Children in Fukushima under the risk of thyroid cancer

A recent news told that the screening test for thyroid gland tumor in Fukushima had revealed that 36% of the cases had nodule(s) or cyst(s). They urgently plan to do the same test for normal control in the other areas. So far as a report found in Pub Med tells, the incidence of thyroid gland nodule in the normal population is only less than 2% as shown below. There was another report by Prof. Yamashita responsible for the administration of the follow up for those children in Fukushima, which gave almost the same figure for the incidence of nudular lesion in the normal population of children. This figure seems epidemiologically accurate even before the on going study gives a result.

The paper quoted below says that those with nodular lesions are fourfold  more prone to develop thyroid cancer. In the case of children in Fukushima, it is clear they have had radiation of I131 due to the plume immediately after the accident. I am sure they are even more susceptible for thyroid cancer. They have not made the scintilation counter exam in time to detect the ingested I131 for the children. In the exam performed in the end of March 2011, too late to detect I131, 45% of children were found to be radiated with that substance.

So far, the prefectural government et al won't give any further examinations to those with the tumorous lesions in the thyroid gland except for the planned next ultrasonogram in a couple of years. The pople won't be given any further info. It is reported that this strategy is mainly determined in the socioeconomical standpoint. I am sure they are wrong. Those children should undergo closer observation.


Pediatr Endocrinol Rev. 2008 Sep;6(1):14-23.
Thyroid nodules and cancers in children.
Josefson J, Zimmerman D.
Division of Endocrinology, Children's Memorial Hospital, Chicago, IL 60614, USA. JJosefson@childrensmemorial.org
Abstract
The incidence of thyroid nodules in children is estimated to be 1 to 1.5% based on clinical examination. Children with thyroid nodules, compared to adults with thyroid nodules, have a fourfold greater risk of developing malignant thyroid disease. Differentiated thyroid carcinoma is the most common pediatric endocrine tumor, constituting 0.5-3% of all childhood malignancies. The thyroid is one of the most frequent sites of secondary neoplasm in children who receive radiation therapy for other malignancies. Thyroid carcinoma has been studied extensively in adults. However, the pediatric literature on this subject is much less complete, owing to the rarity of its diagnosis. This article reviews the predisposing factors, genetics, pathology, pathogenesis , clinical presentation, detailed treatment and follow-up management of children with thyroid carcinoma. Additionally, a discussion regarding the controversial aspects of radioiodine therapy in children is included.