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Increased risk of salivary gland tumors after low-dose irradiation
B Modan1, A Chetrit, E Alfandary
1Department of Clinical Epidemiology, Chaim Sheba Medical Center, and The Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University School of Medicine, Tel Hashomer, Israel.
Objective:
To assess the risk of neoplastic development among persons exposed to scalp irradiation.
Study Design:
Historical cohort study initially; prospective follow-up subsequently.
Method:
Two control groups--population and siblings--matched for age, sex, ethnic origin, and year of immigration. Follow-up from time of irradiation (1950s) until the end of 1991. Linkage with nationwide cancer registry.
Results:
A 4.5-fold incidence of cancer (P < .01) and a 2.6-fold increase of benign tumors were noted. The mean length of latency period until tumor development was 11 years for malignant tumors and 21.5 years for benign. A clear dose response effect for both cancer and benign tumors was demonstrated.
Conclusions:
The study confirms the role of radiation in salivary gland carcinogenesis. It indicates a need for better awareness, a comprehensive examination, and long-term follow-up of patients who have been subjected to head and neck radiation.