Takahashi T, Trott K R, Fujimori K, Simon S L, Ohtomo H, Nakashima N, Takaya K, Kimura N, Satomi S, Schoemaker M J
Second Department of Surgery, Tohoku University Medical School, Sendai, Japan.
Health Phys. 1997 Jul;73(1):199-213. doi: 10.1097/00004032-199707000-00017.
The prevalence of thyroid nodules and thyroid cancer was studied in the indigenous population residing on Ebeye Island, Kwajalein Atoll, in the Republic of the Marshall Islands. This island, centrally located in the nation, is home to about 25% of the nation's population, many who have migrated there from other atolls. The objective of the study was to obtain thyroid disease rate statistics on as much of the population as possible that was alive during the years of nuclear testing and to test the hypothesis that described a linearly decreasing prevalence of palpable nodules with increasing distance from the Bikini test site. 1,322 Marshallese born before 1965 were given a thyroid examination using neck palpation, fine needle aspiration biopsy, and high resolution ultrasound imaging. Approximately 40% of the total population living on this island who are at risk from exposure to radioactive fallout during the years 1946-1958 were screened. Of that group, 815 were alive at the time of the BRAVO test on 1 March 1954. Two hundred sixty-six people with thyroid nodules were found (32.6%): 132 were palpable nodules (16.2%), and 134 were nodules that could be diagnosed with ultrasound only (15.7%). Prevalence of palpable nodules was particularly high in men and women older than 60 y, in men who were 6 to 15 y of age at the time of the BRAVO test, and in women 1 to 10 y of age at the time of the BRAVO test. In 22 people, the clinical diagnosis was most likely cancer though histopathological evidence was only available from 11 operated cases. Of the 11 operated cases, 10 were cancer. Cancer prevalence was particularly high in those women born between 1944 and 1953 (7/220 = 3.2%), i.e., who were children during the early years of nuclear testing. The Ebeye data showed a marginally significant correlation between palpable nodule prevalence among women and distance to Bikini (r = -0.44, p = 0.06). This report summarizes the clinical findings of the thyroid examinations, the age distributions for nodular disease and cancer, and examines the relationship between prevalence of nodules and present day levels of 137Cs in the environment of each atoll.
对居住在马绍尔群岛共和国夸贾林环礁埃贝耶岛上的原住民的甲状腺结节和甲状腺癌患病率进行了研究。该岛位于该国中心位置，约占全国人口的25%，许多人是从其他环礁迁移至此。本研究的目的是获取在核试验期间存活的尽可能多的人群的甲状腺疾病发病率统计数据，并检验一个假设，即随着与比基尼试验场距离的增加，可触及结节的患病率呈线性下降。对1322名1965年以前出生的马绍尔人进行了甲状腺检查，采用颈部触诊、细针穿刺活检和高分辨率超声成像。对该岛上在1946年至1958年期间有暴露于放射性沉降物风险的约40%的总人口进行了筛查。在该组人群中，815人在1954年3月1日“布拉沃”试验时仍然存活。发现266人患有甲状腺结节（32.6%）：132个为可触及结节（16.2%），134个为仅通过超声可诊断的结节（15.7%）。可触及结节的患病率在60岁以上的男性和女性、在“布拉沃”试验时年龄为6至15岁的男性以及在“布拉沃”试验时年龄为1至10岁的女性中尤其高。在22人中，临床诊断很可能为癌症，但只有11例手术病例有组织病理学证据。在这11例手术病例中，10例为癌症。癌症患病率在1944年至1953年出生的女性中尤其高（7/220 = 3.2%），即那些在核试验早期还是儿童的女性。埃贝耶的数据显示，女性中可触及结节患病率与到比基尼的距离之间存在微弱的显著相关性（r = -0.44，p = 0.06）。本报告总结了甲状腺检查的临床结果、结节性疾病和癌症的年龄分布，并研究了结节患病率与每个环礁环境中当前137Cs水平之间的关系。
