1. Incidence of malignant tumors in Republic of Belarus after the Chernobyl accident A. Okeanov, E. Sosnovskaya International Sakharov Environmental University, Minsk Republican Research and Practical Center of Radiation Medicine and Human Ecology, Gomel

2. Распространение чернобыльского выброса (The National Report- 2006)

3. Условные обозначения The contamination of the territory of Belarus with iodine-131 (reconstruction) estimated on 10 May, 1986 (The National Report- 2006)

4. The contamination of the territory of Belarus with caesium-137 (1986) (The National Report- 2006)

5. Dynamics of 137Cs and 90Sr migration by the profile of non- arable peat-marsh drained low-lying type soils in % of total content (The National Report- 2006)

6. The groups of affected population included in the study Group 1 – liquidators Group 2 – evacuated population Group 3 - population living on the contaminated territories over 555 kBk/m 2 Group 5 - population living on the contaminated territories of 37 - 555 kBk/m 2

7. Cancer Registry Materials of cancer populational statistics Materials for assessment of health state of affected population Chernobyl Registry

8. Methodology As a control group the population of the Vitebsk area has been taken. Criteria for choosing Vitebsk area as a control one were the following:  the population of this area has received the lowest dozes of radiation;  the least number of population moved from polluted territories to Vitebsk area. While analyzing the control group all cancer cases among moved population and liquidators were excluded from research. The comparative analysis of cancer incidence was carried out using standardized incidence rates. Standardization of incidence rates of adult population and liquidators was performed by a method of truncated age- standardized rate (TASR) with use of the standard "World".

9. Specifics of surveyed cohorts GroupsNumber in groups (Thousands) Number of person-years (Thousands) Number of cancer cases Liquidators 71.8790.23857 Evacuated 7.582.6331 Population > 555 kBk/m 2 78.3861.82655 population 37-555 kBk/m 2 1245.313698.345490

10. Distribution of liquidators by age (%)

11. Number of detected cancers in the liquidators’ cohort for the period of 1993-2003 Tumor SiteTotalMenWoman All sites38573026831 Stomach40833870 Colon15512728 Lung54052317 Kidney18116516 Urinary bladder1661606 Thyroid255133122 Breast140 -

12. Average levels and dynamics of incidence of malignant tumors among liquidators for the period of 1993-2003. (TASR*±m per 100000 population) Tumor SiteIncidenceRegression rate LiquidatorsControl regionLiquidatorsControl region All sites 422,2±20,6366,4±5,313,15±5,294,69±1,10 Stomach 41,1±3,442,9±1,21,99±0,92-0,99±0,19 Colon 19,1±2,116,1±0,41,14±0,590,24±0,12 Lung 55,6±5,453,6±1,23,78±1,26-0,38±0,31 Kidney 15,7±1,910,8±0,51,78±0,270,68±0,16 Urinary bladder 16,7±1,213,8±0,80,89±0,230,28±0,12 Thiroid gland 28,4±4,110,1±1,01,08±1,030,8±0,18

13. Incidence rate among liquidators depending duration of their staying in the zone (average values for 1993-2003) Period of time (days)Incidence per 100’000 < 30414.7 ± 36.8 30 - 60430.6 ± 31.6 60 - 90465.5 ± 34.8 > 90443,0 ± 29.8 Total422.2 ± 5.3 Control366.4 ± 5.3

14. Effect of A-Bomb Radiation on the Human Body. Shigematsu I. at all.

16. Dynamics of lung tumor incidence (TASR) among liquidators and control group (Vitebsk region) for the period of 1993-2003

17. Dynamics of relative risk of lung cancer among Chernobyl liquidators RR 1997-2003 = 1.26 min - 1,14max - 1,39

18. Standardized rates of lung cancer incidence among exposed survivors in Hiroshima with T65DR (1950-1980) Radiation Dose (rad) 01-910-4950-99100-199200-299300-399400+ Rate per 10 5 36,437,845,753,184,376,197,691,9 Relative risk 1.001,041,251,462,322,092,682,52 Tsuomu Yamamoto at all. Lung Cancer Incidence among Japanese A-Bomb Survivors, 1950-80/J, Radiat,Res,,156-171 (1987).

