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CHAPTER 11

Achievement of Age- and Sex-Matching across RERF's Eight Dose-Groups






The Importance of Matching :


          When analysts approach the A-Bomb Survivor database for the purpose of learning how cancer-risk varies with radiation-dose, they need reasonable assurance that persons in each of RERF'S Dose-Groups are alike in their cancer-risk -- except for radiation dose. In other words, analysts need a sound basis for thinking that the spontaneous cancer-rates would be the same in all eight RERF Dose-Groups in the absence of any radiation exposure from the bomb.

          Age and sex are features having a profound influence on spontaneous cancer-rates. Age and sex can also affect spontaneous cancer-rates indirectly, by affecting rates at which the non-cancer causes of death compete with cancer.

          Therefore, we must ask, "Are the Dose-Groups in the A-Bomb Study alike in the age and sex of their members?."

A Possible Misinterpretation:


          Analysts must avoid misinterpreting RERF allusions to "comparability" of age and sex between heavily and lightly irradiated survivors (Bee71, p.615), and to "sex-and age-matched" samples in the A-Bomb Study (Pr87a, p.153). Given the history of the study (Chapter 5), it is understandable that there are important differences across the eight RERF Dose-Groups in both age-distribution at the time of bombing (ATB) and in male-female ratios.

          These differences mean that it would be false to assume that the observed cancer-rates in the eight Dose-Groups incorporate comparable spontaneous rates, and therefore it would be false to assume that the differences in observed cancer-rates are exclusively due to radiation.

          Unfortunately, the dissimilar distributions of age and sex in RERF's eight Dose-Groups may not be evident, to outside analysts, from RERF reports. As noted in Chapter 7, RERF was very cooperative about supplying the necessary data, and those data are incorporated into our Master Table 26-A,B,C,D and all the tables derived therefrom.

Illustration of the Need for Matching :


          We will use some entries in Table 11-B to illustrate that problems would arise from using the raw data, unmatched for age and sex. (Table 11-B comes from Master Table 26-A,B for males;   column-headings are more fully described there.)

          In Table 11-B, Column C identifies the RERF Dose-Group. Columns A and B show that every Dose-Group is composed of persons in five age-bands, according to age at the time of bombing (ATB);   the age-bands are described in Table 11-A. For brevity, the RERF diskette named each age-band by the midpoint of its age-range (Column A).

          In Table 11-B, Column F tells the number of persons initially in each age-band when the follow-up began in 1950, and the total initial persons in each Dose-Group. The number of persons in an age-band over the total persons in its Dose-Group is the fraction entered in Column G. For instance, the entry G17 is entry F17 divided by entry F23.

          Now, if we compare the fractions in G17-G21 with the fractions in G41-G45, we see that the age-distribution in the male Reference Group (Dose-Groups 1+2) is quite different from the age-distribution in Dose-Group 5. This means that at the end of the 1982 follow-up, these two groups of persons are bound to have different cancer-rates per 10,000 initial persons, even if both groups were unexposed by the bombing, simply because their age-distributions differ. In other words, the cancer-risk of these two groups is not alike, except for radiation dose.

          When we turn to Table 11-D and make the same comparison for the females (entries G17-G21 versus G41-G45), we find that their distribution of ages is also not alike across Dose-Groups. Nor is it like the male distribution.

          The problem is compounded when we discover that the male-female ratio is not the same across Dose-Groups either. For instance, in the Reference Group, the ratio is (27585 males /38443 females), or 0.7176, whereas in Dose-Group 5, the ratio is (1386 males/ 1742 females), or 0.7956.

Conclusion about the Need :


          Dissimilarities like this pervade the database. Therefore we can be certain that the eight RERF Dose-Groups do not share the same spontaneous cancer death-rate, and that the eight groups would show different cancer death-rates during the follow-up even if no group had been exposed to bomb radiation at all. Therefore, it is imperative for every analyst to develop some method to overcome these confounding variables. Otherwise, it would be impossible to distinguish the age and sex effect on cancer death-rate from the radiation effect.

Our Method of Matching for Age and Sex :


Combination of Dose-Groups :


          Like many other analysts, we combine Dose-Groups 1+2 to make the Reference Group. The reasons were discussed earlier:   Realism about hidden doses from residual radioactivity, and achievement of a statistically more reliable control group (see Chapters 8 and 9).

          We make another combination of Dose-Groups at the outset:   Dose-Groups 6+7+8. If readers look again at Table 4-A, Column F, they will see that very few persons are in the three highest Dose-Groups. Death from acute radiation sickness probably accounts for the sparsity. It should be remembered that the Lifespan Study, of potential delayed radiation effects, did not begin until 1950 -- after the acute effects from radiation had already occurred.

          By combining Dose-Groups 6+7+8, we achieve a Dose-Group almost comparable to Dose-Group 5 in size and statistical reliability, and we reduce the hazard of attributing biological meaning to the random fluctuations of small numbers.

Guiding Principles :


          Our method of matching the Dose-Groups for age and sex distribution follows two principles.

  1. We want to achieve a database in which all Dose-Groups enter the lifespan follow-up in 1950 as directly comparable cohorts, alike in both age-distribution and sex-distribution. In other words, all Dose-Groups must be alike in the fraction of their total Initial persons who are males age-5-ATB, alike in the fraction of their total initial persons who are females age-5-ATB, alike in the fraction of their total initial persons who are males age-15-ATB, females age-15-ATB, and so forth.

  2. We want to stay as close to the original raw numbers as possible.

          The result is achieved by taking care of the age-normalization first, and then the sex-normalization. The notes of Tables 11-A through 11-H explain the logic and process step by step.

Net Result of Proper Matching :


          Table 11-H presents the data after both age and sex matching have been achieved, and male and female observations have been combined.

          Spontaneous cancer-rates, in-so-far as they are affected by age-distribution and sex-ratio, have been rendered identical from Dose-Group to Dose-Group by the normalization process. Moreover, age- or sex-related sensitivity to induction of cancer by radiation itself will not differ across Dose-Groups, because age-distribution and sex-ratio across Dose-Groups have been rendered the same.

          The cancer death-rates labeled "observed" in this book are the values from Table 11-H.

Comparison of Raw and Normalized Observations :


          Comparison of the raw and normalized observations is readily made by a comparison of data from Table 4-A with those of Table 11-H. The number of initial persons in each dose-group is the same in both tables. The doses remain very nearly the same. The comparison is made in the tabulation which follows.

------------------------------------------------------------
|                                                          |
|                   Observed   Observed    Change          |
|                   Cancer     Cancer      in Ca-          |
| Dose-    Initial  Deaths     Deaths      Deaths  Percent |
| Group    Persons  (Raw)      Normalized          Change  |
|                                                          |
|----------------------------------------------------------|
|                                                          |
| Ref 1+2  66,028   4,155      4,297.1     +142.1  + 3.42% |
| Exposed  25,203   1,895      1,918.7     + 23.7  + 1.25% |
|                                                          |
| SUM      91,231   6,050      6,215.8                     |
|                                                          |
|----------------------------------------------------------|
|                                                          |
| 1+2      66,028   4,155      4,297.1     +142.1  + 3.42% |
|  3       14,943   1,055      1,064.0      + 9.0  + 0.85% |
|  4        4,225     314        305.8      - 8.2  - 2.55% |
|  5        3,128     253        261.6      + 8.6  + 3.40% |
| 6-8       2,907     273        287.3      +14.3  + 5.25% |
|                                                          |
| SUM      91,231   6,050      6,215.8                     |
|                                                          |
------------------------------------------------------------

Preventing Overestimation of Radiation-Risk at Low Doses :


          The two top rows in the tabulation show that the normalized data have resulted in a larger percentage increase in cancer-deaths in the Reference Group (1+2) than in the exposed groups. Since mean doses are virtually unaffected by normalization, this means that there will be a smaller increment in cancer-deaths per centi-sievert (rem) among exposed persons in the normalized database than in the raw database.

          We have also made the comparison of raw and normalized data for the exposed groups separately, in the tabulation.

          For Dose-Group 3 (the lowest exposure), normalization has resulted in a far smaller percentage increase in cancer-deaths than in the Reference Group. The net effect will be to lessen the radiation-induction of cancer per rem for that comparison. Chapter 13, Part 3, will show this in detail.

          Similarly, for Dose-Groups 4 and 5, the effect of normalization will be to lessen the radiation-induction of cancer or to leave it unchanged. For the very high-dose group of exposed (6+7+8), normalization will produce an increase in radiation-induction of cancer per rem.

          Overall, the effects of matching for age and sex are (A) a decrease in risk-estimates for low-dose exposure, and (B) a decrease in the supra-linear curvature of the dose-response relationship.

