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, 28 (1), 11-22

Lessons From Fukushima: Latest Findings of Thyroid Cancer After the Fukushima Nuclear Power Plant Accident

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Lessons From Fukushima: Latest Findings of Thyroid Cancer After the Fukushima Nuclear Power Plant Accident

Shunichi Yamashita et al. Thyroid.

Abstract

The increase in risk for late-onset thyroid cancer due to radiation exposure is a potential health effect after a nuclear power plant accident mainly due to the release of radioiodine in fallout. The risk is particularly elevated in those exposed during infancy and adolescence. To estimate the possibility and extent of thyroid cancer occurrence after exposure, it is of utmost importance to collect and analyze epidemiological information providing the basis for evaluation of radiation risk, and to consider radiobiology and molecular genetics. In this regard, the dose-response of cancer risk, temporal changes in the rates of thyroid cancer, its histopathological types and subtypes, and frequency of underlying genetic abnormalities are important. At present, however, it is difficult or impossible to distinguish radiation-induced thyroid cancer from spontaneous/sporadic thyroid cancer because molecular radiation signatures, biomarkers of radiation exposure, or genetic factors specific to radiation-induced cancer have not yet been identified. The large-scale ultrasound screening in Fukushima Prefecture of Japan demonstrated a high detection rate of thyroid cancer in young individuals, revealing 116 and 71 cases in the first and second rounds, respectively, among the same cohort of approximately 300,000 subjects. These findings raised concerns among residents and the public that it might be due to putative exposure to radiation from the accident at Fukushima Daiichi Nuclear Power Plant. This review summarizes evaluations by international organizations and reviews scientific publications by the authors and others on childhood thyroid cancer, especially those relevant to radiation, including basic studies on molecular mechanisms of thyroid carcinogenesis. Clinical details are also provided on surgical cases in Fukushima Prefecture, and the effect of thyroid ultrasound screening is discussed. Correct understanding of issues relating to radiation and the thyroid are essential for interpretation of thyroid cancer in Fukushima.

Keywords: Chernobyl; Fukushima; radiation exposure; thyroid cancer; thyroid surgery; ultrasound thyroid screening.

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Incidence of thyroid cancer in patients of different age groups at diagnosis in Belarus after the Chernobyl accident. Data are derived from the same set as in Demidchik et al. (23).
<b>FIG. 2.</b>
FIG. 2.
Distribution of different types of genetic alterations in papillary thyroid carcinoma tissues in Chernobyl areas and Japan, and in the The Cancer Genome Atlas project. Data shown are age range (rounded mean age) of patients. Data are summarized from different publications.
<b>FIG. 3.</b>
FIG. 3.
Outline of the Fukushima Health Management Survey, and calendar terms and official titles of thyroid ultrasound screening cycles. Information is from the Radiation Medical Science Center, Fukushima Medical University website (86).

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