Midorikawa Sanae, Tanigawa Koichi, Suzuki Satoru, Ohtsuru Akira
1 Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan.
2 Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.
Asia Pac J Public Health. 2017 Mar;29(2_suppl):63S-73S. doi: 10.1177/1010539516686164.
A thyroid ultrasound examination program has been conducted in the aftermath of the Fukushima Daiichi Nuclear Power Plant accident to address concerns about the increased risk of thyroid cancer similar to those experienced by local residents after the 1986 Chernobyl accident. This is the second-largest thyroid cancer screening in younger age ever, following only that conducted after Chernobyl. As the natural history of thyroid cancer in younger populations is not well characterized, large-scale screening using thyroid ultrasound could result in overdiagnosis, even with careful planning, as has been experienced in South Korea. Awareness regarding the thyroid gland is generally low among residents, who tend to directly associate examination results with radiation exposure and are likely to develop newfound anxiety and feelings of self-condemnation and guilt. We reviewed the dilemma surrounding cancer screening and particularly underscored the need to address psychosocial issues associated with possible overdiagnosis. We modified our approach to address individual and social anxiety induced by results of screening conducted after the Fukushima accident. These findings and our experiences regarding the psychosocial issues related to thyroid examination should assist residents in their lifelong decision making and help them prepare for future disasters.
福岛第一核电站事故发生后，开展了一项甲状腺超声检查项目，以应对人们对甲状腺癌风险增加的担忧，这种担忧类似于1986年切尔诺贝利事故后当地居民所经历的情况。这是有史以来第二大规模的针对年轻人的甲状腺癌筛查，仅次于切尔诺贝利事故后的筛查。由于年轻人群体中甲状腺癌的自然病史尚不明确，即便精心规划，使用甲状腺超声进行大规模筛查仍可能导致过度诊断，韩国就曾有过这样的经历。居民对甲状腺的认知普遍较低，他们往往将检查结果直接与辐射暴露联系起来，很可能会产生新的焦虑以及自责和内疚感。我们审视了癌症筛查所面临的困境，尤其强调了应对与可能的过度诊断相关的心理社会问题的必要性。我们调整了方法，以应对福岛事故后筛查结果引发的个人和社会焦虑。这些发现以及我们在甲状腺检查相关心理社会问题方面的经验，应有助于居民做出终身决策，并帮助他们为未来的灾难做好准备。
