Incidence of benign gastrointestinal tumors among atomic bomb survivors

Using the Hiroshima and Nagasaki tumor and tissue registries, benign tumors of the stomach, colon, and rectum were identified among members of the Life Span Study cohort of atomic bomb survivors. During the period 1958-1989, a total of 470 cases with histologically confirmed benign gastrointestinal tumors (163 stomach, 215 colon, and 92 rectum) were identified among approximately 80,000 Life Span Study members with known radiation doses, who were alive in 1958. Restricting the analysis to adenomatous tumors not detected at autopsy, a dose-response relation was observed for stomach tumors (excess relative risk at 1 sievert (ERR1Sv) = 0.53; 95% confidence interval (CI) -0.01 to 1.43). However, there was little evidence of a dose response for colon tumors (ERR1Sv = 0.14; 95% CI -0.20 to 0.76), and no evidence was present for rectal tumors (ERR1Sv = -0.25; 95% CI undetermined to 0.80). The excess relative risk (ERR) for benign tumors of the stomach is consistent with the excess found for stomach cancer. For cancer of the rectum, the dose response was not significant, but the point estimate of the excess relative risk was positive. The excess relative risk for benign colon tumors is less than that reported for colon cancer (ERR1Sv = 0.72). The authors observed a dramatic increase in colon tumors detected after 1985, suggesting that the relatively recent introduction of colonoscopy may be influencing these results.