The Missing Data from RERF :


          It should be noted that the ability to do age-sex matching in this manner depended on the cooperation of RERF in supplying the data on initial persons -- data now provided to additional analysts by the tables in this book.

          While I was still without the extra data from RERF, I used the "raw" database to make some interim estimates of risk (Go88c;   Go89a). Where space permitted (Go88c), I warned readers that the missing data might either raise or lower the interim values. Those interim values are now superseded and replaced by the values in this book, which are based upon the data which I sought.

          After receiving the data from RERF, I developed more than one method for using them to make age and sex adjustments, and the methods produce closely similar results.

          Results from a method which is not shown in this book assured me that it would be unnecessary to do additional matching for the age-variation across the various Dose-Groups within each separate age-band. It turns out that such adjustments -- which would alter cancer-observations by small fractions of one case -- are too small to matter and can be neglected. However, a responsible analyst does not leave the issue in doubt. The doubt necessarily persisted in my own mind, until RERF supplied the data I requested, which included the true mean ages ATB instead of the midpoints of the age-ranges. In Table 11-B, for instance, a comparison of entries B17, B25, B33, B41, and B49, shows that the true mean age of males age 5 ATB varies across Dose-Groups from 3.92 years old to 4.64 years old. Readers can see the variation within other age-bands too.

Correction-Factor of 1.23 for Underascertainment of Cancer


          Recent RERF reports (Pr87b, p.35;   and Shi88, p.41, pp.49-50) as well as the BEIR-3 Report (Beir80) indicate that, in the Japanese experience, cancer-deaths are underestimated. They use the estimate that measured cancer-deaths in any dose-group -- including Dose-Group 1, of course -- should be multiplied by 1.23. BEIR-3, referring to its own risk-estimates for cancer, says:

          "Finally, the mortality coefficients were expanded by a factor of 1.23 (derived from comparison of autopsy and death-certificate diagnoses) to adjust for incomplete death-certificate ascertainment of cancer" (Beir80, p.196 at the bottom). BEIR-3 cites the RERF study of this issue, by Steer and co-workers (Steer73).

          We, too, have applied the underascertainment facto, of 1.23 in this book. Readers will see where we have handled it, in each of our analyses.

Site-Specific Errors :


          Earlier in its report, BEIR-3 states:   "Death-certificate diagnoses differ greatly in their accuracy, even within the set of neoplastic diseases:   but for the A-bomb survivors, an active autopsy program the period 1961-1969 has provided unusually good information on errors in death-certificate diagnoses" (Beir80, p.154).

Site-Specific Risk-Analysis :


          It should be noted that underascertainment of cancer as the cause of death is not the same issue as misdiagnosis of the original site of a fatal cancer. Error about original site matters only if an analysis is attempting to determine cancer-risk or dose-response for a single site of cancer (say, lung-cancer) or a group of cancers (say, respiratory cancers).

          Whenever overall risk of fatal cancer is the information sought by an analysis, subdivision of the cancers by site can be and should be avoided (see Chapter 12). This book contains no site-specific analysis.






Table 11-A
Notes for Tables 11-B,C,D,E :   Age-Normalization of Observations Across Dose-Groups.


    1.    SOURCE OF THE DATA:   In Table 11-B for males, all the data in Columns A through N (other than Col.G) come from Master Tables 26-A for Hiroshima and 26-B for Nagasaki. The Master Tables were rearranged by Dose-Group instead of by age-band. Within a Dose-Group, the dose received by a particular age-band was not the same in the two cities. In combining the cities to make Table 11-B, we weighted each dose by the number of persons who received it. We have combined the observations for Dose-Groups 6+7+8 to lessen the instability of small numbers (see text). We have combined Dose-Groups 1+2 for use as our Reference Group (see text), and also preserved them separately for other purposes. In Table 11-D, female entries come in similar fashion from Master Tables 26-C and 26-D. (In all tables, "per 10K init" means "per 10,000 initial persons" in the row.)


    2.    OVERVIEW:   We are going to convert Table 11-B into Table 11-C (and Table 11-D into Table 11-E). The purpose of this conversion or normalization is to insure that we will examine groups of people who are truly comparable with respect to their cancer-risk, except for their different radiation doses. To be comparable, RERF's eight Dose-Groups must start the lifespan follow-up with the same distribution of ages in each Dose-Group.
           We will use the fractions in the raw female Reference Group as the standard to which all other Dose-Groups, both male and female, will conform with respect to age-distribution within a Dose-Group. Those fractions have been calculated in Table 11-D, Col.G, Rows 17-21. The denominator for each calculation was 38,443 persons -- the total number in the Dose-Group. For instance, the fraction entered in Col.G, Row 21, is (6007 / 38443), or 0.156.

THE TWO-STEP CONVERSION-PROCESS :   For brevity, these notes will describe only the conversion of Table 11-B into 11-C (males). Exactly the same simple process converts Table 11-D into Table 11-E (females).


        STEP 1:
        ======   In each Dose-Group, we are going to keep the total number of initial persons the same as in the raw data. Above, we specified that in each age-normalized Dose-Group, fractions of total persons from each age-band will be like the Female Reference Group:

        0.180 from the age-band 5 years ATB (0 through 9 years old ATB);          from Table 11-D, entry G17.
        0.193 from the age-band 15 years ATB (10 through 19 years old ATB);   from Table 11-D, entry G18.
        0.241 from the age-band 27 years ATB (20 through 34 years old ATB);   from Table 11-D, entry G19.
        0.230 from the age-band 42 years ATB (35 through 49 years old ATB);   from Table 11-D, entry G20.
        0.156 from the age-band 60 years ATB (50 years and older ATB);            from Table 11-D, entry G21.

In Table 11-C, we fill Col.G with these fractions, and then calculate appropriate new entries for Col.F.

        EXAMPLE USING MALE DOSE-GROUP 1 :   To obtain entry F60 for Table 11-C, we calculate the number which is 0.156 times the total 15,406 male persons initially in Dose-Group 1, and enter 2407.30 initial persons. (Note:   our calculations were done with fractions having many more than three decimal places;   calculations done without the extra digits will not match the entries exactly. The entry 2407.30 comes from multiplying 15,406 initial persons by the fraction 0.156257316.) Step 1 completes such calculations for Table 11-C, Column F.


        STEP 2:
        ======   The observations in Table 11-B, Cols. H through N, must be adjusted up or down accordingly. The conversion is simply the ratio of (new number of persons / old number of persons) times (old observation).

EXAMPLE USING MALE DOSE-GROUP 1, OBSERVED CANCER-DEATHS :

        The new number of initial persons = 2407.30 persons (from Table 11-C, entry F60).
        The old number of initial persons = 2946 persons (Table 11-BB, entry F5).
        The old number of cancer-deaths = 447 cancer deaths (from Table 11-B, entry N5).
        The new number of cancer-deaths =
                                (2407.30 persons / 2946 persons) x (447 cancer-deaths) = 365.26 cancer-deaths.

Thus, 365.26 cancer-deaths is the age-normalized entry N60 for Table 11-C.

        In that fashion, all the age-normalized entries for Columns H through N were calculated for Table 11-C. Thereafter, all the rates in Columns P through T were newly calculated. For each age-band within a Dose-Group, the observed rates still match the corresponding entries in Table 11-B, and are undistorted by the normalization. The appropriate effect of age-normalization is seen only in a Dose-Group's summary row. In Table 11-C (Rows 62, 70, 78, 86, 94, 102, 110), doses have also been adjusted accordingly. In Table 11-E (females), Row 78 shows no dose change because this group is the standard.






