A Comparison of Yamashita et al 1998 and National Thyroid Cancer Data in Japan

The purpose of this post is to inform the public that :

a.Fukushima Medical University staff engaged in the Thyroid health survey of Fukushima children cite sources based on Chernobyl data which the staff claims support 1. A long 4-5 year latent period for thyroid cancer 2. A slow progression of the disease. In fact these sources actually confirm that latent periods in early onset cases of the disease post Chernobyl were very short, and these sources report that disease progression in the early onset cases post Chernobyl was rapid. The authors of these Chernobyl reports include Dr S. Yamashita, formerly of the Fukushima Medical University Fukushima Thyroid Health Survey.

b. In 2013, National Cancer statistics have been created for the period 1975 to 2008. This national data has been created from from diverse local and regional medical repositories. The data is available to the public at the link given below.

1.
http://www.ncbi.nlm.nih.gov/pubmed/9700473 Abstract

https://www.jstage.jst.go.jp/article/endocrj1993/45/2/45_2_203/_pdf Free Full Text.

Childhood thyroid cancer: comparison of Japan and Belarus.
Shirahige Y, Ito M, Ashizawa K, Motomura T, Yokoyama N, Namba H, Fukata S, Yokozawa T, Ishikawa N, Mimura T, Yamashita S, Sekine I, Kuma K, Ito K, Nagataki S.
Source

First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.

Endocr J. 1998 Apr;45(2):203-9.

Abstract

The high incidence of childhood thyroid cancer in Belarus is suspected to be due to radiation exposure after the Chernobyl reactor accident. To clarify the clinical and histological characteristics of childhood thyroid cancer in Belarus, we therefore compared these patients to a radiation non-exposed control series in Japan. In Belarus, 26 thyroid cancers in subjects aged 15 or younger were diagnosed among 25,000 screened between 1991 and 1995 by Chernobyl-Sasakawa Health and Medical Cooperation Project. The clinical and morphologic features of these 26 cases were compared to 37 childhood thyroid cancers in Japan diagnosed between 1962 and 1995. The age distribution at operation in Belarus showed a peak at 10 years old, with a subsequent fall in numbers. In contrast, the age distribution at operation in Japan showed a smooth increase between the ages of 8 and 14. The mean tumor diameter was smaller in Belarus than that in Japan (1.4 +/- 0.7 vs. 4.1 +/- 1.7 cm, P < 0.001). The sex ratio, regional lymph node metastasis, extension to surrounding tissues or lung metastasis did not differ significantly. Histologically, all cases in Belarus were papillary and in Japan 33 cases were papillary and 4 cases were follicular carcinomas. Among papillary carcinomas, the frequency of a solid growth pattern, a criteria for classifying a tumor as poorly differentiated, was higher in Belarus than that in Japan (61.5 vs. 18.2%, P < 0.001). The difference between the features of childhood thyroid cancer in Japan and Belarus may be due to the difference in the process of carcinogenesis, but more direct evidence and further analysis by molecular epidemiology are needed in Belarussian cases. end quote

Yamashita et al above cite the Chernobyl-Sasakawa Health and Medical Cooperation Project as their data source. The public data published by this organization is : http://www.smhf.or.jp/data01/chernobyl_decade.pdf
Chernobyl A Decade – Proceedings of the Fifth Chernobyl Sasakawa Medical Cooperation Symposium, Kiev, Ukraine, 14-15 October 1996 (International Congress S.)
Shunichi Yamashita (Edited by), Yoshisada Shibata (Edited by)

The source of the data from which the following chart is derived is:
Center for Cancer Control and Information Services,
National Cancer Center, Japan

Matsuda A, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H and The Japan Cancer Surveillance Research Group. Cancer Incidence and Incidence Rates in Japan in 2007: A Study of 21 Population-based Cancer Registries for the Monitoring of Cancer Incidence in Japan (MCIJ) Project. Japanese Journal of Clinical Oncology, 43: 328-336, 2013 Download Source Data as Excel spreadsheets at http://ganjoho.jp/pro/statistics/en/table_download.html


Source: Matsuda et. al. as above.

3. http://link.springer.com/content/pdf/10.1007/BF02035773.pdf
Deposition of gamma-emitting nuclides in Japan after the reactor-IV accident at Chernobyl‘

Journal of Radioanalytical and Nuclear Chemistry
Volume 116, Issue 2 , pp 291-306
Cover Date 1987-12-01
Authors

M. Aoyama (1)
K. Hirose (1)
Y. Sugimura (1)

Author Affiliations

1. Geochemical Laboratory, Meteorological Research Institute, Nagamine 1-1, Yatabe, 305, Tsukuba, Ibaraki, (Japan)

Abstract

The wet and dry deposition of gamma-emitting nuclides are presented for Tsukuba and eleven stations in Japan following the nuclear reactor accident at Chernobyl’. In Japan fallout from the reactor at Chernobyl’ was first detected on May 3, 1986, a week after the accident. Abruptly high radioactive deposition, which mainly consists of131I,132I,103Ru,137Cs and134Cs, was observed in early May. The cumulative amount of131I,103Ru and137Cs in May at Tsukuba were 5854±838 Bq·m−2, 364±54 Bq·m−2 and 130±26 Bq·m−2 (decay was corrected to April 26), respectively. The monthly137Cs deposition in May corresponds to 2.5% of the cumulative137Cs deposition during the period from 1960 through 1982. Most of the Chernobyl’ radioactivities, especially131I, are scavenged from the atmosphere by the wet removal process.

