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On the Descrippon About Childhood Thyroid Cancer in UNSCEAR White 1 Workshop on the occasion of Dr. Mar-n Tondel vising Osaka /20 On the descrip-on about childhood thyroid cancer in UNSCEAR White Paper 2016 Tomoya Yamauchi Graduate School of Mari-me Sciences, Kobe Univreisty 21st April 2019 Shin-Osaka Maru-biru Bekkan, 5-3 On the descrip-on of childhood thyroid Cancer in UNSCEAR White Paper 2016 2/20 Focusing on two paragraphs of 111 & 112 in UNSEAR 2016 White Paper, we examine by what way they deny the analy-cal result of the excess of childhood thyroid cancer in Fukushima Prefecture based on the conven-onal epidemiology. As the report style, these paragraph is completely out of usual scien-fic manner. They have never adequate knowledge about epidemiology, especially on the role of regional classificaon as an operaon variable, an importance of external comparison based on ordinal incidence, and -me interval aer the exposure. The main paper in the present discussion is that published by Tsuda et al. in Epidemiology in 2016. ORIGINAL ARTICLE 5IZSPJE$BODFS%FUFDUJPOCZ6MUSBTPVOE"NPOH 3FTJEFOUT"HFT:FBSTBOE:PVOHFSJO'VLVTIJNB +BQBOUP Toshihide Tsuda,a Akiko Tokinobu,b Eiji Yamamoto,c and Etsuji Suzukib the assumption that the rest of examinees were disease free, an incidence Background: After the Great East Japan Earthquake and Tsunami ORIGINAL ARTICLE rate ratio of 12 has already been observed (95% CI = 5.1, 23). in March 2011, radioactive elements were released from the Fuku- Conclusions: An excess of thyroid cancer has been detected by shima Daiichi Nuclear Power Plant. Based on prior knowledge, con- ultrasound among children and adolescents in Fukushima Prefecture cern emerged about whether an increased incidence of thyroid cancer within 4 years of the release, and is unlikely to be explained by a among exposed residents would occur as a result. screening surge. Methods: After the release, Fukushima Prefecture performed ultra- 5IZSPJE$BODFS%FUFDUJPOCZsound6MUSBTPVOE thyroid screening on all residents"NPOH ages ≤18 years. The first (Epidemiology 2016;27: 316–322) round of screening included 298,577 examinees, and a second round 3FTJEFOUT"HFT:FBSTBOE:PVOHFSbegan in April 2014. WeJO analyzed'VLVTIJNB the prefecture results from the first and second round up to December 31, 2014, in comparison with the +BQBOUPOn the descrip-on of childhoodJapanese annual incidence and the incidence within thyroid a reference EpidemiologyCancer area t 7PMVNF in UNSCEAR he/VNCFS Fukushima .BZ WhiteDaiichi NPaper 2016uclearThyroid CancerPower Among Plant Young People released in Fukushima radio3/20- in Fukushima Prefecture. Tactive elements after the Great East Japan Earthquake and Tsunami on March 11, 2011. As the wind shifted direction over Toshihide Tsuda,a Akiko Tokinobu,b Eiji Yamamoto,Results: Thec highestand Etsuji incidence Suzuki rateORIGINAL ratio,b using ARTICLE a latency period of 4 years, was observed in the central middle district of the prefecture com- time, 131I, 134Cs, and 137Cs, in addition to other radionuclides, were pared with the Japanese annual incidence (incidence rate ratio = 50; 95% released to both the northwest and the south of the plant.1 The rela- the assumptionconfidence that interval the rest [CI of] examinees = 25, 90). Twerehe prevalence disease free, of anthyroid incidence cancer was tive amounts of radioactive material released were estimated to be Background: After the Great East Japan Earthquake and Tsunami 131 137 134 rate ratio6055IZSPJE of per 12 millionhas already examinees$BODFS been observed (95%%FUFDUJPO CI (95% = 302, CI =1,082) 5.1,CZ 23). and6MUSBTPVOE the prevalence "NPOH9.1% I, 17.5% Cs, and 38.5% Cs. Compared with Cher- in March 2011, radioactive elements were released from the Fuku- Conclusions:odds ratio A comparedn excess withof thyroid the reference cancer district has beenin Fukushima detected Prefecture by nobyl where one reactor melted down, at Fukushima three reac- shima Daiichi Nuclear Power Plant. Based on prior knowledge, con- 3FTJEFOUT"HFT:FBSTBOE:PVOHFSJO'VLVTIJNB ultrasoundwas 2.6 among (95% children CI = 0.99, and 7.0). adolescents In the second in Fukushima screening round, Prefecture even under tors melted down.2 Radiation released into the atmosphere from cern emerged about whether an increased incidence of thyroid cancer +BQBOUP within 4 years of the release, and is unlikely to be explained by a the Fukushima accident was estimated to be approximately 900 among exposed residents would occur as a result. screeningTsudaEditors’ et al.surge. Note:Toshihide A commentary Tsuda,a onAkiko this Tokinobu, article appearsb Eiji Yamamoto, on page 323.c and Etsuji SuzukibpetabecquerelEpidemiology (131I: 500 petabecquerel, t 7PMVNF 137C/VNCFSs: 10 petabecquerel). .BZ Methods: After the release, Fukushima Prefecture