Table 11-B
Raw Data for Males, by Dose-Groups :
Hiroshima + Nagasaki Combined, 1950-1982.
=========================================================================================================================================
|                                                                                                                            ALL        |
|     A     B     C       D       E      F      G       H      I     J      K      L    M      N   O     P      Q     R    DEATH    T   |
|                       RBE=2  RBE=20          INIT.                                               |    CANC   CANC   ALL  MINUS        |
|          MALE         T65DR    DS86          PERS         [----- VARIOUS CAUSES OF DEATH ------] |  DEATHS DEATHS DEATH    ALL    PYR |
|    DISK  TRUE  RERF   ORGAN   ORGAN  MALES   OVER   PERS.          ALL   ALL             ALL CANC|    /10K    PER  /10K  MALIG    PER |
|Row AGE    AGE  DOSE-   DOSE    DOSE   INIT.  TOTAL  YEARS   ALL   DIS-   NEO-   ALL  LEUK  EXCEPT|   INIT.    10K  INIT.  /10K   INIT.|
|No. ATB    ATB   GRP   (rems)  (rems)  PERS.  PERS.  (PYR)  CAUSE  EASE  PLASM  MALIG        LEUK | PERSONS    PYR  PERS   INIT   PERS |
|=======================================================================================================================================|
| 1    5   4.13    1    0.000   0.082   3787   0.246  119484   178   107    15     14    4     10  |   26.41   0.84   470    433  31.55 |
| 2   15  13.99    1    0.000   0.084   3290   0.214  100188   392   263    57     53    4     49  |  148.94   4.89  1191   1030  30.45 |
| 3   27  28.20    1    0.000   0.092   1860   0.121   53743   512   470   148    140    7    133  |  715.05  24.75  2753   2000  28.89 |
| 4   42  42.57    1    0.000   0.092   3523   0.229   82845  2295  2169   606    581   15    566  | 1606.59  68.32  6514   4865  23.52 |
| 5   60  58.18    1    0.000   0.091   2946   0.191   38168  2869  2774   471    450    3    447  | 1517.31 117.11  9739   8211  12.96 |
| 6                                                                                                |                                    |
| 7   MALE, RAW    1    0.000   0.088  15406   1.000  394429  6246  5783  1297   1238   33   1205  |  782.16  30.55  4054   3251  25.60 |
|=======================================================================================================================================|
| 9    5   4.21    2    1.449   1.595   3031   0.249   95555   152    89    19     17    2     15  |   49.49   1.57   501    445  31.53 |
|10   15  13.91    2    1.707   2.195   3088   0.254   94585   356   272    73     68    4     64  |  207.25   6.77  1153    933  30.63 |
|11   27  27.83    2    1.533   2.149   1433   0.118   41127   372   338    97     94    3     91  |  635.03  22.13  2596   1940  28.70 |
|12   42  42.67    2    1.572   2.160   2476   0.203   57506  1672  1582   424    402    5    397  | 1603.39  69.04  6753   5129  23.23 |
|13   60  58.10    2    1.502   2.006   2151   0.177   27959  2088  2021   320    304    4    300  | 1394.70 107.30  9707   8294  13.00 |
|14                                                                                                |                                    |
|15   MALE, RAW    2    1.559   2.000  12179   1.000  316732  4640  4302   933    885   18    867  |  711.88  27.37  3810   3083  26.01 |
|=======================================================================================================================================|
|17    5   4.16  1+2    0.644   0.755   6818   0.247  215039   330   196    34     31    6     25  |   36.67   1.16   484    439  31.54 |
|18   15  13.95  1+2    0.827   1.106   6378   0.231  194773   748   535   130    121    8    113  |  177.17   5.80  1173    983  30.54 |
|19   27  28.04  1+2    0.667   0.987   3293   0.119   94870   884   808   245    234   10    224  |  680.23  23.61  2684   1974  28.81 |
|20   42  42.61  1+2    0.649   0.945   5999   0.217  140351  3967  3751  1030    983   20    963  | 1605.27  68.61  6613   4974  23.40 |
|21   60  58.14  1+2    0.634   0.899   5097   0.185   66127  4957  4795   791    754    7    747  | 1465.57 112.96  9725   8246  12.97 |
|22                                                                                                |                                    |
|23   MALE, RAW  1+2    0.688   0.932  27585   1.000  711161 10886 10085  2230   2123   51   2072  |  751.13  29.14  3946   3177  25.78 |
|=======================================================================================================================================|
|25    5   4.10    3   10.491  13.323   1547   0.263   48977    64    36     5      3    2      1  |    6.46   0.20   414    394  31.66 |
|26   15  14.09    3   11.111  13.918   1112   0.189   34398   106    86    27     25    6     19  |  170.86   5.52   953    728  30.93 |
|27   27  28.21    3   11.568  15.341    703   0.119   20191   199   178    57     56    2     54  |  768.14  26.74  2831   2034  28.72 |
|28   42  42.73    3   11.470  15.466   1381   0.235   32453   898   849   255    247    7    240  | 1737.87  73.95  6503   4714  23.50 |
|29   60  58.16    3   11.055  14.809   1145   0.194   15625  1106  1085   166    160    5    155  | 1353.71  99.20  9659   8262  13.65 |
|30                                                                                                |                                    |
|31   MALE, RAW    3   11.076  14.468   5888   1.000  151644  2373  2234   510    491   22    469  |  796.54  30.93  4030   3196  25.75 |
|=======================================================================================================================================|
|33    5   3.92    4   34.784  39.792    359   0.213   11247    16     8     0      0    0      0  |    0.00   0.00   446    446  31.33 |
|34   15  14.55    4   35.238  36.527    342   0.203   10540    38    29    10     10    1      9  |  263.16   8.54  1111    819  30.82 |
|35   27  27.30    4   35.539  38.013    237   0.141    6869    63    59    13     12    1     11  |  464.14  16.01  2658   2152  28.98 |
|36   42  42.49    4   35.665  40.562    438   0.260   10251   288   278    85     84    2     82  | 1872.15  79.99  6575   4658  23.40 |
|37   60  57.14    4   35.662  42.639    308   0.183    4633   293   287    53     51    0     51  | 1655.84 110.09  9513   7857  15.04 |
|38                                                                                                |                                    |
|39   MALE, RAW    4   35.372  39.600   1684   1.000   43540   698   661   161    157    4    153  |  908.55  35.14  4145   3213  25.86 |
|=======================================================================================================================================|
|33    5   3.92    4   34.784  39.792    359   0.213   11247    16     8     0      0    0      0  |    0.00   0.00   446    446  31.33 |
|34   15  14.55    4   35.238  36.527    342   0.203   10540    38    29    10     10    1      9  |  263.16   8.54  1111    819  30.82 |
|35   27  27.30    4   35.539  38.013    237   0.141    6869    63    59    13     12    1     11  |  464.14  16.01  2658   2152  28.98 |
|36   42  42.49    4   35.665  40.562    438   0.260   10251   288   278    85     84    2     82  | 1872.15  79.99  6575   4658  23.40 |
|37   60  57.14    4   35.662  42.639    308   0.183    4633   293   287    53     51    0     51  | 1655.84 110.09  9513   7857  15.04 |
|38                                                                                                |                                    |
|39   MALE, RAW    4   35.372  39.600   1684   1.000   43540   698   661   161    157    4    153  |  908.55  35.14  4145   3213  25.86 |
|=======================================================================================================================================|
|41    5   4.64    5   71.647  72.789    189   0.136    5966     8     6     5      4    2      2  |  105.82   3.35   423    212  31.56 |
|42   15  15.20    5   71.796  67.754    371   0.268   11368    40    33     7      6    1      5  |  134.77   4.40  1078    916  30.64 |
|43   27  27.79    5   71.154  70.735    224   0.162    6307    72    66    28     25    3     22  |  982.14  34.88  3214   2098  28.15 |
|44   42  42.26    5   69.453  74.855    368   0.266    8805   233   224    73     73    1     72  | 1956.52  81.77  6332   4348  23.93 |
|45   60  56.48    5   72.237  81.509    234   0.169    3061   228   219    43     41    1     40  | 1709.40 130.67  9744   7991  13.08 |
|46                                                                                                |                                    |
|47   MALE, RAW    5   71.124  73.130   1386   1.000   35507   581   548   156    149    8    141  | 1017.32  39.71  4192   3117  25.62 |
|=======================================================================================================================================|
|49    5   3.98  6-8  171.560  185.85    212   0.164    6393    27    21    16     15    9      6  |  283.02   9.38  1274    566  30.16 |
|50   15  15.29  6-8  182.896  201.84    363   0.281   10947    54    47    21     20    3     17  |  468.32  15.53  1488    937  30.16 |
|51   27  27.96  6-8  171.103  184.68    232   0.179    6752    64    60    27     27    5     22  |  948.28  32.58  2759   1595  29.10 |
|52   42  42.31  6-8  183.497  205.62    314   0.243    6822   231   226    76     74   10     64  | 2038.22  93.81  7357   5000  21.73 |
|53   60  56.17  6-8  188.681  221.49    173   0.134    2446   167   164    31     30    4     26  | 1502.89 106.29  9653   7919  14.14 |
|54                                                                                                |                                    |
|55   MALE, RAW  6-8  179.844  199.69   1294   1.000   33360   543   518   171    166   31    135  | 1043.28  40.47  4196   2913  25.78 |
|_______________________________________________________________________________________________________________________________________|
Abbreviations: PERS. = PERSON(s) ;   PYR = PERSON-YEARS ;   MALIG = MALIGNANCIES ;   LEUK - LEUKEMIA ;   CANC = CANCER ;   INIT. = INITIAL ;   /10K = PER 10,000 .





