Lessons learned from Chernobyl and Fukushima on thyroid cancer screening and recommendations in case of a future nuclear accident

Exposure of the thyroid gland to ionizing radiation at a young age is the main recognized risk factor for differentiated thyroid cancer. After the Chernobyl and Fukushima nuclear accidents, thyroid cancer screening was implemented mainly for children, leading to case over-diagnosis as seen in South...

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Detalles Bibliográficos
Autores: Cléro, Enora, Ostroumova, Evgenia, Demoury, Claire, Grosche, Bernd, Kesminiene, Ausrele, Liutsko, Liudmila, Motreff, Yvon, Oughton, Deborah, Pirard, Philippe, Rogel, Agnès, Van Nieuwenhuyse, An, Laurier, Dominique, Cardis, Elisabeth
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/53018
Acceso en línea:http://hdl.handle.net/10230/53018
http://dx.doi.org/10.1016/j.envint.2020.106230
Access Level:acceso abierto
Palabra clave:Health monitoring
Nuclear accident
Recommendation
Screening
Thyroid cancer
Descripción
Sumario:Exposure of the thyroid gland to ionizing radiation at a young age is the main recognized risk factor for differentiated thyroid cancer. After the Chernobyl and Fukushima nuclear accidents, thyroid cancer screening was implemented mainly for children, leading to case over-diagnosis as seen in South Korea after the implementation of opportunistic screening (where subjects are recruited at healthcare sites). The aim of cancer screening is to reduce morbidity and mortality, but screening can also cause negative effects on health (with unnecessary treatment if over-diagnosis) and on quality of life. This paper from the SHAMISEN special issue (Nuclear Emergency Situations - Improvement of Medical And Health Surveillance) presents the principles of cancer screening, the lessons learned from thyroid cancer screening, as well as the knowledge on thyroid cancer incidence after exposure to iodine-131. The SHAMISEN Consortium recommends to envisage systematic health screening after a nuclear accident, only when appropriately justified, i.e. ensuring that screening will do more good than harm. Based on the experience of the Fukushima screening, the consortium does not recommend mass or population-based thyroid cancer screening, as the negative psychological and physical effects are likely to outweigh any possible benefit in affected populations; thyroid health monitoring should however be made available to persons who request it (regardless of whether they are at increased risk or not), accompanied with appropriate information and support.