Objective
The purpose of the ECLIS study is to monitor the incidence of leukaemia and lymphoma in children aged 0-14 in Europe since 1980, and to investigate whether any trends observed can be linked to the estimated exposure to radiation as a result of the Chernobyl accident in 1986. In compliance with the recommendations of the international panel of independent experts reporting to the CEC in 1990, the study relies upon ongoing routine data collection systems (cancer registries) for information on leukaemia and lymphoma cases. Thus, some 36 cancer registries located in 23 countries are active participants, supplying annual listings of cases registered, and estimatesl of the population at risk, by sex and single year of age. Data management, and quality control(evaluation of completeness and validity) is the responsibility of the coordinating centre. In some centres in Central and Eastern Europe, special ad-hoc mechanisms of case finding have been implemented, in order to supplement the existing cancer notification systems. Estimates of exposure to radiation are made on the basis of year and place of residence. The annual average effective dose equivalents of radiation, by geographic area and time since accident (years 1, 1-4, and 1-70) have been provided by UNSCEAR, based upon environmental radiation measurements and uniform modelling of rates of decay (physical and biological) and bodily intake.
Childhood leukaemia was chosen for monitoring purposes because, based on previous data (mainly the Lifespan Study and Oxford Survey of Childhood Cancers), it is the cancer likely to show the earliest and largest increase in excess relative risk following radiation exposure. Lymphomas were added because diagnostic distinction from leukaemia is not always straightforward. Leukaemia also has the advantage that it is diagnosed in a relatively uniform manner, and does not exist for long -periods in a subclinical or benign form (unlike, eg., thyroid cancer), so there is little likelihood of artificial trends due to enhanced surveillance. Geographic variation in risk within Europe pre-Chernobyl is also rather modest, and there are no clear environmental risk factors likely to be linked to the Chernobyl radiation exposure, and thus act as confounders in the analysis.
Results at 5 1/2 years follow up suggest no significant increase in risk in relation to estimated exposure. This result is compatible with current estimates of risk (ERR about 50/Sv); the study has sufficient power to exclude an effect 2-3 times larger than this. There is, however, a suggestion that risk in the 1987 birth cohort (exposea in utero) is elevated (not significant, however).
The study should continue until follow up is complete for 10 years post accident, by which time almost all radiation-induced cases will have occurred.
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Programme(s)
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Coordinator
69372 Lyon
France
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