Table 11-C
Age-Normalized Data for Males, by Dose-Groups :
Hiroshima + Nagasaki Combined, 1950-1982.
==========================================================================================================================================
|     A     B     C       D       E       F      G       H      I     J      K     L     M      N   O     P      Q     R      ALL    T   |
|                       RBE=2  RBE=20           INIT.                                               |    CANC   CANC   ALL  DEATH        |
|          MALE         T65DR    DS86            PERS         [----- VARIOUS CAUSES OF DEATH -----] |  DEATHS DEATHS DEATH  - ALL    PYR |
|    DISK  TRUE  RERF   ORGAN   ORGAN    MALES   OVER   PERS.         ALL   ALL             ALL CANC|    /10K    PER  /10K  MALIG    PER |
|Row AGE    AGE  DOSE-   DOSE    DOSE    INIT.  TOTAL  YEARS   ALL   DIS-   NEO-  ALL   LEUK  EXCEPT|   INIT.    10K  INIT.  /10K  INIT. |
|No. ATB    ATB   GRP  (rems)  (rems)    PERS.  PERS.  (PYR)  CAUSE  EASE  PLASM  MALIG        LEUK | PERSONS    PYR  PERS   INIT   PERS |
|========================================================================================================================================|
| 56   5    4.13    1   0.000   0.082  2779.20  0.180   87687   131    79    11     10    3    7.34 |   26.41   0.84   470    433  31.55 |
| 57  15   13.99    1   0.000   0.084  2966.75  0.193   90344   353   237    51     48    4   44.19 |  148.94   4.89  1191   1030  30.45 |
| 58  27   28.20    1   0.000   0.092  3710.94  0.241  107225  1022   938   295    279   14  265.35 |  715.05  24.75  2753   2000  28.89 |
| 59  42   42.57    1   0.000   0.092  3541.82  0.230   83287  2307  2181   609    584   15  569.02 | 1606.59  68.32  6514   4865  23.52 |
| 60  60   58.18    1   0.000   0.091  2407.30  0.156   31189  2344  2267   385    368    2  365.26 | 1517.31 117.11  9739   8211  12.96 |
| 61                                                                                                |                                    |
| 62  MALE, NORM    1   0.000   0.089 15406.00  1.000  399732  6157  5701  1352   1289   38 1251.16 |  812.13  31.30  3997   3160  25.95 |
|========================================================================================================================================|
| 64   5    4.21    2   1.449   1.595  2197.05  0.180   69264   110    65    14     12    1   10.87 |   49.49   1.57   501    445  31.53 |
| 65  15   13.91    2   1.707   2.195  2345.32  0.193   71837   270   207    55     52    3   48.61 |  207.25   6.77  1153    933  30.63 |
| 66  27   27.83    2   1.533   2.149  2933.63  0.241   84195   762   692   199    192    6  186.29 |  635.03  22.13  2596   1940  28.70 |
| 67  42   42.67    2   1.572   2.160  2799.94  0.230   65029  1891  1789   479    455    6  448.94 | 1603.39  69.04  6753   5129  23.23 |
| 68  60   58.10    2   1.502   2.006  1903.06  0.156   24736  1847  1788   283    269    4  265.42 | 1394.70 107.30  9707   8294  13.00 |
| 69                                                                                                |                                    |
| 70  MALE, NORM    2   1.556   2.038 12179.00  1.000  315062  4880  4540  1030    980   20  960.13 |  788.35  30.47  4007   3202  25.87 |
|========================================================================================================================================|
| 72   5    4.16  1+2   0.644   0.755  4976.25  0.180  156951   241   143    25     23    4   18.25 |   36.67   1.16   484    439  31.54 |
| 73  15   13.95  1+2   0.827   1.106  5312.07  0.193  162221   623   446   108    101    7   94.11 |  177.17   5.80  1173    983  30.54 |
| 74  27   28.04  1+2   0.667   0.987  6644.57  0.241  191428  1784  1630   494    472   20  451.98 |  680.23  23.61  2684   1974  28.81 |
| 75  42   42.61  1+2   0.649   0.945  6341.76  0.230  148370  4194  3965  1089   1039   21 1018.02 | 1605.27  68.61  6613   4974  23.40 |
| 76  60   58.14  1+2   0.634   0.899  4310.36  0.156   55922  4192  4055   669    638    6  631.71 | 1465.57 112.96  9725   8246  12.97 |
| 77                                                                                                |                                    |
| 78  MALE, NORM  1+2   0.684   0.945 27585.00  1.000  714891 11033 10239  2385   2272   58 2214.08 |  802.64  30.97  4000   3176  25.92 |
|========================================================================================================================================|
| 80   5    4.10    3  10.491  13.323  1062.18  0.180   33628    44    25     3      2    1    0.69 |    6.46   0.20   414    394  31.66 |
| 81  15   14.09    3  11.111  13.918  1133.86  0.193   35075   108    88    28     25    6   19.37 |  170.86   5.52   953    728  30.93 |
| 82  27   28.21    3  11.568  15.341  1418.28  0.241   40734   401   359   115    113    4  108.94 |  768.14  26.74  2831   2034  28.72 |
| 83  42   42.73    3  11.470  15.466  1353.64  0.230   31810   880   832   250    242    7  235.25 | 1737.87  73.95  6503   4714  23.50 |
| 84  60   58.16    3  11.055  14.809   920.04  0.156   12555   889   872   133    129    4  124.55 | 1353.71  99.20  9659   8262  13.65 |
| 85                                                                                                |                                    |
| 86  MALE, NORM    3  11.183  14.648  5888.00  1.000  153802  2322  2176   529    511   22  488.80 |  830.16  31.78  3944   3076  26.12 |
|========================================================================================================================================|
| 88   5    3.92    4  34.784  39.792   303.79  0.180    9517    14     7     0      0    0    0.00 |    0.00   0.00   446    446  31.33 |
| 89  15   14.55    4  35.238  36.527   324.29  0.193    9995    36    27     9      9    1    8.53 |  263.16   8.54  1111    819  30.82 |
| 90  27   27.30    4  35.539  38.013   405.64  0.241   11756   108   101    22     21    2   18.83 |  464.14  16.01  2658   2152  28.98 |
| 91  42   42.49    4  35.665  40.562   387.15  0.230    9061   255   246    75     74    2   72.48 | 1872.15  79.99  6575   4658  23.40 |
| 92  60   57.14    4  35.662  42.639   263.14  0.156    3958   250   245    45     44    0   43.57 | 1655.84 110.09  9513   7857  15.04 |
| 93                                                                                                |                                    |
| 94  MALE, NORM    4  35.393  39.357  1684.00  1.000   44287   662   626   152    148    4  143.41 |  851.62  32.38  3933   3055  26.30 |
|========================================================================================================================================|
| 96   5    4.64    5  71.647  72.789   250.03  0.180    7892    11     8     7      5    3    2.65 |  105.82   3.35   423    212  31.56 |
| 97  15   15.20    5  71.796  67.754   266.90  0.193    8178    29    24     5      4    1    3.60 |  134.77   4.40  1078    916  30.64 |
| 98  27   27.79    5  71.154  70.735   333.85  0.241    9400   107    98    42     37    4   32.79 |  982.14  34.88  3214   2098  28.15 |
| 99  42   42.26    5  69.453  74.855   318.64  0.230    7624   202   194    63     63    1   62.34 | 1956.52  81.77  6332   4348  23.93 |
|100  60   56.48    5  72.237  81.509   216.57  0.156    2833   211   203    40     38    1   37.02 | 1709.40 130.67  9744   7991  13.08 |
|101                                                                                                |                                    |
|102  MALE, NORM    5  71.145  73.162  1386.00  1.000   35927   559   527   156    148   10  138.40 |  998.53  38.52  4036   2968  25.92 |
|========================================================================================================================================|
|104   5    3.98  6-8  171.56  185.85   233.43  0.180    7040    30    23    18     17   10    6.61 |  283.02   9.38  1274    566  30.16 |
|105  15   15.29  6-8  182.90  201.84   249.19  0.193    7515    37    32    14     14    2   11.67 |  468.32  15.53  1488    937  30.16 |
|106  27   27.96  6-8  171.10  184.68   311.69  0.241    9071    86    81    36     36    7   29.56 |  948.28  32.58  2759   1595  29.10 |
|107  42   42.31  6-8  183.50  205.62   297.49  0.230    6463   219   214    72     70    9   60.63 | 2038.22  93.81  7357   5000  21.73 |
|108  60   56.17  6-8  188.68  221.49   202.20  0.156    2859   195   192    36     35    5   30.39 | 1502.89 106.29  9653   7919  14.14 |
|109                                                                                                |                                    |
|110  MALE, NORM  6-8  179.05  198.76  1294.00  1.000   32947   567   542   177    172   33  138.86 | 1073.08  42.14  4380   3054  25.46 |
|________________________________________________________________________________________________________________________________________|
Abbreviations: PERS. = PERSON(s) ;   PYR = PERSON-YEARS ;   MALIG = MALIGNANCIES ;   LEUK - LEUKEMIA ;   CANC = CANCER ;   INIT. = INITIAL ;   /10K = PER 10,000 .





