Nagataki Shigenobu
Nagasaki University, Ito Hospital, and Radiation Effects Association, Tokyo, Japan.
Eur Thyroid J. 2016 Dec;5(4):219-223. doi: 10.1159/000448890. Epub 2016 Sep 23.
Because of the March 2011 nuclear accident in Fukushima, Japan, the Fukushima Prefecture initiated a thyroid ultrasound examination program. The first cycle of examinations on all children (more than 300,000) of the Fukushima Prefecture identified 116 patients as having malignant or suspected malignant thyroid nodules, and in the second cycle 59 new cases were identified. According to the available data, the thyroid cancers found by the screening are unlikely to be due to radiation, but the possibility cannot be excluded.
The current thyroid ultrasound examination program has been detecting thyroid cancers, regardless of the cause, in all children in the Fukushima Prefecture. Fukushima Prefecture is already taking measures against thyroid cancer, even if an increase occurs in radiation-induced thyroid cancer in Fukushima Prefecture. Therefore, the urgent challenge is how to treat children with thyroid cancer found by the screening.
At the end of each cycle, the findings must be carefully discussed with experts around the world and among stakeholders in Fukushima, and a consensus must be reached regarding whether the current program will be continued or needs improvement. In addition, the survey should be improved as an epidemiological follow-up research program. Before starting this, a consensus must be reached with the inhabitants with regard to carrying out epidemiological research for several decades. Dialogue absolutely must continue among all stakeholders to determine how best to formulate a program to deal with urgent matters and to determine the next stage of any epidemiological research.
由于2011年3月日本福岛发生核事故,福岛县启动了一项甲状腺超声检查项目。福岛县对所有儿童(超过30万)进行的第一轮检查中,有116名患者被确诊为患有恶性或疑似恶性甲状腺结节,第二轮检查又发现了59例新病例。根据现有数据,筛查发现的甲状腺癌不太可能是由辐射引起的,但也不能排除这种可能性。
目前的甲状腺超声检查项目一直在福岛县所有儿童中检测甲状腺癌,无论其病因如何。即使福岛县辐射诱发的甲状腺癌有所增加,福岛县也已经在采取措施应对甲状腺癌。因此,紧迫的挑战是如何治疗筛查中发现的患有甲状腺癌的儿童。
在每个周期结束时,必须与世界各地的专家以及福岛的利益相关者仔细讨论检查结果,就当前项目是继续进行还是需要改进达成共识。此外,作为一项流行病学随访研究项目,该调查应得到改进。在此之前,必须就开展数十年的流行病学研究与居民达成共识。所有利益相关者之间绝对必须继续对话,以确定如何最好地制定应对紧急事项的方案,并确定任何流行病学研究的下一阶段。