Fukushima Thyroid Examination Fact Sheet: May/June 2014

In October 2011, seven months after the Fukushima Dai-ichi nuclear power plant meltdowns
and explosions, Fukushima refecture be!an th"roid ultrasound examination, as part of
Fukushima #ealth $ana!ement %urve"
1
&now called Fukushima #ealth %urve"', in over
()0,000 children* +hese children were "oun!er than 1, at the time of the accident, and most
of them did not receive ade-uate protection of stable iodine tablets for prevention of th"roid
cancer* +his was intended to be the baseline examination to assess the current condition of
their th"roid !lands* +he th"roid !land is known to be affected, especiall" in children, b"
radioactive iodine 1(1 emitted from a nuclear accident*
+he plan was to conduct the preliminar" &first-round' th"roid ultrasound examination in all
()0,000 plus children, be!innin! with municipalities with the hi!hest radiation exposure
doses* .ith Fukushima $edical /niversit" &F$/' bein! the sole conductor of the examination
initiall", as commissioned b" Fukushima refecture, the first round of the examination was
completed in late $arch 2010, at the end of Fiscal 1ear 201(* 2umulative results have been
released ever" 2 to 0 months
2
, as the examination pro!ressed on each "ear3s cohort*
+he final results of the first round of th"roid ultrasound examination from October 2011 to
$arch 2010 are not "et known as of $a" 2010, since the secondar" examination has not
been completed* #owever, the results tallied up to $arch (1, 2010 were released on $a" 14,
2010, at the 15th refectural Oversi!ht 2ommittee $eetin! for Fukushima #ealth %urve"
(
*
+h"roid ultrasound examinations conducted on 245,511 Fukushima children &final results
known for 2,6,05) children as of Februar" 21, 2010' since October 2011, revealed that
1(),,00 children &06*67' had an 8928 assessment, with either c"sts 20*0 mm or smaller or
nodules 5*0 mm or smaller* In addition, 2,0)4 children &0*67' had a : assessment, indicatin!
c"sts 20*1 mm or lar!er or nodules 5*1 mm or lar!er, -ualif"in! them for secondar"
examinations, includin! a more detailed ultrasound examination, blood and urine tests
checkin! for th"roid function and iodine excretion, and fine-needle aspiration biops" if
necessar"* Of these 2,0)4 children, 1,650 actuall" received the secondar" examination*
%o far, there are 04 papillar" th"roid cancer cases, which were the most common form of
th"roid cancer found in children after the 14,) 2hernob"l accident, and (4 have suspect
biopsies, meanin! the" need sur!er" to obtain a section of th"roid !land for tissue biops"*
9nother cancer case is suspected to be of the poorl"-differentiated subt"pe, with the final
tissue dia!nosis pendin!* +he total number of confirmed th"roid cancer cases is 50, and the
total number of confirmed and suspected cancer cases is 40 &this number is sometimes
reported as ,4, excludin! one case that was confirmed to be beni!n'* (2 were male and 5,
were female, with an avera!e a!e of 10*6 ; 2*6 &a!e ran!e )-1,' at the time of the accident*
+he tumor si<e ran!ed from 5*1 mm to 00*5 mm* +he "oun!est was a !irl who was ) at the
time of the accident*
+he incidence, or more accuratel", prevalence, is thus (0*1 per 100,000 overall or 1)*) per
100,000 for confirmed cases so far* 9lthou!h it is not possible at this time to determine if
these cancers are radiation-induced or not, drawin! on =apanese cancer incidence statistics,
( or fewer cases of th"roid cancer would be expected in this population per "ear* &In 2010,
normal incidence of th"roid cancer in =apan was 0*1 in 100,000 below a!e 15 and 1*1 in
100,000 in a!e 15-14
0,5'*
9ccordin! to the >ational 2ancer Institute, pediatric th"roid cancer
incidence in the /%, is 0*2 in 100,000 below a!e 15 and 1*6) per 100,000 in a!e 15-14 &12*2
in 100,000 in adults
)
'*
%o far, the official consensus of the $inistr" of the ?nvironment &$O?' of the =apanese
!overnment, F$/, and the /nited >ations %cientific 2ommittee on the ?ffect of 9tomic