Table 11-D
Raw Data for Females, by Dose-Groups :
Hiroshima and Nagasaki Combined, 1950-1982.
=========================================================================================================================================
|                                                                                                                            ALL        |
|     A     B     C       D       E      F      G       H      I     J      K      L    M      N   O     P      Q     R    DEATH    T   |
|                       RBE=2  RBE=20          INIT.                                               |    CANC   CANC   ALL  MINUS        |
|          Fem.         T65DR    DS86   FE-    PERS         [----- VARIOUS CAUSES OF DEATH ------] |  DEATHS DEATHS DEATH    ALL    PYR |
|    DISK  TRUE  RERF   ORGAN   ORGAN  MALES   OVER   PERS.          ALL   ALL             ALL CANC|    /10K    PER  /10K  MALIG    PER |
|Row AGE    AGE  DOSE-   DOSE    DOSE   INIT.  TOTAL  YEARS   ALL   DIS-   NEO-   ALL  LEUK  EXCEPT|   INIT.    10K  INIT.  /10K   INIT.|
|No. ATB    ATB   GRP   (rems)  (rems)  PERS.  PERS.  (PYR)  CAUSE  EASE  PLASM  MALIG        LEUK | PERSONS    PYR  PERS   INIT   PERS |
|=======================================================================================================================================|
| 1    5   4.09    1    0.000   0.082   3842   0.177  122363   102    79    23     20    2     18  |   46.85   1.47   265    213  31.85 |
| 2   15  14.95    1    0.000   0.087   4185   0.192  130296   280   233    73     70    4     66  |  157.71   5.07   669    502  31.13 |
| 3   27  26.71    1    0.000   0.093   5193   0.239  158651   670   646   227    219    6    213  |  410.17  13.43  1290    868  30.55 |
| 4   42  41.70    1    0.000   0.095   5084   0.234  136916  2241  2165   543    515   14    501  |  985.44  36.59  4408   3395  26.93 |
| 5   60  59.00    1    0.000   0.091   3463   0.159   53998  3259  3168   393    376    3    373  | 1077.10  69.08  9411   8325  15.59 |
| 6                                                                                                |                                    |
| 7 FEMALE, RAW    1    0.000   0.090  21767   1.000  602224  6552  6291  1259   1200   29   1171  |  537.97  19.44  3010   2459  27.67 |
|=======================================================================================================================================|
| 9    5   4.06    2    1.427   1.584   3093   0.185   98447    91    64    23     22    2     20  |   64.66   2.03   294    223  31.83 |
|10   15  14.80    2    1.502   1.721   3218   0.193  100803   196   168    58     51    1     50  |  155.38   4.96   609    451  31.32 |
|11   27  26.67    2    1.505   1.903   4067   0.244  123272   563   533   200    188    5    183  |  449.96  14.85  1384    922  30.31 |
|12   42  41.71    2    1.475   1.848   3754   0.225  100120  1709  1640   448    431    7    424  | 1129.46  42.35  4552   3404  26.67 |
|13   60  59.13    2    1.471   1.815   2544   0.153   39086  2364  2312   258    238    3    235  |  923.74  60.12  9292   8357  15.36 |
|14                                                                                                |                                    |
|15 FEMALE, RAW    2    1.478   1.783  16676   1.000  461729  4923  4717   987    930   18    912  |  546.89  19.75  2952   2394  27.69 |
|=======================================================================================================================================|
|17    5   4.08  1+2    0.637   0.752   6935   0.180  220810   193   143    46     42    4     38  |   54.79   1.72   278    218  31.84 |
|18   15  14.88  1+2    0.653   0.797   7403   0.193  231099   476   401   131    121    5    116  |  156.69   5.02   643    480  31.22 |
|19   27  26.69  1+2    0.661   0.888   9260   0.241  281923  1233  1179   427    407   11    396  |  427.65  14.05  1332    892  30.45 |
|20   42  41.71  1+2    0.627   0.840   8838   0.230  237037  3950  3805   991    946   21    925  | 1046.62  39.02  4469   3399  26.82 |
|21   60  59.05  1+2    0.623   0.821   6007   0.156   93084  5623  5480   651    614    6    608  | 1012.15  65.32  9361   8339  15.50 |
|22                                                                                                |                                    |
|23 FEMALE, RAW  1+2    0.641   0.824  38443   1.000 1063953 11475 11008  2246   2130   47   2083  |  541.84  19.58  2985   2431  27.68 |
|=======================================================================================================================================|
|25    5   3.98    3   10.702   13.548  1547   0.171   49157    52    42    13     13    4      9  |   58.18   1.83   336    252  31.78 |
|26   15  14.86    3   10.714   13.790  1663   0.184   51876   115    97    27     26    3     23  |  138.30   4.43   692    535  31.19 |
|27   27  26.82    3   10.987   14.848  2189   0.242   66414   301   278   131    126    5    121  |  552.76  18.22  1375    799  30.34 |
|28   42  41.60    3   10.989   15.224  2291   0.253   61023  1050  1014   287    278    4    274  | 1195.98  44.90  4583   3370  26.64 |
|29   60  58.71    3   10.826   14.896  1365   0.151   21653  1279  1247   175    161    2    159  | 1164.84  73.43  9370   8190  15.86 |
|30                                                                                                |                                    |
|31 FEMALE, RAW    3   10.864   14.534  9055   1.000  250123  2797  2678   633    604   18    586  |  647.16  23.43  3089   2422  27.62 |
|=======================================================================================================================================|
|33    5   4.17    4   34.652   39.233   372   0.146   11771    12    11     4      4    1      3  |   80.65   2.55   323    215  31.64 |
|34   15  15.16    4   36.457   39.149   543   0.214   17078    30    23     7      7    0      7  |  128.91   4.10   552    424  31.45 |
|35   27  26.60    4   35.604   42.377   670   0.264   20277   109   104    42     38    2     36  |  537.31  17.75  1627   1060  30.26 |
|36   42  41.64    4   34.654   43.001   582   0.229   15535   276   258    81     79    3     76  | 1305.84  48.92  4742   3385  26.69 |
|37   60  58.50    4   35.351   43.680   374   0.147    5770   351   338    44     41    2     39  | 1042.78  67.60  9385   8289  15.43 |
|38                                                                                                |                                    |
|39 FEMALE, RAW    4   35.392   41.562  2541   1.000   70431   778   734   178    169    8    161  |  633.61  22.86  3062   2397  27.72 |
|=======================================================================================================================================|
|41    5   4.34    5   70.310   74.071   213   0.122    6663    11     9     5      5    2      3  |  140.85   4.50   516    282  31.28 |
|42   15  15.14    5   72.440   68.103   556   0.319   17255    51    42    22     21    3     18  |  323.74  10.43   917    540  31.03 |
|43   27  25.67    5   72.590   75.907   436   0.250   13275    55    52    27     24    2     22  |  504.59  16.57  1261    711  30.45 |
|44   42  41.87    5   70.016   78.935   366   0.210    9741   174   169    47     43    1     42  | 1147.54  43.12  4754   3579  26.62 |
|45   60  58.15    5   71.744   77.444   171   0.098    2549   157   153    28     28    1     27  | 1578.95 105.91  9181   7544  14.91 |
|46                                                                                                |                                    |
|47 FEMALE, RAW    5   71.639   73.979  1742   1.000   49483   448   425   129    121    9    112  |  642.94  22.63  2572   1877  28.41 |
|=======================================================================================================================================|
|49    5         6-8   180.94   197.66   210   0.130    6503    15    12     9      9    3      6  |  285.71   9.23   714    286  30.97 |
|50   15         6-8   166.18   176.34   493   0.306   15168    57    53    27     26    4     22  |  446.25  14.50  1156    629  30.77 |
|51   27         6-8   179.41   203.47   447   0.277   13171    95    90    50     48    7     41  |  917.23  31.13  2125   1051  29.46 |
|52   42         6-8   175.59   202.90   326   0.202    8532   167   163    58     56    6     50  | 1533.74  58.60  5123   3405  26.17 |
|53   60         6-8   171.02   195.56   137   0.085    2035   130   126    24     21    2     19  | 1386.86  93.35  9489   7956  14.86 |
|54                                                                                                |                                    |
|55 FEMALE, RAW  6-8   174.08   193.63  1613   1.000   45408   464   444   168    160   22    138  |  855.55  30.39  2877   1885  28.15 |
|_______________________________________________________________________________________________________________________________________|
Abbreviations: PERS. = PERSON(s) ;   PYR = PERSON-YEARS ;   MALIG = MALIGNANCIES ;   LEUK - LEUKEMIA ;   CANC = CANCER ;   INIT. = INITIAL ;   /10K = PER 10,000 ;   Fem = FEMALES .





