Abstract
Male hunters in Swedish counties with high fallout of (137)Cs after the Chernobyl Nuclear Power Plant (NPP) accident have higher radiation exposure due to higher consumption of game compared with the general population. METHODS: Cancer incidence in Sweden was studied in 9 counties with different (137)Cs fallout after the Chernobyl NPP accident in 1986. In total, 9,267 cancer cases occurred in hunters and 138,909 cancer cases in non-hunters to 31 December 2015. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were calculated using unexposed hunters, or non-hunters, as reference to study internal radiation exposure or hunter life style, respectively. RESULTS: Directly age standardized total cancer incidence showed an increasing trend in non-hunters. For hunters, the total cancer incidence was significantly lower up to 2001 when the total cancer incidence crossed over the weaker non-hunter trend and remained higher for the following 15 years. IRRs for total cancer in hunters versus non-hunters for each county did not show any clear exposure response pattern. IRRs for hunters versus non-hunters were higher regardless of rural/non-rural status with slightly higher risk estimates for the rural settings. The IRR for hunters was 1.06 (95% CI 1.04-1.08) 1986-2015, representing an excess of 531 cancer cases in hunters. CONCLUSION: An increased total incidence of cancer was identified for male hunters compared with male non-hunters. No obvious association between cancer and (137)Cs from the Chernobyl NPP accident could be identified, although the exposure classification was too crude to exclude such an association.