Sunday, November 18, 2012

Is Thyroid Cancer in Children Rare in Japan?

Tweets that get retweeted by people in Japan that I follow have been abuzz with the talk given by Dr. Helen Caldicott, whom Mr. Kouta Kinoshita has invited to speak in several cities in Japan. Many seem to be freaking out, particularly as the news of another case of thyroid cancer found among Fukushima children broke at the same time and Dr. Caldicott states it is extremely rare for children to have thyroid cancer.

Is it that rare?

People on Twitter are saying "2 cases [actually one confirmed case in September and one suspected case this time] of thyroid cancer among 114,000 children tested so far in Fukushima, that's extraordinarily high, not seen anywhere else in the world! It's usually one in several millions for children!"

So I decided to look for the data on thyroid cancer cases by sex and age, and found it at Japan's National Cancer Center's website for cancer statistics.

According to Center for Cancer Control and Information Services, National Cancer Center, Japan (from their excel sheet cancer_incidence(1975-2007).xls):

Number of cases in 2007

age 0 - 14: zero
age 15 - 19: 14

age 0 - 9: zero
age 10 -14: 6
age 15 - 19: 41

Disease rates in 2007 (cases per 100,000)

age 0 - 14: zero
age 15 - 19: 0.4

age 0 - 9: zero
age 10 - 14: 0.2
age 15 - 19: 1.3

The sex and the age of the child with the confirmed case have not been disclosed, but the second suspected case is a girl in her late teens, between 16 and 18 years old, as disclosed by the Fukushima Medical University committee.

There are total 365,590 children in Fukushima aged 0 to 19 as of October 2011, according to the Fukushima prefectural government data. (Excel sheet)

National Cancer Center's data shows the disease rate for girls aged 10 to 14 hasn't changed much over the years, but that for girls aged 15 to 19 has risen with the rise of the overall rate for the entire females. For Japanese females, a big jump seems to have happened between 1989 and 1991.

As a comparison, here's the link to UK's thyroid cancer incidence statistics. The rate for females age 15 to 19 looks to be slightly above 1 per 100,000.


(UPDATE) One of my Twitter followers sent me a tweet with the link to Dr. Caldicott's speech. In it, she says the first confirmed case of thyroid cancer was a 12-year-old boy. No idea how she got that information, as the Fukushima prefectural government and Fukushima Medical University haven't disclosed the details of the child at all.

So, for that age group (10 to 14), the maximum rate since 1975 is 0.5 per 100,000 in 1999, according to the National Cancer Center data above.


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Anonymous said...

It's a bit too early, in any case.

Nancy said...

Right now I am more worried about the unusual levels of nodules (both number of kids with them and number/size of nodules found). Also those that have been able to get a second opinion, the doctors found much worse abnormalities than the Health Survey did.
The health survey is peddling a couple of inaccurate ideas to the public. One that nobody had thyroid abnormalities until 4 years after Chernobyl. That is known to not be true. It took 4 years before outside testing was allowed by the government and some were found at that point to already have cancers and some had spread outside the thyroid.

This is an important window of time right now for these kids. The health survey is a joke and is not a replacement for real medical care. The efforts to intimidate doctors into not testing or treating children for what might be radiation relate thyroid problems has become THE problem now. This is when these kids need real medical oversight and the health survey is not doing this. A scan by a lab tech that gets an assembly line classification without an exam, medical history and bloodwork is NOT proper medical care. These kids need access to a doctor of their choice now and that doctor should be deciding the course of care for that child. Not this arbitrary 2 year recheck nonsense.

The cancer classifications are worrying even if they are currently within the normal numbers because the nodules rates are not within the normal numbers and it is known the health survey is missing or misinforming about childrens actual condition. The two cancers found might be nothing, the health survey has no way of knowing for sure if they are fuku related or not. They are making assurances they can't factually make.

Anonymous said...

Back to the kitchen with you.

Anonymous said...

