@article{fdi:010090168,
  title = {{A}ssessment of differentiated thyroid carcinomas in {F}rench {P}olynesia after atmospheric nuclear tests performed by {F}rance},
  author = {de {V}athaire, {F}. and {Z}idane, {M}. and {X}haard, {C}. and {S}ouchard, {V}. and {C}hevillard, {S}. and {O}ry, {C}. and {R}achedi, {F}. and {N}unez, {S}. and {L}eufroy, {A}. and {N}oel, {L}. and {G}uerin, {T}. and {S}han, {L}. and {B}ost-{B}ezeaud, {F}. and {P}etitdier, {P}. and {S}oubiran, {G}. and {A}llodji, {R}. and {R}en, {Y}. and {D}oyon, {F}. and {T}aquet, {M}arc and {G}ardon, {J}acques and {B}ouville, {A}. and {D}rozdovitch, {V}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}mportance{D}ue to the amount of iodine 131 released in nuclear tests and its active uptake by the thyroid, differentiated thyroid carcinoma ({DTC}) is the most serious health risk for the population living near sites of nuclear tests. {W}hether low doses to the thyroid from nuclear fallout are associated with increased risk of thyroid cancer remains a controversial issue in medicine and public health, and a misunderstanding of this issue may be associated with overdiagnosis of {DTC}s. {D}esign, {S}etting, and {P}articipants{T}his case-control study was conducted by extending a case-control study published in 2010 that included {DTC}s diagnosed between 1984 and 2003 by adding {DTC}s diagnosed between 2004 and 2016 and improving the dose assessment methodology. {D}ata on 41 atmospheric nuclear tests conducted by {F}rance between 1966 and 1974 in {F}rench {P}olynesia ({FP}) were assessed from original internal radiation-protection reports, which the {F}rench military declassified in 2013 and which included measurements in soil, air, water, milk, and food in all {FP} archipelagos. {T}hese original reports led to an upward reassessment of the nuclear fallout from the tests and a doubling of estimates of the mean thyroid radiation dose received by inhabitants from 2 m{G}y to nearly 5 m{G}y. {I}ncluded patients were diagnosed from 1984 to 2016 with {DTC} at age 55 years or younger and were born in and resided in {FP} at diagnosis; 395 of 457 eligible cases were included, and up to 2 controls per case nearest by birthdate and matched on sex were identified from the {FP} birth registry. {D}ata were analyzed from {M}arch 2019 through {O}ctober 2021. {E}xposure{T}he radiation dose to the thyroid gland was estimated using recently declassified original radiation-protection service reports, meteorological reports, self-reported lifestyle information, and group interviews of key informants and female individuals who had children at the time of these tests. {M}ain {O}utcomes and {M}easures{T}he lifetime risk of {DTC} based on {B}iological {E}ffects of {I}onizing {R}adiation ({BEIR}) {VII} models was estimated. {R}esults{A} total of 395 {DTC} cases (336 females [85.1%]; mean [{SD}] age at end of follow-up, 43.6 [12.9] years) and 555 controls (473 females [85.2%]; mean [{SD}] age at end of follow-up, 42.3 [12.5] years) were included. {N}o association was found between thyroid radiation dose received before age 15 years and risk of {DTC} (excess relative risk [{ERR}] per milligray, 0.04; 95% {CI}, -0.09 to 0.17; {P}=.27). {W}hen excluding unifocal noninvasive microcarcinomas, the dose response was significant ({ERR} per milligray, 0.09; 95% {CI}, -0.03 to 0.02; {P}=.02), but several incoherencies with the results of the initial study reduce the credibility of this result. {T}he lifetime risk for the entire {FP} population was 29 cases of {DTC} (95% {CI}, 8-97 cases), or 2.3% (95% {CI}, 0.6%-7.7%) of 1524 sporadic {DTC} cases in this population. {C}onclusions and {R}elevance{T}his case-control study found that {F}rench nuclear tests were associated with an increase in lifetime risk of {PTC} in {FP} residents of 29 cases of {PTC}. {T}his finding suggests that the number of thyroid cancer cases and the true order of magnitude of health outcomes associated with these nuclear tests were small, which may reassure populations of this {P}acific territory.},
  keywords = {{POLYNESIE} {FRANCAISE}},
  booktitle = {},
  journal = {{JAMA} {N}etwork {O}pen},
  volume = {6},
  numero = {5},
  pages = {[13 ]},
  ISSN = {2574-3805},
  year = {2023},
  DOI = {10.1001/jamanetworkopen.2023.11908},
  URL = {https://www.documentation.ird.fr/hor/fdi:010090168},
}