Detection of thyroid cancer among children and adolescents in Fukushima, Japan: a population-based cohort study of the Fukushima Health Management Survey.

IF 9.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL EClinicalMedicine Pub Date : 2024-08-26 eCollection Date: 2024-09-01 DOI:10.1016/j.eclinm.2024.102722
Hideto Takahashi, Seiji Yasumura, Kunihiko Takahashi, Tetsuya Ohira, Hiroki Shimura, Hitoshi Ohto, Satoru Suzuki, Shinichi Suzuki, Tetsuo Ishikawa, Satoshi Suzuki, Enbo Ma, Masanori Nagao, Susumu Yokoya, Kenji Kamiya
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Abstract

Background: Thyroid ultrasound examinations using a cohort study design (from the Fukushima Health Management Survey [FHMS]) were conducted after the nuclear power plant accident caused by the Great East Japan Earthquake in 2011. This study investigated the association between radiation exposure and the detection of thyroid cancer in children and adolescents.

Methods: The cohort study has been conducted in Fukushima prefecture in Japan since 2011. The primary outcome was the external dose. We enrolled 253346 examinees who lived in Fukushima at the time of the accident (Dataset A), including 113120 examinees who had data on external radiation exposure (ERE) (Dataset B). The median dose in the examinee's district was used for missing dose. The association between ERE and detection of thyroid cancer or suspected thyroid cancer was analyzed using Poisson regressions with two types of explanatory variables: sex, age, overweight status, and district (Model 1), and past medical history, family history of thyroid cancer, frequency of seafood consumption, and frequency of seaweed consumption in addition to Model 1 (Model 2).

Findings: During the second and third rounds of examinations, a total of 97 thyroid patients were detected, for a detection rate of 10.328 [ 10 5 year - 1 ] (95% confidence interval: 8.464-12.602 [ 10 5 year - 1 ]). Multivariate Poisson regression showed that the detection rate ratio of the ERE (1+ mSv) to <1 (mSv) was 1.577 (0.715-3.394) in Model 1 and 1.596 (0.726-3.512) in Model 2, for Dataset A; and 1.677 (0.746-3.773) in Model 1 and 1.669 (0.743-3.748) in Model 2, for Dataset B.

Interpretation: Our study showed no association between radiation exposure with extremely low dose which were more than 99.9% of all the exposure was less than 5 mSv, and thyroid cancer detection, when the follow-up period was an average of 3.7 years at the present, using the cohort study design.

Funding: The National Health Fund for Children and Adults Affected by Nuclear Incidents in Japan.

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日本福岛儿童和青少年甲状腺癌检测:福岛健康管理调查的人群队列研究。
背景:2011年东日本大地震引发核电站事故后,采用队列研究设计(来自福岛健康管理调查[FHMS])进行了甲状腺超声波检查。本研究调查了辐射暴露与儿童和青少年甲状腺癌检测之间的关系:这项队列研究自 2011 年起在日本福岛县开展。主要结果是外部剂量。我们招募了事故发生时居住在福岛县的253346名受检者(数据集A),其中包括有外部辐射照射(ERE)数据的113120名受检者(数据集B)。缺失剂量采用受检者所在地区的剂量中位数。采用泊松回归分析了ERE与甲状腺癌或疑似甲状腺癌检出率之间的关系,其中包含两种解释变量:性别、年龄、超重状况和地区(模型1),以及除模型1之外的既往病史、甲状腺癌家族史、海鲜食用频率和海藻食用频率(模型2):在第二轮和第三轮检查中,共发现 97 名甲状腺患者,检出率为 10.328 [ 10 5 年-1 ](95% 置信区间:8.464-12.602 [ 10 5 年-1 ])。多变量泊松回归显示,ERE(1+ mSv)与解释的检出率比值:我们的研究表明,采用队列研究设计,在目前平均 3.7 年的随访期内,99.9% 以上的极低剂量辐射照射低于 5 mSv 与甲状腺癌检出率之间没有关联:日本核事故受害儿童和成人国民健康基金。
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来源期刊
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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