Um, why didn't they carry out a reference survey on an unaffected population (ideally also tsunami evacuees, non-contaminated zone, double-blind study)? Seems like standard international practice for medical investigations, and would settle the "abnormalous nodule" question. (But a lot of pretty standard international stuff such as "catalytic hydrogen recombiners" and "vent filters" apparently didn't make it to Japan as well.)

Anonymous said...

A bit too early? Or too late, depending on your perspective.

I'd imagine it must be getting increasingly difficult to find a control group for non-contaminated people, what with the increase of all the different kinds of dangerous crap we've been screwing around with lately, how commonly they're used, and how easily they travel across the planet.

Anonymous said...

A bit early for cancers to show up. Even if they do, I think (and hope) that it will be at the limit of statistical significance - say, 3 or 4 new cases in 2014 instead of the usual 2 or something like that.

Anonymous said...

Nancy, this is not the result of general health survey but ultrasound testing. Also, they've never said it took 4 years for the thyroid abnormalities to show up in Chernobyl. They said thyroid cancer.

arevamirpal::laprimavera said...

Anon at 6:18AM, as with so many other things since the accident, it apparently didn't occur to the government officials to test children outside Fukushima in a systematic way, until very recently. Now they say they will start testing.

The number of cases for thyroid cancer in children under 20 (legal definition of non-adult in Japan) each year looks too small to run a meaningful statistical analysis, but I'm sure there will be some people claiming "100% jump in thyroid cancer in children" or something to that extent.

Anonymous said...

It is possible to test if a thyroid cancer is caused by absorbtion of particles from Fukushima reactors or not. Their is a DNA test that does that.
Anti Nuclear Associations would be wise to offer to test freely the persons from Japan or are suffering from thyroid cancer. If the cancers are cause by the Fukushima, the patients DNA will have had their DNA altered in a specific way. The patients should be compensated by the autorities.

moreover, similar DNA tests for other types of cancers should be possible, similar to proving that some cancers are caused by smoking by exmining the DNA.

Anonymous said...

They should test all thyroid cancers in Japan to find the signature of radiations on the DNA.
They could find out that the cancers that they assumed were not caused by radiations (such as caused by iodine and cesium absobtion), could actually have also been caused by contamination. Either Fukushima 3/11 on-going accident or other very minor accident that were at first considered minor or not dangerous. This way they would not be able to lie to population anymore. It is not enough to say that it is not caused by Fukushima, they should prove it because 43% of kids have Fukushima caused nodules on their thyroid, it is normal to assume that Fukushima is the cause.

Anonymous said...

>43% of kids have Fukushima caused nodules on their thyroid

They most certainly do not. Stop spreading loose talk.

Anonymous said...

Here's an interesting thyroid fact Pacific islanders suffer some of the highest rates of thyroid cancer in the world. The study discounts nuclear testing as a major factor due to distance from the testing areas but it sure seems strange because the US, UK and France blew many tons of fallout into the air and sea.

"In most continental nations, the incidence rates of thyroid cancer among women range from about two to about six cases per year per 100 000 population. This is the situation throughout Europe, North and South America, Asia, and Australia. In contrast, rates among numerous Pacific island groups exceed six per 100 000. The world's highest incidence rates (exceeding 15 per 100 000) are reported among females in Hawaii, French Polynesia, and New Caledonia. The high rates in the Pacific islands tend to affect all ethnic groups, although considerably more so native (Polynesian, Melanesian) than European (white) residents. Among western countries, the highest rates of thyroid cancer are reported for the island of Iceland, while no excess is seen among residents of islands of the South Atlantic ocean."

arevamirpal::laprimavera said...

Anon above, thanks for the info. The rate among Japanese women is rather high, too. In 2007, it was 12.9 per 100,000 for all women, with the 40 to 44 age group exceeding 15 and highest 24 in the 60 to 64 group.

Anonymous said...