19. Dynamics of stomach tumor incidence (TASR) among liquidators and control group

20. Dynamics of urinary bladder cancer relative risk among Chernobyl liquidators RR (1997-2003) = 1,65 min - 1,37 max - 1,98

21. Relative risk of urinary bladder cancer incidence among Chernobyl liquidators Duration of staying in zone (days) RR 1993- 1996 95% confidential interval RR 1997- 2003 95% confidential interval minmaxminmax <301,040.641,681.411.071.87 30-601.500.753.021.500.992,27 60-903.921.758,752.090.944,66 >901.510.832.742.742.141.592.90 Total1.331.330.971.821.651.371.98

22. Dynamics of relative risk of kidney cancer among Chernobyl liquidators RR (1997-2003) = 1,24min - 1,05max - 1,47

23. Relative risk of malignant tumors incidence among liquidators for the period of 1997-2003 Tumor site Incidence rate (TASR*±m per 100000) RR 95% confidential interval LiquidatorsControl group Lower boarder Upper boarder All sites464,6379,31,231,181,27 Stomach46,940,81,151,021,29 Colon22,216,71,331,111,59 Lung66,352,61,261.141,39 Kidney19,115,41,241,051,47 Urinary bladder18,711,41,651,371,98 Thyroid32,212,32,622,233,07

24. Dynamics of thyroid gland cancer incidence among Chernobyl liquidators and control population

25. Incidence of thyroid cancer among Belarus population exposed to 131 I at the age of 0-18 years Year Thyroid cancer incidence 10 5

26. Incidence of thyroid cancer among Belarus population exposed to 131 I at the age of 19 and older Year Thyroid cancer incidence 10 5

27. КАРТА ЙОДНОЙ ОБЕСПЕЧЕННОСТИ ДЕТЕЙ И ПОДРОСТКОВ, ПРОЖИВАЮЩИХ НА ТЕРРИТОРИИ РЕСПУБЛИКИ БЕЛАРУСЬ MAP OF IODINE SUPPLY OF CHILDREN AND ADOLESCENCE OF BELARUS - 20  g/l > 100  g/l

28. Incidence of cancer among evacuated population and control group Tumor site Groups EvacuatedControl group All sites 341,53±25,63366,41±5,33 Stomach 39,17±10,2642,89±1,18 Colon 5,69±2,5816,22±0,38 Lung 29,35±8,96   53,32±1,25 Breast 35±17,6259,25±1,21 Kidney 4,27±3,9913,95±0,82 Urinary bladder 2,92±1,9510,63±0,33 Thyroid 74,28±15,73  10,06±0,96

29. Relative risk thyroid cancer among evacuated population Population 1993-19961997-2003 RR 95% CI RR 95% CI lower border upper border lower border upper border Total9,004,7916,916,834,5910,17 Male6,150,8445,015,857,7232,50 Female8,264,2416,075,493,48,88

30. Trends of cancer morbidity among population living in contamination area >555 kBk/m 2 and control group

31. Relative risk of cancer among population living in contamination area 37-555 kBk/m 2 Tumor Site 1997-2003 RR 95% CI lower border upper border All sites 1,151,131,17 Stomach 1,030,981,07 Colon 1,231,151,32 Lung 0,930,890,98 Breast 1,251,181,32 Kidney 0,940,861,02 Urinary bladder 1,050,971,15 Thyroid 1,461,331,59

32. Age distribution of breast cancer morbidity among population living in contamination area (37-555kBk/m 2 ) and control region Incidence per 100000 women

33. Groups of populationRecorded changes 1 group – liquidators RR significant higher for cancer of stomach, colon, lung, kidney, urinary bladder, thyroid 2 group – evacuated population Thyroid cancer 7 times higher then in Vitebsk population 3 group (> 555kBk/m 2 ) The dynamics of cancer increase is significantly higher then in Vitebsk population 5 group (37- 555kBk/m 2 ) RR is significantly higher for cancer of colon, urinary bladder, breast and thyroid

34. Expected effects 30 thousand additional cases of a cancer among liquidators; 100 thousand additional cases of a cancer among population living on the contamination territories; 3 thousand additional cases of a thyroid cancer among evacuated population; 5-7 million diseases and infringements of function of a thyroid gland among the population as a consequence of influence of radioactive iodine