A large excess risk of thyroid cancer was observed among Belarusian/Russian/Baltic Chornobyl cleanup workers. A more recent study of Ukraine cleanup workers found more modest excess risks of thyroid cancer. Dose errors in this data are substantial, associated with model uncertainties and questionnaire response. Regression calibration is often used for dose-error adjustment, but may not adequately account for the full error distribution. We aimed to examine the impact of exposure-assessment uncertainties on thyroid cancer among Ukrainian cleanup workers using Monte Carlo maximum likelihood, and compare with results derived using regression calibration. Analyses assessed the sensitivity of results to various components of internal and external dose. Regression calibration yielded an excess odds ratio per Gy (EOR/Gy) of 0.437 (95% CI − 0.042, 1.577, p = 0.100), compared with the EOR/Gy using Monte Carlo maximum likelihood of 0.517 (95% CI − 0.039, 2.035, p = 0.093). Trend risk estimates for follicular morphology tumors exhibited much more extreme effects of full-likelihood adjustment, the EOR/Gy using regression calibration of 3.224 (95% CI − 0.082, 30.615, p = 0.068) becoming ~ 50% larger, 4.708 (95% CI − 0.075, 85.143, p = 0.066) when using Monte Carlo maximum likelihood. Results were sensitive to omission of external components of dose. In summary, use of Monte Carlo maximum likelihood adjustment for dose error led to increases in trend risks, particularly for follicular morphology thyroid cancers, where risks increased by ~ 50%, and were borderline significant. The unexpected finding for follicular tumors needs to be replicated in other exposed groups.

在白俄罗斯/俄罗斯/波罗的海切尔诺贝利清理工人中观察到甲状腺癌的风险大大增加。最近一项针对乌克兰清理工人的研究发现，患甲状腺癌的超额风险较小。该数据中的剂量误差很大，与模型不确定性和问卷响应相关。回归校准通常用于剂量误差调整，但可能无法充分考虑完整的误差分布。我们的目的是使用蒙特卡罗最大似然法检查暴露评估不确定性对乌克兰清理工人甲状腺癌的影响，并与使用回归校准得出的结果进行比较。分析评估了结果对内部和外部剂量的各个组成部分的敏感性。回归校准得出每 Gy 的超额优势比 (EOR/Gy) 为 0.437 (95% CI − 0.042, 1.577, p  = 0.100)，而使用蒙特卡罗最大似然法的 EOR/Gy 为 0.517 (95% CI − 0.039, p = 0.100)。 2.035，p  = 0.093）。滤泡形态肿瘤的趋势风险估计表现出完全似然调整的更为极端的影响，使用回归校准的 EOR/Gy 为 3.224 (95% CI − 0.082, 30.615, p  = 0.068)，变得约 50% 更大，为 4.708 (95%) 使用蒙特卡洛最大似然法时，CI − 0.075, 85.143, p = 0.066)。结果对剂量外部成分的遗漏很敏感。总之，使用蒙特卡罗最大似然调整剂量误差导致趋势风险增加，特别是对于滤泡形态甲状腺癌，风险增加约 50%，并且达到临界显着水平。滤泡性肿瘤的意外发现需要在其他暴露组中复制。