"...They most certainly do not. Stop spreading loose talk...."

is this a joke? 43% of thyroid cyst on japanese children have certainly nothing to do with Fukushima? is this a joke or you are working for the Japanese government?
Have you done a little bit of reading about DNA damage by radiation from radionuclides?
Seems you know nothing about it!
A little bit of learning for you:
even very little contamination (even less than 2 times normal background) does severly damage DNA.
I would call you a murderer if you were in front of me denying the reality to people around you.
Shame on you if you are guilty of causing pain to others. Surely, since you are so self confident, you must have read the latest research results that show that very little contamination causes very severe DNA damage? And you want people to think that Fukushima has nothing to do with thyroid cancers or thyroid cyst? Are you out of your mind or are you an irrational japanese fascist that can only think with his emotions?

Anonymous said...

Anon above, 0.5% of children tested so far in Fukushima had nodules larger than 5mm, the size the specialists pay close attention to. 0.005% of children, or 5 children, had cysts larger than 20mm, the size the specialists pay close attention to. Please stop trashing others just because they see things differently (i.e. with better numbers).

The anon you're trashing anonymously is responding to another anon (probably you) claiming 43% of Fukushima children had nodules. That's BS, or sloppy scare tactics. So you now self-corrected it to "cysts".

Anonymous said...

Countries with the highest rates of thyroid cancer.

Country Incidence per 100,000 individuals
1 Iceland 16.3
2 Israel 15.8
3 Malta 15.7
4 United States 14.2
5 Qatar 14.1
6 Croatia 14
7 Belarus 13.1
8 Vanuatu 12.8
9 Cyprus 12.3
10 France 12.1
Source: International Agency for Research on Cancer

Anonymous said...

"...0.005% of children, or 5 children, had cysts larger than 20mm...

that is total bs number. Can you read Japase?
Read again:

43.1% have cysts of size over 20mm, increase from 35% last year.
And you are saying specialists look at size of more than 20mm? Well, this is 43%.
Are you planning to change your story now by saying that specialists are looking at over 50mm?
that 5cm you know. I hope they start looking at it as you say, from 2cm. I hope you would be scared if you children have 2cm size cysts on their thyroid, probably you don't have children to be dangerous. Do you know that these people are now risking their lives? And you want to tell us everything is just normal and fine?
No where else in the world children has cyst of over 2cm at a rate of 43%. You think this is normal? You want us to think it is normal? What kind of preaching are you doing now? Do you work for the Japanese governement or what? Who are you? Are you working for the nuclear industry? Identify please?

Anonymous said...

"...cysts larger than 20mm, the size the specialists pay close attention to..."

Can you please tell us who is the specialist who says this is fine? Because this sounds totally ridiculous. No where in the world so many children have cysts like that, and you want people to think that this is normal, people should pretend nothing is bad for health here?
You must work for the nuclear industry to spread such claim. What is going in Fukushima, Kanto and Japan is not normal at all.

But I must say, the numbers are not easy to read from the table.
But even if the cyst are 1.5cm, this is still not normal at all that 43% of the children have such cyst. I would be worried that I am being contaminated and thatis would be much better for my health that this contamination stops.
Stop telling children are fine with cyst in their thyroid, this is total crap. A cyst on the thyroid might be fine if it natural, but if it caused by an on-going contamination, the children must move away from the source of danger. This is basic common sense.

arevamirpal::laprimavera said...

Anon above, 5 children out of 95,954 who were tested in 2011 and 2012 so far had cysts larger than 20 millimeters.

The number you're quoting, 43%, from your link, is the percentage of children in the 2012 test as reported back in September who had any cyst at all, including 0.007% (or 3 people) who had cysts larger than 20mm. Your link has the older Fukushima government page than my latest post below, but I don't see anywhere that says 43% having cysts larger than 20mm.

And please stop accusing other commenters as "working for the government or TEPCO". I'm very tired of it, and it is not productive.

Anonymous said...

test them for radiation DNA damage.
DNA can't get repaired.

