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The objective of the present study was to estimate cancer risk associated with the low-level radiation exposure of an average annual effective dose of 6.4 mSv (including internal exposure) in the high background-radiation areas (HBRA) in Yangjiang, China. The mortality survey consisted of two steps, i.e., the follow-up of cohort members and the ascertainment of causes of death. The cohort members in HBRA were divided into three dose-groups on the basis of environmental dose-rates per year. The mortality experiences of those three dose groups were compared with those in the residents of control areas by means of relative risk (RR). During the period 1987-1995, we observed 926,226 person-years by following up 106,517 subjects in the cohort study, and accumulated 5,161 deaths, among which 557 were from cancers. We did not observe an increase in cancer mortality in HBRA (RR = 0.96, 96% CI, 0.80 to 1.15). The combined data for the period 1979-95 included 125,079 subjects and accumulated 1,698,316 person-years, observed 10,415 total deaths and 1,003 cancer deaths. The relative risk of all cancers for whole HBRA as compared with the control area was estimated to be 0.99 (95% CI, 0.87 to 1.14). The relative risks of cancers of the stomach, colon, liver, lung, bone, female breast and thyroid within whole HBRA were less than one, while the risks for leukemia, cancers of the nasopharynx, esophagus, rectum, pancreas, skin, cervix uteri, brain and central nervous system, and malignant lymphoma were larger than one. None of them were significantly different from RR = 1. Neither homogeneity tests nor trend tests revealed any statistically significant relationship between cancer risk and radiation dose. We did not find any increased cancer risk associated with the high levels of natural radiation in HBRA. On the contrary, the mortality of all cancers in HBRA was generally lower than that in the control area, but not statistically significant.

Cancer Mortality in the High Background Radiation Areas of Yangjiang, China during the Period between 1979 and 1995