Table 11-E
Age-Normalized Data for Females, by Dose-Groups :
Hiroshima and Nagasaki Combined, 1950-1982.
==========================================================================================================================================
|                                                                                                                            ALL         |
|     A     B     C       D       E       F      G       H      I     J      K      L    M      N   O     P      Q     R    DEATH     T  |
|                       RBE=2  RBE=20           INIT.                                               |    CANC   CANC   ALL  MINUS        |
|          Fem.         T65DR    DS86     FE-    PERS         [----- VARIOUS CAUSES OF DEATH -----] |  DEATHS DEATHS DEATH    ALL    PYR |
|    DISK  TRUE  RERF   ORGAN   ORGAN    MALES   OVER  PERS.          ALL   ALL             ALL CANC|    /10K    PER  /10K  MALIG    PER |
|Row AGE    AGE  DOSE-   DOSE    DOSE    INIT.  TOTAL  YEARS   ALL   DIS-   NEO-   ALL  LEUK  EXCEPT|   INIT.    10K  INIT.  /10K  INIT. |
|No. ATB    ATB   GRP  (rems)  (rems)    PERS.  PERS.  (PYR)  CAUSE  EASE  PLASM  MALIG        LEUK | PERSONS    PYR  PERS   INIT   PERS |
|========================================================================================================================================|
| 56   5    4.09    1   0.000   0.082  3926.70  0.180  125060   104    81    24     20    2   18.40 |   46.85   1.47   265    213  31.85 |
| 57  15   14.95    1   0.000   0.087  4191.69  0.193  130505   280   233    73     70    4   66.11 |  157.71   5.07   669    502  31.13 |
| 58  27   26.71    1   0.000   0.093  5243.15  0.241  160183   676   652   229    221    6  215.06 |  410.17  13.43  1290    868  30.55 |
| 59  42   41.70    1   0.000   0.095  5004.21  0.230  134767  2206  2131   534    507   14  493.14 |  985.44  36.59  4408   3395  26.93 |
| 60  60   59.00    1   0.000   0.091  3401.25  0.156   53035  3201  3112   386    369    3  366.35 | 1077.10  69.08  9411   8325  15.59 |
| 61                                                                                                |                                    |
| 62 FEMALE, NORM   1   0.000   0.090 21767.00  1.000  603550  6468  6209  1246   1188   29 1159.05 |  532.48  19.20  2971   2426  27.73 |
|========================================================================================================================================|
| 64   5    4.06    2   1.427   1.584  3008.30  0.180   95751    89    62    22     21    2   19.45 |   64.66   2.03   294    223  31.83 |
| 65  15   14.80    2   1.502   1.721  3211.31  0.193  100593   196   168    58     51    1   49.90 |  155.38   4.96   609    451  31.32 |
| 66  27   26.67    2   1.505   1.903  4016.85  0.241  121752   556   526   198    186    5  180.74 |  449.96  14.85  1384    922  30.31 |
| 67  42   41.71    2   1.475   1.848  3833.79  0.230  102249  1745  1675   458    440    7  433.01 | 1129.46  42.35  4552   3404  26.67 |
| 68  60   59.13    2   1.471   1.815  2605.75  0.156   40035  2421  2368   264    244    3  240.70 |  923.74  60.12  9292   8357  15.36 |
| 69                                                                                                |                                    |
| 70 FEMALE, NORM   2   1.478   1.784 16676.00  1.000  460380  5007  4799  1000    942   18  923.81 |  553.97  20.07  3002   2438  27.61 |
|========================================================================================================================================|
| 72   5    4.08  1+2   0.637   0.752  6935.00  0.180  220810   193   143    46     42    4   38.00 |   54.79   1.72   278    218  31.84 |
| 73  15   14.88  1+2   0.653   0.797  7403.00  0.193  231099   476   401   131    121    5  116.00 |  156.69   5.02   643    480  31.22 |
| 74  27   26.69  1+2   0.661   0.888  9260.00  0.241  281923  1233  1179   427    407   11  396.00 |  427.65  14.05  1332    892  30.45 |
| 75  42   41.71  1+2   0.627   0.840  8838.00  0.230  237037  3950  3805   991    946   21  925.00 | 1046.62  39.02  4469   3399  26.82 |
| 76  60   59.05  1+2   0.623   0.821  6007.00  0.156   93084  5623  5480   651    614    6  608.00 | 1012.15  65.32  9361   8339  15.50 |
| 77                                                                                                |                                    |
| 78 FEMALE, NORM 1+2   0.641   0.824 38443.00  1.000 1063953 11475 11008  2246   2130   47 2083.00 |  541.84  19.58  2985   2431  27.68 |
|========================================================================================================================================|
| 80   5    3.98    3  10.702  13.548  1633.49  0.180   51905    55    44    14     14    4    9.50 |   58.18   1.83   336    252  31.78 |
| 81  15   14.86    3  10.714  13.790  1743.73  0.193   54394   121   102    28     27    3   24.12 |  138.30   4.43   692    535  31.19 |
| 82  27   26.82    3  10.987  14.848  2181.13  0.241   66176   300   277   131    126    5  120.57 |  552.76  18.22  1375    799  30.34 |
| 83  42   41.60    3  10.989  15.224  2081.73  0.230   55449   954   921   261    253    4  248.97 | 1195.98  44.90  4583   3370  26.64 |
| 84  60   58.71    3  10.826  14.896  1414.91  0.156   22445  1326  1293   181    167    2  164.81 | 1164.84  73.43  9370   8190  15.86 |
| 85                                                                                                |                                    |
| 86 FEMALE, NORM   3  10.858  14.504  9055.00  1.000  250369  2755  2637   615    586   18  567.97 |  627.25  22.69  3043   2396  27.65 |
|========================================================================================================================================|
| 88   5    4.17    4  34.652  39.233   458.39  0.180   14504    15    14     5      5    1    3.70 |   80.65   2.55   323    215  31.64 |
| 89  15   15.16    4  36.457  39.149   489.32  0.193   15390    27    21     6      6    0    6.31 |  128.91   4.10   552    424  31.45 |
| 90  27   26.60    4  35.604  42.377   612.07  0.241   18523   100    95    38     35    2   32.89 |  537.31  17.75  1627   1060  30.26 |
| 91  42   41.64    4  34.654  43.001   584.17  0.230   15593   277   259    81     79    3   76.28 | 1305.84  48.92  4742   3385  26.69 |
| 92  60   58.50    4  35.351  43.680   397.05  0.156    6125   373   359    47     44    2   41.40 | 1042.78  67.60  9385   8289  15.43 |
| 93                                                                                                |                                    |
| 94 FEMALE, NORM   4  35.339  41.535  2541.00  1.000   70136   791   747   178    169    8  160.58 |  631.95  22.90  3113   2449  27.60 |
|========================================================================================================================================|
| 96   5    4.34    5  70.310  74.071   314.25  0.180    9831    16    13     7      7    3    4.43 |  140.85   4.50   516    282  31.28 |
| 97  15   15.14    5  72.440  68.103   335.46  0.193   10411    31    25    13     13    2   10.86 |  323.74  10.43   917    540  31.03 |
| 98  27   25.67    5  72.590  75.907   419.61  0.241   12776    53    50    26     23    2   21.17 |  504.59  16.57  1261    711  30.45 |
| 99  42   41.87    5  70.016  78.935   400.48  0.230   10659   190   185    51     47    1   45.96 | 1147.54  43.12  4754   3579  26.62 |
|100  60   58.15    5  71.744  77.444   272.20  0.156    4058   250   244    45     45    2   42.98 | 1578.95 105.91  9181   7544  14.91 |
|101                                                                                                |                                    |
|102 FEMALE, NORM   5  71.426  75.009  1742.00  1.000   47734   540   517   143    135    9  125.40 |  719.83  26.27  3101   2328  27.40 |
|========================================================================================================================================|
|104   5          6-8  180.94  197.66   290.98  0.180    9011    21    17    12     12    4    8.31 |  285.71   9.23   714    286  30.97 |
|105  15          6-8  166.18  176.34   310.62  0.193    9556    36    33    17     16    3   13.86 |  446.25  14.50  1156    629  30.77 |
|106  27          6-8  179.41  203.47   388.53  0.241   11448    83    78    43     42    6   35.64 |  917.23  31.13  2125   1051  29.46 |
|107  42          6-8  175.59  202.90   370.83  0.230    9705   190   185    66     64    7   56.88 | 1533.74  58.60  5123   3405  26.17 |
|108  60          6-8  171.02  195.56   252.04  0.156    3744   239   232    44     39    4   34.95 | 1386.86  93.35  9489   7956  14.86 |
|109                                                                                                |                                    |
|110 FEMALE, NORM 6-8  174.95  195.83  1613.00  1.000   43464   568   545   183    173   23  149.64 |  927.73  34.43  3524   2452  26.95 |
|________________________________________________________________________________________________________________________________________|
Abbreviations: PERS. = PERSON(s) ;   PYR = PERSON-YEARS ;   MALIG = MALIGNANCIES ;   LEUK - LEUKEMIA ;   CANC = CANCER ;   INIT. = INITIAL ;   /10K = PER 10,000 ;   Fem = FEMALES .