performed ultra- Editors’ Note: Letters to the Editor regarding this article can be found on the 131 FIGURE. .BQ PG 'VLVTIJNBThe radiologic1SFGFDUVSF equivalence to I International Nuclear Event sound thyroid screening on all residents ages ≤18 years. The first (EpidemiologyEPIDEMIOLOGY 2016;27: website 316–322) in the May 2016 issue at http://journals.lww.com/BOETDSFFOJOHBSFBTGPSUIFmSTUSPVOEPG the assumption that the rest of examinees were disease free, an incidence Background: After the Great East Japan Earthquake and Tsunami TDSFFOJOHGSPNScaleUPmTDBM wasZFBST approximately one-sixth of the 5,200 petabecquerel round of screening included 298,577 examinees, and a second round epidem/pages/default.aspx rate ratio of 12 has already been observed (95% CI = 5.1, 23). in March 2011, radioactive elements were released from the Fuku- 3 Submitted 25 January 2015; accepted 10 August 2015.Conclusions: An excess of thyroid cancercalculated has been detected to haveby been released by the131 Chernobyl accident. began in April 2014. We analyzed the prefecture results from the first TABLEshima Daiichi 2. N uclear1SFWBMFODF Power Plant. Based1SFWBMFODF on prior knowledge,0EET con- 3BUJPT 103 BOEinhalation*ODJEFODF was the highest3BUF among3BUJPT all estimated *33 radiation dosesJO &BDIwere due%JTUSJDU to substantialVQ I concentrationsUP%FDFNCFS in the south area of From the aDepartment of Human Ecology, Graduateultrasound School among of E childrennvironmental and adolescents in Fukushima Prefecture cern emerged about whether an increased incidence of thyroid cancer to the thyroid, ground shine was Ithen second its highest,health and ingesrisk- assessment,the plant, together with exposurethe World differences Healthbetween radioac Organi- - and second round up to December 31, 2014, in comparison with the and Life Science, Okayama University, Okayama,within Japan;4 years ofbDepartment the release,tion wasand ofthe is lowest.unlikely The to report be explainedindicated that by the a proportion of tive iodine and the total air dose rate. among exposed residents would occur as a result. 9–11 he Fukushima Daiichi Nuclear Power Plantscreening released surge. radio-exposure via ground shine increased as time advanced. InternalIn additionComparison to Japanese sourcesExternal that were cited Comparison by the Japanese annual incidence and the incidence within a reference area Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceu- zation predicted that an excess of thyroid4 cancer12 cases would Methods: After the release, Fukushima Prefecture performed ultra- PrevalenceAside from the screeningof Thyroid in Fukushima Cancer Prefecture that is World Health Organization, Unno et al. reported chrono- c the subject of this study, Watanobe et al.6 conducted a screening logical changes in 131I radioactivity levels in fallout per day soundactive thyroidtical screeningelements Sciences, on all after residentsOkayama the ages G University,≤reat18 years. E astThe Okayama, firstJapan ( EpidemiologyE Japan;arthquake and 2016;27: Departmentand 316–322) result6 from radiation-exposed children based ona a prelimi- in Fukushima Prefecture. T in various cities; in 131I radioactivity levels in spinach, cow’s Areasround of and screening Districts included 298,577(1) to examinees,(9) and a second round exerciseCases from 2012 toper 2013 10 including (95% thyroid CI)ultrasonography for POR (95% CI) IRR (95% CI) of Information Science, Faculty of Informatics, Okayama University of 4,5milk, and chicken eggs; and in tap water pollution with 131I Results: The highest incidence rate ratio, using a latency period of 4 Tbegansunami in April on 2014. March We analyzed 11, the 2011. prefecture A resultss the from wind the first shifted direction over1,137 Fukushima residentsnary ages dose 18 years andassessment. younger at the time When the World Health Organization 131 Science,134 Okayama,137 Japan. of the accident. No thyroid cancer was detected in this screening. from March to May of 2011 in various areas of east Japan. years, was observed in the central middle district of the prefecture com- time,and second Iround, Cup s,to Decemberand C31,s, 2014, in addition in comparison to with other the radionuclides, wereIn regions of Japan otherreported than Fukushima, a preliminarythe Japanese Minis- Tdosehey did notestimation consider radioiodine in exposure 2012, through it inhalaestimated- NearestPresented area (1) earlier (2011 aspects fiscal year)of this research at conferenceshe of Fukushima the International Daiichi N Sociuclear- Power359 Plant (201, released 592) radio- 1.5 (0.63, 4.0) 30 (17, 49) Japanese annual incidence and the incidence within a reference area 1 try of Environment conducted thyroid screening of 4,365 chil- tion. They also measured radioiodine concentrations in breast
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