Suzuki S
Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Clin Oncol (R Coll Radiol). 2016 Apr;28(4):263-271. doi: 10.1016/j.clon.2015.12.027. Epub 2016 Jan 25.
The accident at the Fukushima Daiichi Nuclear Power Plant occurred after the Great East Japan Earthquake on 11 March 2011, releasing a large amount of radioactive materials into the atmosphere. Questions were raised regarding the health effects of radiation exposure, which led to increased anxiety among the Fukushima residents about the possible development of thyroid cancer. Thus, thyroid ultrasound examinations began for those who were from the areas where the radiation doses were highest, and will continue for the long term. In total, 300 476 subjects aged 18 years or younger at the time of the disaster were screened from 9 October 2011 to 31 March 2014. The participation rate was 81.7% of the total population of this age and in the affected area. Among them, the proportions of those who fell into the categories A1 (no nodules or cysts present), A2 (nodule ≤ 5 mm or cyst ≤ 20 mm diameter), B (nodule > 5 mm or cyst > 20 mm diameter) and C (immediate need for further investigation) were 51.5, 47.8, 0.8 and 0%, respectively; 2294 subjects in categories B and C were recommended to undergo a confirmatory examination; 113 were subsequently diagnosed with malignancy or suspected malignancy by fine needle aspiration cytology. The full-scale survey (second round survey) began in April 2014, and was completed by 30 June 2015, and comprised 169 455 subjects (participation rate; 44.7%). The proportions of those who fell into the categories A1, A2, B and C were 41.6, 57.6, 0.8 and 0% (no case), respectively; 1223 subjects in category B were recommended to undergo a confirmatory examination, 25 of these were subsequently diagnosed with malignancy or suspected malignancy by fine needle aspiration cytology. The thyroid cancers identified in this survey so far are unlikely to be due to radiation exposure, and are more likely to be the result of screening using highly sophisticated ultrasound techniques. However, it would be advisable to continue long-term screening to determine whether the risk of childhood and adolescent thyroid cancer due to radiation exposure increases or not.
2011年3月11日东日本大地震后，福岛第一核电站发生事故，大量放射性物质释放到大气中。辐射暴露对健康的影响引发了诸多问题，这导致福岛居民对甲状腺癌可能发病的焦虑情绪增加。于是，针对来自辐射剂量最高地区的人群开始进行甲状腺超声检查，并将长期持续下去。从2011年10月9日至2014年3月31日，总共对灾难发生时年龄在18岁及以下的300476名受试者进行了筛查。参与率为该年龄组及受灾地区总人口的81.7%。其中，属于A1类（无结节或囊肿）、A2类（结节≤5毫米或囊肿直径≤20毫米）、B类（结节>5毫米或囊肿直径>20毫米）和C类（急需进一步检查）的比例分别为51.5%、47.8%、0.8%和0%；B类和C类的2294名受试者被建议接受确诊检查；随后有113人通过细针穿刺细胞学检查被诊断为恶性肿瘤或疑似恶性肿瘤。全面调查（第二轮调查）于2014年4月开始，并于2015年6月30日完成，共有169455名受试者（参与率为44.7%）。属于A1类、A2类、B类和C类的比例分别为41.6%、57.6%、0.8%和0%（无病例）；B类的1223名受试者被建议接受确诊检查，其中25人随后通过细针穿刺细胞学检查被诊断为恶性肿瘤或疑似恶性肿瘤。到目前为止，本次调查中发现的甲状腺癌不太可能是由辐射暴露引起的，而更有可能是使用高度精密的超声技术进行筛查的结果。然而，继续进行长期筛查以确定辐射暴露导致儿童和青少年甲状腺癌的风险是否增加是明智的。