Table 11-F
Male and Females Summary Data, Preparatory to Sex-Ratio Normalization.
1950-1982, Cities Combined.
====================================================================================================================================
|                                                                                                                       ALL        |
|      A    C      D       E        F      H       I      J       K     L      M       N    O    P       Q       R    DEATH    T   |
|                 RBE=2  RBE=20                                                             |   CANC    CANC    ALL   MINUS        |
|                 T65DR    DS86                  [------- VARIOUS CAUSES OF DEATH --------] | DEATHS  DEATHS  DEATH     ALL    PYR |
|          RERF   ORGAN   ORGAN          PERSON           ALL    ALL               ALL CANC |   /10K     PER   /10K   MALIG    PER |
|Row  SEX  DOSE    DOSE    DOSE   INIT.   YEARS   ALL    DIS-   NEO-   ALL    LEUK   EXCEPT |   INIT.    10K  INIT.    /10K  INIT. |
|No.        GRP  (rems)  (rems)  PERSONS  (PYR)  CAUSE   EASE  PLASM  MALIG            LEUK | PERSONS    PYR   PERS   INIT.  PERS. |
|                                                                                           |                                      |
|111   M     1    0.000   0.089  15406   399732   6157   5701   1352   1289    38   1251.16 |  812.13  31.30   3997    3160  25.95 |
|112   M     2    1.556   2.038  12179   315062   4880   4540   1030    980    20    960.13 |  788.35  30.47   4007    3202  25.87 |
|113   M   1+2    0.684   0.945  27585   714891  11033  10239   2385   2272    58   2214.08 |  802.64  30.97   4000    3176  25.92 |
|114   M     3   11.183  14.648   5888   153802   2322   2176    529    511    22    488.80 |  830.16  31.78   3944    3076  26.12 |
|115   M     4   35.393  39.357   1684    44287    662    626    152    148     4    143.41 |  851.62  32.38   3933    3055  26.30 |
|116   M     5   71.145  73.162   1386    35927    559    527    156    148    10    138.40 |  998.53  38.52   4036    2968  25.92 |
|117   M   6-8   179.05  198.76   1294    32947    567    542    177    172    33    138.86 | 1073.08  42.14   4380    3054  25.46 |
|118                                                                                        |                                      |
|119   M   1-8                   37837   981855  15144  14109   3400   3251   128   3123.54 |                                      |
|==================================================================================================================================|
|121   F     1    0.000   0.090  21767   603550   6468   6209   1246   1188    29   1159.05 |  532.48  19.20   2971    2426  27.73 |
|122   F     2    1.478   1.784  16676   460380   5007   4799   1000    942    18    923.81 |  553.97  20.07   3002    2438  27.61 |
|123   F   1+2    0.641   0.824  38443  1063953  11475  11008   2246   2130    47   2083.00 |  541.84  19.58   2985    2431  27.68 |
|124   F     3   10.858  14.504   9055   250369   2755   2637    615    586    18    567.97 |  627.25  22.69   3043    2396  27.65 |
|125   F     4   35.339  41.535   2541    70136    791    747    178    169     8    160.58 |  631.95  22.90   3113    2449  27.60 |
|126   F     5   71.426  75.009   1742    47734    540    517    143    135     9    125.40 |  719.83  26.27   3101    2328  27.40 |
|127   F   6-8   174.95  195.83   1613    43464    568    545    183    173    23    149.64 |  927.73  34.43   3524    2452  26.95 |
|128                                                                                        |                                      |
|129   F   1-8                   53394  1475656  16130  15455   3364   3192   106   3086.59 |                                      |
|==================================================================================================================================|
|131   M+F 1-8                   91231  2457511  31274  29564   6764   6444   233   6210.13 |                                      |
|__________________________________________________________________________________________________________________________________|





Table 11-G
Sex-Ratio Normalization of Male and Female Data.
1950-1982, Cities Combined.
Notes:   See Table 11-F.
====================================================================================================================================
|                                                                                                                       ALL        |
|      A    C      D       E        F        H       I      J      K      L      M      N    O    P       Q       R   DEATH    T   |
|                 RBE=2  RBE=20                                                              |   CANC    CANC    ALL  MINUS        |
|                 T65DR    DS86                   [------- VARIOUS CAUSES OF DEATH  -------] | DEATHS  DEATHS  DEATH    ALL    PYR |
|          RERF   ORGAN   ORGAN           PERSON            ALL    ALL              ALL CANC |   /10K     PER   /10K  MALIG    PER |
|Row  SEX  DOSE    DOSE    DOSE   INIT.    YEARS    ALL    DIS-   NEO-   ALL   LEUK   EXCEPT |   INIT.    10K  INIT.   /10K  INIT. |
|No.        GRP  (rems)  (rems)  PERSONS   (PYR)   CAUSE   EASE  PLASM  MALIG           LEUK | PERSONS    PYR   PERS  INIT.  PERS. |
|                                                                                            |                                     |
|132   M     1   0.000   0.089  15530.02   402950   6207   5747   1363   1300   38   1261.23 |  812.13  31.30   3997   3160  25.95 |
|133   M     2   1.556   2.038  12054.96   311853   4830   4494   1020    970   20    950.36 |  788.35  30.47   4007   3202  25.87 |
|134   M   1+2   0.684   0.945  27584.98   714891  11033  10239   2385   2272   58   2214.08 |  802.64  30.97   4000   3176  25.92 |
|135   M     3  11.183  14.648   6242.84   163071   2462   2307    561    542   24    518.25 |  830.16  31.78   3944   3076  26.12 |
|136   M     4  35.393  39.357   1765.11    46420    694    656    159    155    5    150.32 |  851.62  32.38   3933   3055  26.30 |
|137   M     5  71.145  73.162   1306.81    33874    527    497    147    140    9    130.49 |  998.53  38.52   4036   2968  25.92 |
|138   M   6-8  179.05  198.76   1214.48    30923    532    508    166    161   31    130.32 | 1073.08  42.14   4380   3054  25.46 |
|139                                                                                         |                                     |
|140   M                        38114.22   989179  15249  14207   3419   3270  127   3143.46 |                                     |
|==================================================================================================================================|
|142   F     1   0.000   0.090  21642.98   600112   6431   6174   1239   1181   29   1152.44 |  532.48  19.20   2971   2426  27.73 |
|143   F     2   1.478   1.784  16800.04   463804   5044   4835   1007    949   18    930.68 |  553.97  20.07   3002   2438  27.61 |
|144   F   1+2   0.641   0.824  38443.02  1063953  11475  11008   2246   2130   47   2083.00 |  541.84  19.58   2985   2431  27.68 |
|145   F     3  10.858  14.504   8700.16   240558   2647   2534    591    563   17    545.71 |  627.25  22.69   3043   2396  27.65 |
|146   F     4  35.339  41.535   2459.89    67897    766    723    172    163    8    155.45 |  631.95  22.90   3113   2449  27.60 |
|147   F     5  71.426  75.009   1821.19    49904    565    541    149    141   10    131.10 |  719.83  26.27   3101   2328  27.40 |
|148   F   6-8  174.95  195.83   1692.52    45607    596    572    192    181   24    157.02 |  927.73  34.43   3524   2452  26.95 |
|149                                                                                         |                                     |
|150   F                        53116.78  1467919  16049  15378   3350   3179  106   3072.28 |                                     |
|==================================================================================================================================|
|152  M+F  1-8                     91231  2457098  31299  29585   6769   6449  233   6215.75 |                                     |
|__________________________________________________________________________________________________________________________________|





Notes For Conversion Of Table 11-F Into Table 11-G :

  1. Rows 111 through 117 (Males) are simply transfers of Rows 62,70,78,86,94,102,110 from Table 11-C.
    Rows 121 through 127 (Females) are simply transfers of Rows 62,70,78,86,94,102,110 from Table 11-E.
    Col. B (Age) is omitted because age-bands are now combined.
    Col. G (Ratio) is omitted because all the values transferred would be 1.0 .

