Excess thyroid cancer in Fukushima children not the result of “screening effect”

A relationship between radiation exposure and pediatric thyroid cancer has been consistently denied by the Central Government as well as the Prefecture. But the Interim Summary might have brought this subject back to where it started. Some changes were beginning to be noticeable amongst the researchers and physicians following these patients.
When the Chernobyl accident occurred, IAEA (International Atomic Energy Agency) reported that the occurrence of pediatric thyroid cancer in the affected areas began to increase 4-5 years after the accident. 
 
Oshidori Mako Interviews Experts Regarding Excess Occurrence of Pediatric Thyroid Cancer in Fukushima, Fukushima Voice, English Version 6 Aug 15, “………
Issue to be considered #2: 
Up to now, many experts have insisted diagnosis of pediatric thyroid cancer in Fukushima was due to screening effect. However, some physicians are beginning to doubt it. What is happening now?……
 
Regarding the surgeries on pediatric thyroid cancer cases in post-accident Fukushima, Dr. Shinichi Suzuki from Fukushima Medical University discussed the details at the 4th session of the Thyroid Examination Assessment Subcommittee held on November 11, 2014.
According to Dr. Suzuki, surgeries were conducted on 55 cases of pediatric thyroid cancer at Fukushima Medical University post-accident up to June 30, 2014. One of 55 cases turned out to be a benign nodule after surgery. Remaining 54 consisted of 52 cases of papillary cancer, and 2 cases of poorly differentiated thyroid cancer. (According to the Clinical Management Guideline or CMG, poorly differentiated cancer is more aggressive than differentiated cancer because of the faster progression due to the faster speed of cancer cell division)….
….of 54 cases that underwent surgery at Fukushima Medical University, 17 had lymph node metastasis, and 2 had distant metastasis with suspicion of multiple lung metastasis. (Thyroid cancer is supposed to progress slowly, but in these cases the progression might have been faster due to young age). Surgical methods included total thyroidectomy in 5 cases and hemithyroidectomy in 49 cases. Total thyroidectomy involving the removal of the entire thyroid gland necessitates lifelong dependence on thyroid hormone medication.
In essence, Dr. Suzuki explained that “surgery was indicated and there was no overdiagnosis” in regards to tumors with large diameter, suspicion for metastasis, or proximity to the trachea or the nerve.
A clinician’s opinion
When I asked Dr. Shimizu regarding Dr. Suzuki’s explanation, he said, “I think Dr. Suzuki’s explanation is reasonable as it is the observation of a specialist actually operating on these patients. I also think the opinion of Dr. Miyauchi, the top surgeon from the Japan Society of Thyroid Surgery, is right.”……….
There was only one occasion during the Subcommittee session where Dr. Shimizu voiced his opinion strongly. It was the 2nd session of the Subcommittee held on March 2, 2014.
“I realize I am the chair of the Subcommittee, but there is something I would like to say outside my role as chair. It has been 10-plus years since I participated in thyroid screening programs in Chernobyl (Editor’s note: Since 1999, Dr. Shimizu has been to Chernobyl as a volunteer, participating in medical support activities, including thyroid ultrasound screening and surgery), but I would like to describe a patient who had thyroid surgery. It was a girl, age 5 or 6, with a large scar in the neck and a hole for tracheostomy in the middle of the neck. This girl will be able to keep living. But she has no voice, she can’t soak in the bathtub up to her neck, and she can’t enjoy conversations with people. What happened to her is that her recurrent laryngeal nerve was damaged on both sides. I don’t know if it is because the nerves had to be resected along with cancer due to the progression of the cancer, or if the nerves were damaged in surgery as they were not identifiable due to the advanced stage of cancer. All I can say for sure is that if the cancer had been detected earlier, this wouldn’t have happened to her………
A relationship between radiation exposure and pediatric thyroid cancer has been consistently denied by the Central Government as well as the Prefecture. But the Interim Summary might have brought this subject back to where it started. Some changes were beginning to be noticeable amongst the researchers and physicians following these patients.
Initial Screening was originally implemented in order to establish a base for studying health effects of the Fukushima NPP accident on thyroid gland. But discovery of excess occurrence was, in a way, unexpected……..
Dr. Tsugane, an epidemiologist, reported, “It is difficult to explain the current situation, with the number of thyroid cancer cases for ages 18 and under in Fukushima Prefecture exceeding 100, solely on the basis of screening effect.”…….
Dr. Tsugane has requested the Division of Surveillance, Center for Cancer Control and Information Services at National Cancer Center to calculate the estimated number of pre-accident cases in Fukushima, from incidence rate based on regional cancer registry. And theanalysis led to the expression, “several tens of times larger,” mentioned in the “Interim Summary Regarding Thyroid Examination.” In essence, the Interim Summary by the Thyroid Examination Assessment Subcommittee overturned the earlier assessment by the Oversight Committee.
The meaning of Initial Screening
When the Chernobyl accident occurred, IAEA (International Atomic Energy Agency) reported that the occurrence of pediatric thyroid cancer in the affected areas began to increase 4-5 years after the accident.
[Editor’s note: IAEA actually did not admit the excess occurrence during the investigation 4-5 years after the accident. However, 8 years after the accident, WHO finally recognized the excess occurrence which began in the fourth post-accident year. Ryuichi Hirokawa, editor of DAYS JAPANand founder/director of Chernobyl Children’s Fund, Japan, covered a symposium in Ukraine three years after the accident where excess occurrence of pediatric thyroid cancer was reported. He also interviewed Belarusian specialists discussing excess occurrence of pediatric thyroid cancer as well as leukemia. However, at the time, such reports were ignored by organizations like IAEA and ICRP (International Commission on Radiation Protection), which insisted there were no health effects. It wasn’t until the eighth post-accident year that excess occurrence became too obvious to be ignored that it was finally acknowledged by these organizations].
Due to the fact that the Chernobyl pediatric thyroid cancer occurrence began to increase 4-5 years after the accident, it was decided after the Fukushima Daiichi nuclear power plant accident that the first round (Initial Screening) of thyroid examination be completed before the effect of the nuclear accident appeared. This way the result of Initial Screening would be considered baseline without the effect of radiation exposure to compare with the result of Full-Scale Screening, scheduled to begin 4-5 years after the accident. However, 112 (confirmed and suspected) cases of thyroid cancer were diagnosed during Initial Screening which supposedly had no effect of radiation exposure. People began to wonder if 112 was too high a number under the circumstance……
Excess occurrence of pediatric thyroid cancer as a result of Initial Screening might be related to the nuclear accident after all, and the thyroid examination outside Fukushima Prefecture might be necessary—that is what a member of the Oversight Committee is saying now. What is the basis of the experts who have kept insisting “there will be no effect of radiation exposure” since immediately after the accident? ….. http://fukushimavoice-eng2.blogspot.jp/2015/08/oshidori-mako-interviews-experts.html
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