Endocrinology and Metabolism Clinics of North America
CHILDHOOD THYROID CANCER FOLLOWING THE CHERNOBYL ACCIDENT: A Status Report
Section snippets
THE ACCIDENT
Nuclear power reactors have a large inventory of radioiodine and other radionuclides. These are generated as fission products from uranium and plutonium and are held within the metal cladding of the fuel elements. An accident destroying the integrity of the fuel cladding will release a number of radionuclides as gases, aerosols, or particulates. If there is a containment structure, such as the concrete shell over most reactors designed in the United States, it will confine such materials unless
CLINICAL EXPERIENCE AND ACCRUAL OF THYROID CANCERS
Authorities in Belarus and Ukraine, realizing the potential health implications of the Chernobyl accident, began intensive screening of children in the contaminated regions soon after the accident. The first report in the international literature of a rise in cases of thyroid cancer in Belarus 20 was greeted with considerable skepticism. 6, 36, 41 Although the validity of the pathological findings was confirmed, 1, 4, 12 the early onset of disease—only 4 years after exposure—was unexpected on
EPIDEMIOLOGY
Epidemiologic studies must be performed to obtain confirmation and definition of a link between the Chernobyl accident and the unprecedented
increase in thyroid cancer among children, risk coefficients that may be compared with those for exposure to x-ray and gamma radiation, 28, 42 precise information on time response, and evidence of the influence of demographic characteristics such as age and sex upon risk. In addition, the belated and unsystematic use of KI and the pockets of mild goiter
ONGOING AND FUTURE INQUIRIES
The Chernobyl accident and its consequences have stimulated considerable interest in the possibility of learning more about the nature of childhood thyroid cancer, its etiology, and its pathogenesis. A primary goal is to verify that there is a cause-effect relationship between the Chernobyl accident and the increasing prevalence of thyroid cancer in the immediate surroundings. The opportunity to arrive at a quantitative estimate of the risk coefficient for developing thyroid cancer after
ACKNOWLEDGMENT
The authors thank their Belarusian, Ukrainian, American, and other colleagues with whom they have collaborated in the discussion, development, and implementation of joint cooperative studies.
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Discussion and conclusions
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Address reprint requests to David V. Becker, MD, Professor of Radiology and Medicine, Director of Nuclear Medicine, The New York Hospital-Cornell Medical Center, 520 East 68th Street, Room St-221, New York, NY 10021
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From the Division of Nuclear Medicine, the Departments of Radiology and Medicine, The New York Hospital-Cornell Medical Center, New York City, New York (DVB); the Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases (JR); the Radiation Epidemiology Branch (GWB), and the Radiation Effects Branch (ACB, BWW), National Cancer Institute, Bethesda, Maryland