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Lessons from Fukushima: Latest Findings of Thyroid Cancer After the Fukushima Nuclear Power Plant Accident

机译：福岛的教训：福岛核电站事故后甲状腺癌的最新发现

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The increase in risk for late-onset thyroid cancer due to radiation exposure is a potential health effect after a nuclear power plant accident mainly due to the release of radioiodine in fallout. The risk is particularly elevated in those exposed during infancy and adolescence. To estimate the possibility and extent of thyroid cancer occurrence after exposure, it is of utmost importance to collect and analyze epidemiological information providing the basis for evaluation of radiation risk, and to consider radiobiology and molecular genetics. In this regard, the dose–response of cancer risk, temporal changes in the rates of thyroid cancer, its histopathological types and subtypes, and frequency of underlying genetic abnormalities are important. At present, however, it is difficult or impossible to distinguish radiation-induced thyroid cancer from spontaneous/sporadic thyroid cancer because molecular radiation signatures, biomarkers of radiation exposure, or genetic factors specific to radiation-induced cancer have not yet been identified. The large-scale ultrasound screening in Fukushima Prefecture of Japan demonstrated a high detection rate of thyroid cancer in young individuals, revealing 116 and 71 cases in the first and second rounds, respectively, among the same cohort of approximately 300,000 subjects. These findings raised concerns among residents and the public that it might be due to putative exposure to radiation from the accident at Fukushima Daiichi Nuclear Power Plant. This review summarizes evaluations by international organizations and reviews scientific publications by the authors and others on childhood thyroid cancer, especially those relevant to radiation, including basic studies on molecular mechanisms of thyroid carcinogenesis. Clinical details are also provided on surgical cases in Fukushima Prefecture, and the effect of thyroid ultrasound screening is discussed. Correct understanding of issues relating to radiation and the thyroid are essential for interpretation of thyroid cancer in Fukushima.
机译：放射线暴露导致的晚期甲状腺癌风险增加是核电厂事故后的潜在健康影响，这主要是由于放射性尘埃释放引起的。在婴儿期和青春期暴露的人群中，这一风险特别高。为了估计暴露后甲状腺癌发生的可能性和程度，至关重要的是收集和分析流行病学信息，为评估放射风险提供基础，并考虑放射生物学和分子遗传学。在这方面，癌症风险的剂量反应，甲状腺癌发生率的时间变化，其组织病理学类型和亚型以及潜在的遗传异常发生频率非常重要。但是，目前，很难或不可能将放射诱发的甲状腺癌与自发性/散发性甲状腺癌区分开来，因为尚未发现分子放射特征，放射线暴露的生物标记或特定于放射诱发癌的遗传因素。在日本福岛县进行的大规模超声检查显示，年轻人中甲状腺癌的检出率很高，在大约30万名受试者的同一轮研究中，第一轮和第二轮分别发现116例和71例。这些发现引起了居民和公众的担忧，这可能是由于福岛第一核电站事故的假定辐射所致。这篇综述总结了国际组织的评估，并回顾了作者和其他人关于儿童甲状腺癌的科学出版物，特别是与放射有关的那些出版物，包括甲状腺癌发生的分子机制的基础研究。还提供了福岛县外科手术病例的临床细节，并讨论了甲状腺超声筛查的效果。正确理解与辐射和甲状腺有关的问题对于解释福岛的甲状腺癌至关重要。

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