@article {Tondel1011, author = {Martin Tondel and Peter Hjalmarsson and Lennart Hardell and G{\"o}ran Carlsson and Olav Axelson}, title = {Increase of regional total cancer incidence in north Sweden due to the Chernobyl accident?}, volume = {58}, number = {12}, pages = {1011--1016}, year = {2004}, doi = {10.1136/jech.2003.017988}, publisher = {BMJ Publishing Group Ltd}, abstract = {Study objective: Is there any epidemiologically visible influence on the cancer incidence after the Chernobyl fallout in Sweden? Design: A cohort study was focused on the fallout of caesium-137 in relation to cancer incidence 1988{\textendash}1996. Setting: In northern Sweden, affected by the Chernobyl accident in 1986, 450 parishes were categorised by caesium-137 deposition: \<3 (reference), 3{\textendash}29, 30{\textendash}39, 40{\textendash}59, 60{\textendash}79, and 80{\textendash}120 kiloBecquerel/m2. Participants: All people 0{\textendash}60 years living in these parishes in 1986 to 1987 were identified and enrolled in a cohort of 1 143 182 persons. In the follow up 22 409 incident cancer cases were retrieved in 1988{\textendash}1996. A further analysis focused on the secular trend. Main results: Taking age and population density as confounding factors, and lung cancer incidence in 1988{\textendash}1996 and total cancer incidence in 1986{\textendash}1987 by municipality as proxy confounders for smoking and time trends, respectively, the adjusted relative risks for the deposition categories were 1.00 (reference \<3 kiloBecquerel/m2), 1.05, 1.03, 1.08, 1.10, and 1.21. The excess relative risk was 0.11 per 100 kiloBecquerel/m2 (95\% CI 0.03 to 0.20). Considering the secular trend, directly age standardised cancer incidence rate differences per 100 000 person years between 1988 to 1996 and the reference period 1986{\textendash}1987, were 30.3 (indicating a time trend in the reference category), 36.8, 42.0, 45.8, 50.1, and 56.4. No clear excess occurred for leukaemia or thyroid cancer. Conclusions: Unless attributable to chance or remaining uncontrolled confounding, a slight exposure related increase in total cancer incidence has occurred in northern Sweden after the Chernobyl accident.}, issn = {0143-005X}, URL = {https://jech.bmj.com/content/58/12/1011}, eprint = {https://jech.bmj.com/content/58/12/1011.full.pdf}, journal = {Journal of Epidemiology \& Community Health} }