"...The anon you're trashing anonymously is responding to another anon (probably you) claiming 43% of Fukushima children had nodules..."

this is a fact, 43% have cyst. I would worry my kids have cysts of 1cm and live in Japan now.
It would be ignorant to ignore the fact that contamination is wide spread and that a cyst on the thyroid is a sign that my children have been contaminated. I would need to be more careful if I am to be a good parent because the contamination is on-going and every day they are becoming more contaminated. It has nothing to do with "scare tactic", it is just commom sense to save people.
I would say you are using a "pro-nuclear activist tactic" to tell people not worry about radiation.
This is non-sense. Radiation are dangerous, they are very lethal and have killed may people so far and impaired the lifes of many children near chernobyl. It is un-wise not to tell the truth to other to be careful about radiation. Tell them the truth, they will be the one to judge, but don't hide it because it would be a "scared tactict" to do so.

Cancer migh be cured, but radiation caused the damages and will cause many others problems like those that we see in Japan now, like higher rate of cardiac arrest, pneumonia, eyes disease (glaucoma, cataract or retinal detachment from cesium and other radionuclides burns)or leukemia for example.

Anonymous said...

"...Spec so far in Fukushima had nodules larger than 5mm, the size the specialists pay close attention to..."¸

Did you read this?

"The data should be made available. And they should be consulting with international experts ASAP. And the lesions on the ultrasounds should all be biopsied and they're not being biopsied. And if they're not being biopsied then that's ultimate medical irresponsibility. Because if some of these children have cancer and they're not treated they're going to die...Haugen agreed with the Caldicott's assessment that it is surprising for kids to "have this many nodules and cysts seen, especially this soon after the accident," and the fact that "this something that is not more widely known. He added that ultrasound technology is much more sensitive today so cysts (i.e. small sacs of fluid) smaller than 2 centimeters don't need to be biopsied but solid nodules (i.e. clumps of cells) larger than 5 millimeters should be biopsied... "

A specialist said that only 5cm or more must be biopsied but that is not the same thing as saying that only children with 5cm or more must be paid closed attention to. Some specialists think that they should all be biopsied. Because the problem with radiation is that it is slowly damaging further, therefore it needs to be acted upon to avoid certain further damages.

Anonymous said...

Anon at 9:01PM, have you attended elementary school at all? Get your unit straight. 5cm is 50mm.

Also, nodules are very different from cysts, in case you haven't figured that out yet.

Anonymous said...

Caldicott would be just funny if she didn't scare people (retarded people that don't know how to read, but still).

@laprimavera, the cancer statistics you are quoting are from cases detected every year by regular medical practice? Cause the thyroid screening they are conducting right now is anything but regular. Doctors don't usually test 100,000 kids to check if they have thyroid cancer. This means that some asymptomatic tumors would be detected much earlier than they would have been before March 11.

arevamirpal::laprimavera said...

Anon at 11:54PM, yes, they are cases detected by regular practice each year. I know what you're saying. That's what I've been trying to tell to people and miserably failed so far.

Anonymous said...

"...they are cases detected by regular practice each year..."

yes, but never 43% of kids have been detected with cysts in any case. This is what Caldicott wrote:

it is surprising for kids to "have this many nodules and cysts seen, especially this soon after the accident"

Caldicott is very worried for people in Fukushima, Kanto, Japan and other regions affected.
Your are misquoting if you think that the message is that people should not be worried.

Radiations are dangerous and kill slowly over time. The vast majority of people affected by Chernobyl became sick over decades.
Thyroid is sensitive to radiation and people contaminated will often have thyroid damage. When there is wide spread contamination and people have thyroid cysts or nodule, it is a sign of concern.

I can't beleive someone is trying to down play the danger here. This is not reasonable. Lives are at risk here. Children's lives.

Anonymous said...

Anon, I'm not misquoting Caldicott, I think she is batshit insane.

>but never 43% of kids have been detected with cysts in any case

There has never been a study like this. From previous studies we can say that nodules and cysts are very common in adults (up to 67% of the general population has thyroid cysts or nodules when examined with high frequency ultrasound), but there is no precedent of similar studies in kids between 2 and 20 years, and specially no study reporting cysts so small. Usually doctors only recommend biopsies if the cyst is over 1 or 2 centimeters, and in Fukushima they are reporting cysts even smaller than 3 millimeters. A millimeter is ten times smaller than a centimeter, since you seem to have problems with that.

