A Comprehensive Review of the Progress and Evaluation of the Thyroid Ultrasound Examination Program, the Fukushima Health Management Survey.
A Comprehensive Review of the Progress and Evaluation of the Thyroid Ultrasound Examination Program, the Fukushima Health Management Survey.
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DOI：
10.2188/jea.je20210271
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发表时间：
2022
影响因子：
4.7
通讯作者：
中科院分区：
文献类型：
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2011年3月11日发生的东日本大地震和随后发生的海啸导致福岛第一核电站发生事故，核反应堆遭到大面积损坏，导致大量放射性污染。作为福岛健康管理调查项目的一部分，福岛县实施了甲状腺超声检查（TUE）计划，以回应核事故发生时0-18岁居民对辐射暴露造成的健康风险的担忧。该计划包括初步检查和确认检查。在初步检查中，使用便携式超声设备检查甲状腺结节和囊肿。进行验证性检查以进行临床或细胞学诊断。截至2021年6月30日，第一、二、三、四轮调查以及25岁调查中分别有116名、71名、31名、36名和9名受试者被确定为细胞学诊断为恶性或可疑恶性的结节。目前，第四轮调查验证性审查和第五轮调查初步验证性审查正在进行中。结合联合国原子辐射影响科学委员会2020年报告中估计的甲状腺吸收辐射剂量较低，我们的结果表明，福岛县儿童甲状腺癌发病率的增加不是由辐射暴露引起的，而是由高灵敏度的检测方法引起的。正如本次审查中详细介绍的那样，我们的计划中持续存在挑战，例如针对过度诊断风险的行动以及为参与者及其家人提供心理支持。
The Great East Japan Earthquake on March 11, 2011, and the subsequent tsunami caused an accident at the Fukushima Daiichi Nuclear Power Plant, in which extensive damage to the nuclear power reactors resulted in massive radioactive contamination. Fukushima Prefecture implemented the Thyroid Ultrasound Examination (TUE) program as part of the Fukushima Health Management Survey project in response to residents’ anxieties about health risks due to radiation exposure for residents aged 0–18 years at the time of the nuclear accident. This program consisted of the primary examination and the confirmatory examination. In the primary examination, thyroid nodules and cysts were examined using portable ultrasound apparatuses. The confirmatory examination was performed to have clinical or cytological diagnosis. As of June 30, 2021, 116, 71, 31, 36, and 9 examinees in the first, second, third, and fourth round of surveys, and the survey at age 25 years, respectively, were determined to have nodules cytologically diagnosed as malignant or suspicious for malignancy. The confirmatory examination of the fourth-round survey and the primary and confirmatory examination of fifth-round survey are currently in progress. Together with the low thyroid absorbed radiation dose estimated in the United Nations Scientific Committee on the Effects of Atomic Radiation 2020 report, our results suggested that the increased incidence of childhood thyroid cancer in Fukushima Prefecture was not caused by radiation exposure, but rather by the highly sensitive detection method. As detailed in this review, there were ongoing challenges in our program, such as actions against the risk of overdiagnosis and psychological support for participants and their families.