Département de santé publique, Unité de biostatistique, Faculté de médecine et de pharmacie, 2, place Saint-Jacques, 25030 Besançon Cedex
Problem. The increased incidence of childhood thyroid cancer in areas heavily contaminated by the accident at Chernobyl is now well established. Initial studies outside the former USSR showed no evidence of changes in this incidence. France received much less fallout than did the former USSR, but deposition was highly heterogeneous in eastern France, particularly in the region of Franche-Comté. Under the auspices of the Union régionale des médecins libéraux de Franche-Comté (regional association of private practitioners), the general practitioners of this area decided to assess the health consequences in children living in Franche-Comté at the time of the accident of Chernobyl. Method. Incident cases from 1980 through 1998 among children younger than 15 years were collected from general practitioners, specialists, and hospital staff physicians in the Franche-Comté and surrounding regions. A Poisson test was used to analyse temporal heterogeneity (including a 4-year latency period) and spatial heterogeneity (between the 4 administrative areas composing the area) separately. Results. During the 19-year study period, 8 cases of childhood thyroid cancer were identified. The sex ratio was 1.67, and 7 of the cases were diagnosed in children in the 10-14 age group. The standardized incidence rate was 0.15/100,000. The incidence rate increased from 0.13/100,000 (95% CI: 0.03-0.37) in 1980-1989 to 0.26/100,000 (95% CI: 0.08-0.60) in 1990-1998. No variations were significant, however, either in space (p = 0.44) or time (p = 0.48). Conclusions. Although this study did not observe a significant increase in the incidence of childhood thyroid cancer after Chernobyl, it highlights two needs : first, for the assessment of the consequences of the accident at Chernobyl in France among a wider population, and second, for an extension of the follow-up period. This study also illustrates the role that private practice physicians can play in the field of public health.