Wednesday, January 25, 2012

1143 Children (Over 30%) of 3765 Tested for Thyroid Abnormalities in Fukushima Had Lumps or Cysts (Updated)

(UPDATE: The document issued by the Fukushima Prefecture's expert committee is here (PDF, in Japanese).

Total number of children tested: 3765
No. of children found with lumps [nodules] 5.1 millimeter or larger: 26
No. of children found with lumps [nodules] less than 5.1 millimeter: 56
No. of children found with cysts 20.1 millimeter or larger: 0
No. of children found with cyst less than 20.1 millimeter: 1086
No. of children with no lumps [nodules], cysts: 2622

There are children who have both lump [nodule] and cyst.

============================================


Waaaiiit a minute...

I was looking for more information on the post I wrote about the lumps on the thyroid 5.1 millimeters or bigger in diameter found in 0.7% or 26 children out of 3765 children tested in Fukushima Prefecture. I was specifically looking for information on the number of children who had any lump at all.

I've just found it in an unlikely place: Fukushima Minpo, local Fukushima newspaper. I thought they would obfuscate, but they have the details. The article looks like it is a part of a longer article; it is possible it is abbreviated from the article in the print version of the newspaper.

It turns out,

Total number of children tested: 3765
No. of children found with lumps 5.1 millimeters and larger: 26 (0.7% of total)
No. of children found with lumps smaller than 5.1 millimeters: 1117 (29.7% of total)

1143 children, or 30.4% of children tested, were found with lumps of varying sizes.

From Fukushima Minpo (1/25/2012):

検討委員会では、浪江、飯舘両町村、川俣町山木屋地区の18歳以下を対象にした甲状腺検査の結果が報告された。3765人のうち、「直ちに二次検査を要する」と判断された県民はいなかった。

At the expert commission, the result of the thyroid test was reported. The test was done on the children below the age of 18 in Namie-machi, Iitate-mura, and Yamakiya District of Kawamata-machi [all planned evacuation zone]. Of 3765 children, there was no one who was deemed necessary to immediately go through further testing.

直径5・1ミリ以上のしこりなどが確認され、二次検査の対象となったのは26人(0・7%)だったが、検討委座長の山下俊一福島医大副学長は「原発事故に伴う悪性の変化はみられない」と説明している。二次検査が不要の3739人(99・3%)のうち、1117人(29・7%)は5・0ミリ以下のしこりなどが確認されたが、県は「良性」と判断している。

26 children (0.7%) have been found with lumps with 5.1 millimeters or larger in diameter, and will go through further testing [at some time]. However, Shunichi Yamashita, the head of the commission and the vice president of Fukushima Medical University explains, "There is no malignant change due to the nuclear plant accident". Of 3739 children who will not need further testing (99.3% of children tested), 1117 children (29.7%) have been found with lumps 5.0 millimeters or less in diameter. But the prefectural government has decided they are "benign".

甲状腺検査は県民健康管理調査の一環で、浪江、飯舘両町村、川俣町山木屋地区で先行して行われた。他の地域では順次、実施している。

The thyroid testing is part of the Fukushima residents health management survey, and was carried out in Namie, Iitate-mura, and Yamakiya District of Kawamata-machi first. For the other areas, it has been on-going.

It decidedly does not look totally OK to me, and the explanation by the Fukushima officials sounds suspect.

17 comments:

Anonymous said...

The question is: "Why did they chose 5 mm as a limit?". Because from this size the rate is below 1%???
Looks like they are manipulating the facts.

Anonymous said...

FUCKING DISGRACE

Anonymous said...

The only way to tell if a lump in the thyroid is benign or not is to do a biopsy, which means sticking a needle in the neck several times at different angles. Unless they have done that to the 1,143 children, they don't know whether any of them has a malignant tumour. Dr. Damashita is supposedly the chairman of the thyroid medicine association of Japan, but he's apparently unfamiliar with that diagnostic method. It's quite unpleasant for the patient.

Anonymous said...

Thing is, those numbers mean nothing unless you have a control group to compare against.

Unfortunately, I don't think they were checking everyone before this happened, so it is hard to tell if there has been a sudden increase.

One thing they could do, however, is to compare stats from around the country. Do you know if they are doing this checking elsewhere in Japan?

Chibaguy said...

If any of you can read Japanese this is a typical good feeling layout issued by the government. Nice artwork, procedures and contact information and all are here to help people feel better. They even set up a 心の健康(healthy heart)call center which has nothing to do with cesium affecting the heart (it is about the smile).

Anonymous said...

Regarding the 5mm limit comment: That IS a good question, but not in the way you mean it.

There might just be a medical explanation for the 5mm cutoff line, whaddya think?

Of course though, rather than going and checking facts, its always easier to just cast aspersions.

Anonymous said...

Probably the 5mm cut off was to cherry pick the data.

The only way to diagnose benign or malignant is with biopsy of the node and view under a microscope by pathologist.