Anonymous said...

"...there is no precedent of similar studies..."
Did you read this study?

Cystic thyroid lesions in children; by Yoskovitch and all.

over a course of 18 years, 24 childrens between had cyst or partial cyst, quoting:
...Twenty-four patients (19 girls, 5 boys) aged 6 to 18 years received the diagnosis of cystic lesions of the thyroid...; detection was done via ultrasound.

Thyroid abnormalities are more prevalent in US on downwinders, where too mnay people who later became sick from different sorts of rare cancers proven to be caused by radiations from atomic bomb testings.

Same as for Chernobyl.

"I think she is batshit insane".
People who don't agree with you are not insane.
Your habit to insult people and/or reknown scientist and lack of rationality is showing that you are emotionally engaged and biased and therefore probbaly not to be trusted.

Radiations are causing thyroid cancers and thyroid related health issues. You can't deny it.
It is not normal at all that children have 5 cysts on their thyroid. You don't need to insult Dr. Caldicott, any doctor will tell you that there is something really wrong with that, specially in a highly radiactive context. Did you notice that the percentage of children afflicted with cysts in Japan (Fukushima data) have increased since last years test results?
Thyroid cancer is very aggressive in children by the way and a continued exposure to radiations is not a very optimistic situation and will lead to worst health prognostics. I would not want to downplay this if I wanted to save lifes. But you choose your side though history has proven the danger of radiations to children many times already.

Given the knowledge that we have, thyroid cancers will spread in Japan, and you can say that people should not worry, but this is totally wrong.

"...There has never been a study like this..."
This is not true.

Anonymous said...

Anon, the study you quote examined the results of 24 kids who had cystic lesions in the thyroid to analyze the kind of cysts they had. This is very different from examining more that 100,000 kids with high frequency ultrasound to see if they have cysts or not.

>Radiations are causing thyroid cancers and thyroid related health issues.
>Thyroid cancer is very aggressive in children by the way and a continued exposure to radiations is not a very optimistic situation

Thyroid damage happens as a result of radioactive Iodine intake. Since I-131 has a half life of 8 days, the potential damage was caused during the first 2-3 months after the accident.

About Caldicott, it's not that I disagree with her, it's that she does not have clue about what she's talking about and goes around sending apocalyptic messages based on this lack of information. This reflects very badly on the antinuclear movement.

Anonymous said...

Unfortunately, Dr. Caldicott is one of "foreigners" that many Japanese have decided to worship, no matter what, when it comes to the Fukushima nuclear accident. They want to hear bad news, the worse the better. For whatever strange reason or unreason, that fits their temperament - "we're victims, we will all fail, and only foreigners speak the truth to us".

Anonymous said...

"...only foreigners speak the truth to us..."

There are many Japanese scientists who speak the truth and tell people to avoid getting contaminated. Unfortunalty many ignorant pro-nuclear activists tell people that there are no dangers and most Japanese believe them, so they don't avoid the dangers and many will get killed by the radiations. One big problem in Japan though, it's that is not a free speach country. People who say the opposite of what the governement wants them to beleive get into very serious trouble. So many have to hide to tell the truth.

Anonymous said...

>People who say the opposite of what the governement wants them to beleive get into very serious trouble. So many have to hide to tell the truth.

You have no clue. A lot of people in Japan have been calling the government murderers and liars since day one and they still do. Unfortunately, freedom of speech is freedom to lie, and a lot of misinformation has been doing the rounds since day one too, not only from Japan, also from prominent foreign hacks Caldicott.

Anonymous said...

Fukushima npp spewed around huge amounts of radioactive contaminants, including iodine. The latter is known to cause thyroid cancer. If I lived in Fukushima I would test my kids thyroids every six months, without bothering with the statistics fine print. Better safe than sorry.
Even if under normal circumstances a 19mm cyst is not considered a problem after a nuclear accident risks are higher so why not take some extra precaution?
As the government told us, there was "no immediate danger for health", so we have been warned clearly enough.

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