific baseline cancer rates, as well as survival
probabilities, do not change over time. With the same
assumptions, we can calculate the lifetime excess cancer
risk for each year following exposure to a given dose at
a given age, as the life-table-weighted sum of estimated
age-specific excess risks. Of course, in order to be
exposed at a given age one must have survived until that
age, so a modified life table is required, conditional on
survival to the specified exposure age.
As noted in the previous paragraph, life tables are
not perfect, but they do provide a standard way of
accounting for competing mortality risks when estimating future and lifetime risk associated with a particular
exposure of interest. For computational convenience, we
used a simple life table for projecting lifetime radiationrelated excess risk rather than a doubly-decrementedlife
table which takes account of additional mortality due to
radiation-related cancer. This likely resulted in a slight
overestimation of excess cancer risks for most of the
communities, and probably more so for risks associated
with the higher-dose exposures experienced on
Rongelap, Ailinginae, and Utrik in 1954. Similarly, in
the absence of any MIlife tables, the use of standard U.S.
life tables may have led to overestimation of both
baseline and radiation-related cancer; however,the effect

on relative risk and attributable risk is unlikely to be great
considering the greater influences of uncertainty in radiation dose and year-to-year variation in population sizes
by atoll.
Calculation of projected lifetime baseline and

excess risks
In the present analysis, lifetime baseline risk is

calculated from birth or from 1948, whichever occurred
first. Thus, for someone born in 1950, the sex-specific

life table survival probabilities in Fig. 6 would be used,

-

T

1

—

1

|

2
°

Males

— — Females

a
o

Percent Surviving

L

-

g0

August 2010, Volume 99, Number 2

but for someone born in 1942, and known (or assumed)

to have been alive in 1948, an adjusted life table would

20 -

0

4

pop

0

20

40

60

80

100

120

Age (years)

Fig. 6. U.S. male and female life tables used in the preparation of
this report. Drawn from data in NCHS (1997).

be used, with probabilities of survival to ages one, two,

..., Six, each set equal to one and probabilities of survival
until ages seven,eight, etc. (from Fig. 6), each divided by
the Fig. 6 probability of survival to age six (i.e., survival
until 1948). Denoting the adjusted life table probability
to age a by L(a) and the age-specific baseline cancer rate
by Byy(a), the lifetime baseline rate from age six is
calculated as the life table-weighted sum over ages a

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