The question I'd like to know is exactly what methodology did the Japanese authorities follow to decide each node was benign?

Anonymous said...

"It's quite unpleasant for the patient."

Something tells me that little kids will NOT be liking this procedure.

Anonymous said...

A good spot. I imagine somebody is getting a hard time for slipping out these details, a fair bit of spin between 30.4% and the 0.7% reported generally then.

I wonder how the sizes of these lumps would change if the same children were checked again after a few months (something I hope is happening anyway)

I also very much doubt they have done a biopsy on many of these lumps if any, so I don't see how anyone can say they are harmless or not.

I agree a control group is needed to get a more accurate picture but 30% of children having lumps naturally? Sounds a bit of a high % to me.

I wonder how long the GoJ can carry on for before the wheels fall off (as long as they can?)

Anonymous said...

I'm confused by the discrepancy in these numbers. Is the 1117 for "lumps smaller than 5.1 millimeters" in the second source combining the lumps smaller than 5.1 AND the cysts from the source mentioned at the top of the page? (that doesn't add up to 1117, however).

This is a huge discrepancy:

No. of children found with lumps less than 5.1 millimeter: 56
No. of children found with lumps smaller than 5.1 millimeters: 1117

Where are these two sources getting their data from?

Anonymous said...

Thyroid nodules, or lumps, are quite common, occurring in more than 50% of the world's population.

Anonymous said...

@Anon Jan 26 6:39

Thyroid nodules may be common but they are a worry in children under 20 especially if they have been exposed to radiation.

(Nodules are of particular concern when they are found in those under the age of 20. The presentation of benign nodules at this age is less likely, and thus the potential for malignancy is far greater.)

http://en.wikipedia.org/wiki/Thyroid_neoplasm

(Solitary thyroid nodules are more common in females yet more worrisome in males. Other associations with neoplastic nodules are family history of thyroid cancer and prior radiation to the head and neck.

Radiation exposure to the head and neck may be for historic indications such as tonsillar and adenoid hypertrophy, "enlarged thymus", acne vulgaris, or current indications such as Hodgkin's lymphoma. Children living near the Chernobyl nuclear power plant during the catastrophe of 1986 have experienced a 60-fold increase in the incidence of thyroid cancer. Thyroid cancer arising in the background of radiation is often multifocal with a high incidence of lymph node metastasis and has a poor prognosis)

http://en.wikipedia.org/wiki/Thyroid_nodule

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Anonymous said...

No one will be held accountable when these kids get sick, outrageous, thanks japan, you fuckup

Anonymous said...

There seem to be very few statistics regarding very small nodules. Most statistics are about nodules > 1 cm. For example :

http://www.thyroidmanager.org/Chapter18/18-noduletxt.htm

Non-palpable thyroid nodules, typically < 1 cm in size, are usually non-malignant.
Whether to do US guided FNA on all non-palpable nodules, those generally smaller than 1cm and often as small as 3-5mm, is a question not clearly answered. Many patients request biopsy because they are anxious about the problem. Some studies have indicated that the incidence of carcinoma in these clinically non-detectable nodules is effectively the same as in larger nodules. At present our operational approach is to attempt biopsy in nodules 5-10 mm in size, and base treatment on the results. In smaller nodules or those judged very difficult to sample, the patient is advised to have repeated follow-up by exam and US at 6-12 month intervals. In a study of this problem by Papini et al (NR2), 7% of nodules under 1 cm in size were found to harbor carcinomas.

Or there : http://radiographics.rsna.org/content/27/3/847.full

Size of Nodule

The size of a nodule is not helpful for predicting or excluding malignancy. There is a common but mistaken practice of selecting the largest nodule in a multinodular thyroid for FNA. The Society of Radiologists in Ultrasound recently recommended that the selection of a nodule for FNA in a multinodular thyroid be based primarily on US characteristics rather than nodule size (1). Papini et al (2) analyzed their experience with FNA of 402 thyroid nodules, each with a maximal diameter of 8–15 mm. Their findings showed that the selection of nodules for biopsy on the sole basis of a size of more than 1 cm would have led to the selection of 325 of the nodules for FNA, with resultant detection of 61% of thyroid cancers.

Nancy said...

Hoping maybe you see this even though the article is months old. I have been reading studies (got some pre-publish copies) that talk about thyroid problems beyond cancer. Thyroid damage, nodules, etc. can also be caused by iodine 131 exposure and are in MUCH greater number than actual thyroid cancers. So what your seeing here matters beyond cancers. These are signs of thyroid damage and that damage will result in various types of thyroid disorders like hypothyroidism. Making things much worse is that thyroid disorders can be hard to diagnose. Sometimes extensive blood work and an experienced endocrinologist need to be involved. There are lots of thyroid related problems that go undiagnosed in places that don't have nuclear disasters.

juliangreenfield said...

It’s a sheer disgrace that children are suffering from lumps.

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