  2. Next, we want to combine the male and female observations. Our objective remains a series of Dose-Groups which are alike in cancer-risk, except for their radiation-doses. Therefore, the proportions of males and females must be normalized to the same ratio in every Dose-Group. These ratios are not the same, in the absence of normalization. For instance, the ratio in the Reference Group is (27585 males / 38,443 females), or 0.717556. The ratio in Dose-Group 3, however, is (5888 / 9055), or 0.650248. In Dose-Group 5, the ratio is (1386 males / 1742 females), or 0.795637. The sex-ratio normalization is a two-step process again.

STEP 1:   ESTABLISHING THE SEX-NORMALIZED NUMBERS OF PERSONS. ==================================================================

        We shall normalize to the standard of the Reference Group;   therefore, the male-female ratio in every Dose-Group will be 0.717556. We shall continue preserving the original total number of persons in every Dose-Group. These totals (males + females) are calculated from Column F directly above (see also Table 4-A).

EXAMPLE, USING DOSE-GROUP 1.   TOTAL PERSONS = 37,173.   (15,406 MALES + 21,767 FEMALES.)

        Let F = age- and sex-normalized number of females in Dose-Group 1.
        Then 0.717556 times F is the age- and sex-normalized number of males in Dose-Group 1.
        F + (0.717556)(F) = 37,173. And (1.717556)(F) = 37,173. And F = (37,173 / 1.717556).
        And finally, F = 21,642.98 age- and sex-normalized females, for Table 11-G, Col.F, Row 142.
        Male persons = (37,173) - (female persons).
        Males = 15,530.02 persons, the entry for Table 11-G, Col.F, Row 132.

In this fashion, all the entries for Table 11-G, Col.F, were established.
Checking will show that all male-female ratios in Table 11-G are 0.7176 .
Dose-Group 4 is an example :   (F136 / F146) = (1765.11 / 2459.89) = 0.7176 .

STEP 2:   SEX-NORMALIZATION OF THE CORRESPONDING OBSERVATIONS. ====================================================================

        The old observations in Cols. H through N of Table 11-F are normalized by multiplying each one by the ratio of (new persons / old persons).

EXAMPLE, USING MALE DOSE-GROUP 1, OBSERVED PERSON-YEARS :

        The new number of initial persons = 15,530.02 (from Table 11-G, Col.F, Row 132).
        The old number of initial persons = 15,406 (from Table 11-F, Col.F, Row 111).
        The old number of Person-Years = 399,732 (from Table 11-F, Col.H, Row 111).
        The new number of Person-Years = (15530.02 persons / 15406 persons) x (399732 PYR) = 402950 PYR.

That is the new entry for Table 11-G, Col.H, Row 132.

        In that fashion, all the age- and sex-normalized entries for Columns H through N were calculated for Table 11-G. Thereafter, all the rates in Columns P through T were newly calculated, to check that the observed rates still match the corresponding entries in Table 11-F. Mean doses per person (Cols.D,E) remain unchanged.

        Now the data are ready to combine. The combination is shown in Table 11-H. ================================================================

Column S, "All Deaths Minus All Malignancies, per 10,000 Initial Persons," is (for each row) :
[ (Col.I - Col.L) / Col.F ] times 10,000. All malignancies include leukemia, of course.






Table 11-H
Directly Comparable Dose-Groups, after Combination of Male and Female Data.
===============================================================================================================================
|                                                                                                                  ALL        |
|      C         D       E       F        H      I      J      K       L      M       N O      P       Q      R  DEATH      T |
|            RBE=2  RBE=20                                                              |   CANC    CANC    ALL  MINUS        |
|            T65DR    DS86   M + F           [------- VARIOUS CAUSES OF DEATH  -------] | DEATHS  DEATHS  DEATH    ALL    PYR |
|     RERF   ORGAN   ORGAN           PERSON           ALL    ALL               ALL CANC |   /10K     PER   /10K  MALIG    PER |
|Row  DOSE    DOSE    DOSE  INITIAL   YEARS   ALL    DIS-   NEO-     ALL  LEUK   EXCEPT | INITIAL    10K   INIT   /10K   INIT |
|No.   GRP  (rems)  (rems)  PERSONS   (PYR)  CAUSE   EASE  PLASM   MALIG           LEUK | PERSONS    PYR   PERS   INIT   PERS |
|                                                                                       |                                     |
|151   1.0   0.000    0.089  37173  1003062  12638  11920   2602    2481   67   2413.68 |  649.31  24.06   3400   2732  26.98 |
|152   2.0   1.511    1.890  28855   775657   9875   9329   2027    1919   38   1881.04 |  651.89  24.25   3422   2757  26.88 |
|153   1+2   0.659    0.875  66028  1778844  22508  21247   4631    4402  105   4297.08 |  650.80  24.16   3409   2742  26.94 |
|154     3  10.994   14.564  14943   403628   5110   4840   1152    1105   41   1063.97 |  712.02  26.36   3419   2680  27.01 |
|155     4  35.361   40.625   4225   114318   1460   1380    331     318   13    305.77 |  723.72  26.75   3456   2702  27.06 |
|156     5  71.308   74.238   3128    83778   1092   1037    297     280   19    261.58 |  836.27  31.22   3492   2595  26.78 |
|157   6-8  176.66   197.05   2907    76530   1128   1081    358     343   55    287.34 |  988.45  37.55   3882   2703  26.33 |
|                                                                                       |                                     |
|158   1-8          M + F =  91231  2457098  31299  29585   6769    6449  233   6215.75 |                                     |
|=============================================================================================================================|
|                                         ADDITIONAL COMBINATIONS OF DOSE-GROUPS.                                             |
|=============================================================================================================================|
|159   3+4  16.365   20.309  19168   517946   6570   6220   1483    1423   54   1369.74 |  714.60  26.45   3427   2685  27.02 |
|160   3-8  41.673   47.388  25203   678254   8790   8338   2138    2046  128   1918.67 |  761.29  28.29   3488   2676  26.91 |
|161   4+5  50.653   54.924   7353   198096   2552   2417    628     599   31    567.36 |  771.60  28.64   3471   2657  26.94 |
|162   5-8  122.06  133.397   6035   160308   2221   2118    654     623   74    548.93 |  909.57  34.24   3680   2647  26.56 |
|=============================================================================================================================|

  1. The male and female rows of age-sex normalized data, from Table 11-G, have been combined above in three steps.

    STEP 1, USING TABLE 11-G :   The observations in Columns F through N (excluding Column G) were added according to Dose-Group. For example, in Dose-Group 1, to combine male and female observations in those columns, we added Rows 132 and 142. The sums appear in Row 151 of Table 11-H above.

    STEP 2, USING TABLE 11-H :   We calculated new rates for Columns P through T. ("Per 10,000 initial persons" is abbreviated as "per10K Init Pers" where space is short.)

    STEP 3, USING TABLE 11-G :   We recalculated the mean doses. For instance, entry D154 above is the weighted mean T65DR dose in Dose-Group 3 for males and females. It is calculated as follows from Table 11-G :   [(11.183 rems per male x 6242.84 males) + (10.858 rems per female x 8700.16 females)] / 14,943 total persons in Dose-Group 3.

  2. It makes a negligible difference whether Dose-Groups are normalized before they are combined, or normalized after they have been combined. For instance, the difference between the entry N153 above (4297.08 cancer-deaths) and the sum of entries N151 and N152 (sum = 4294.72 cancer-deaths) is 2.36 cases -- a difference of about 0.06 of one percent. When Dose-Groups 6,7,8 are normalized separately, before combination, their combined cancer-deaths are 288.12 compared with 287.34 (entry N157 above) -- a difference of 0.78 cancer-death or about 0.27 of one percent.

  3. RESULT OF NORMALIZATION :   We can be mathematically assured that all Dose-Groups in Table 11-H (including the additional combinations shown in Rows 159-162) are alike in the fraction of their total initial persons who are males age-5-ATB, alike in the fraction of their total initial persons who are females age-5-ATB, and so forth. In other words, all the Dose-Groups above enter the lifespan follow-up in 1950 as directly comparable cohorts, alike in both age-distribution and sex-distribution.






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