@adiation &/>%2?9@' appears to be that the findin! constitutes a Ascreenin! effect,B which
means th"roid cancer is bein! discovered as all children in Fukushima refecture are
screened
6,,
* $O? also conducted a stud" in distant prefectures, supposedl" unaffected b"
radiation exposure, but the stud" population is not a!e- and sex-matched to the Fukushima
cohort and the two datasets cannot be directl" compared
4
*
It should be noted that about 207 of the (),,)51 Fukushima children never underwent the
first round of th"roid ultrasound examination for various reasons* In addition, about 157 of the
2,060 children are "et to under!o the re-uired secondar" examination, and 107 of the 1,650
who underwent the secondar" examination are still awaitin! their results*
In the full-scale examination be!innin! 9pril 2010, those born between 9pril 2, 2011 and 9pril
1, 2012 will be included, some of who were exposed in utero, makin! the total to be examined
(,5,000 in a two-"ear period* Fukushima refecture is now offerin! more facilities to conduct
the examination in Fukushima* 9!reements have been si!ned with various medical facilities
nationwide to conduct the th"roid examination, so that 16,)(0 children residin! outside
Fukushima refecture can have an easier access*
9dditional informationC
%hunichi 1amashita, in char!e of the Fukushima #ealth %urve" until $arch 201(, initiall"
claimed an" th"roid cancer discovered durin! the screenin! would be latent cancers which
would not have been discovered until much later if the screenin! hadn3t been conducted*
9t the =une 201( meetin! of the +h"roid ?xamination 9ssessment %ubcommittee, %hinichi
%u<uki, an F$/ professor currentl" directin! the th"roid examination, admitted that some of
the 50 cancer cases had l"mph node metastasis or s"mptoms such as hoarseness which
validated th"roidectom"* %u<uki had also maintained these cancers represented latent
cancers*
+his revelation came when %u<uki was !rilled about the possibilit" of overdia!nosis and
overtreatment b" one of the subcommittee members, DenEi %hibu"a
10
, a public health
specialist at the /niversit" of +ok"o Fraduate %chool of $edicine* %hibu"a co-authored an
article raisin! the issue of th"roid cancer overdia!nosis and overtreatment, published in
Gancet
11
in $a" 2010*
9lthou!h %u<uki mentioned the existence of conditions which would Eustif" sur!er", he would
not release an" detailed data such as the actual number of such cases* #owever, his
admittance of l"mph node metastasis in some of the cases seems to contradict the initial
claim that these cancers were latent cancers which would never have been found*
+his is a controversial topic, and we are awaitin! a release of some of the data b" F$/* :"
the wa", althou!h no lon!er attendin! the refectural Oversi!ht 2ommittee $eetin! for
Fukushima #ealth %urve", %hunichi 1amashita remains as the senior director of th"roid
ultrasound examination
12
*
1 http://www.fmu.ac.jp/radiationhealth/publications/media/Yasumura_S_et_al_J_Epidemiol.pdf
2 http://www.fmu.ac.jp/radiationhealth/results/
3 http://www.fmu.ac.jp/radiationhealth/results/media/152_!h"roid_#ltrasound_E$amination.pdf
% http://&anjoho.jp/pro/statistics/en/table_download.html
5 Matsuda A, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H and The Japan Cancer Surveillance Research
Group. Cancer Incidence and Incidence Rates in Japan in 2008: A Study of 25 Population-based Cancer Registries for the
Monitoring of Cancer Incidence in Japan (MCIJ) Project. Japanese Journal of Clinical Oncology, 44(4): 388-396, 2013
' http://seer.cancer.&o)/statfacts/html/th"ro.html
* http://www.fmu.ac.jp/radiationhealth/wor+shop2,1%,2/presentation/-o-hairs_Summar"_E.pdf
. http://www.unscear.or&/docs/reports/2,13/13.5%1._/eport_2,13_0nne$_0.pdf
1 http://www.plosone.or&/article/info230doi2231,.13*1223journal.pone.,,.322,
1, http://www.&hp.m.uto+"o.ac.jp/profile/staff/+shibu"a/
11 http://www.thelancet.com/journals/lancet/article/455S,1%,'*3'61%7',1,1,/fullte$t
12 http://www.fmu.ac.jp/radiationhealth/whoweare/"amashita.html