4. http://www.rri.kyoto-u.ac.jp/NSRG/reports/kr79/kr79pdf/Malko2.pdf

Chernobyl Radiation-induced Thyroid Cancers in Belarus
Mikhail V. MALKO
Joint Institute of Power and Nuclear Research, National Academy of Sciences of Belarus Krasin Str. 99, Minsk, Sosny, 220109, Republic
of Belarus: mvmalko@malkom.belpak.minsk.by QUOTE: ” absence of marked latency period is another feature of radiation-induced thyroid cancers caused in Belarus as a result of this accident. “

end quote.

annual averages over eight year periods:
1971 to 1978 = 10/8 = 1.25
1979 to 1986 = 6/8 = 0.75
1987 to 1994 = 331/8 = 41.38
1995 to 2002 = 241/3 = 80.33


Conclusions

Doctor Yamashita

Dr Yamashita is now well known throughout Japan and the world for communicating a particular public health perspective of risk of disease to people living within areas contaminated by the Fukushima Reactor accident of March 2011. I am therefore citing the paper “Childhood thyroid cancer: comparison of Japan and Belarus.
Shirahige Y, Ito M, Ashizawa K, Motomura T, Yokoyama N, Namba H, Fukata S, Yokozawa T, Ishikawa N, Mimura T, Yamashita S, Sekine I, Kuma K, Ito K, Nagataki S. as “Yamashita et. al.

This paper is interesting as a comparison of Dr Yamashita’s published views in 1998 with those he has expressed since March 2011.

1. The Latent Period for Thyroid Cancer

Since the reactor accident Dr Yamashita and his colleagues in Fukushima have repeatedly stated that the experience of Chernobyl confirmed that the latent period for childhood thyroid cancer was five years. As a result, to date authorities monitoring the affected children of Fukushima have stated that no cases of thyroid cancer has yet arisen due to the Fukushima nuclear accident.

However Yamashita et al 1998, reported the following: “tumors
arising in the Chernobyl population began developing with surprising rapidity and short latency.”
(Yamashita et. al., 1998, pdf page 2, journal page 204). The authors consider this rapid onset of disease to be notable compared to thyroid cancers which occurred prior to the Chernobyl nuclear accident. (ibid, pdf page 2, journal page 204).

However, Malko describes that the lack of latent period period he found in the Belarus Chernobyl exposed population could be explained in terms of the large sample size and the normally low rate of incidence of the disease. That is, where a causative event affects a large population, it is easy to see the increase in incidence of resulting disease. It becomes possible, with little or no doubt, to assign cause to effect if the cause is a strong trigger, the normal incidence of the disease is low, and the population affected by the cause is large. (Radiation-induced Thyroid Cancers in Belarus, Mikhail V. MALKO, Joint Institute of Power and Nuclear Research, National Academy of Sciences of Belarus.)

In contrast, Yamashita et al 1998 call for more research in the matter.

US CDC publication of “Minimum Latency & Types or Categories of Cancer” John Howard, M.D., Administrator World Trade Center Health Program, 9.11 Monitoring and Treatment, Revision: May 1, 2013, http://www.cdc.gov/wtc/pdfs/wtchpminlatcancer2013-05-01.pdf states that the latent period for Thyroid cancer is :
“2.5 years, based on low estimates used for lifetime risk modeling of low-level ionizing radiation studies”, pdf page 1.

Given that authorities as diverse as Malko, Belarus, US CDC/9.11 Health Monitoring and Treatment, USA, and Yamashita et al 1998 all contradict Yamashita post March 2011, I conclude that the following statement issued to the public and the media by Fukushima Medical University in relation to the rapid rise in cases of thyroid cancer cases suffered by the children of Fukushima, as monitored by the University, to be in error:

“Researchers at Fukushima Medical University, which has been taking the leading role in the study, have said they do not believe the most recent cases are related to the nuclear crisis.”

They point out that thyroid cancer cases were not found among children hit by the 1986 Chernobyl nuclear accident until four to five years later.” end quote.
Japan Times. Kyodo. 06/05/2013 http://www.japantimes.co.jp/news/2013/06/05/national/fukushima-survey-lists-12-confirmed-15-suspected-thyroid-cancer-cases/#.UbCB7Ovrk7A

Further : “…experts at Fukushima Medical University said that it is too early to link the cancer cases to the nuclear disaster. They said the 1986 Chernobyl accident showed that it takes at least four to five years before thyroid cancer is detected.” Source: Thyroid cancer hits Fukushima
5 Jun 2013, 12:57 pm – Source: AAP, SBS TV Australia, http://www.sbs.com.au/news/article/1774837/Thyroid-cancer-hits-Fukushima

I conclude that the dogmatic stance taken by Yamashita and the Fukushima Medical University since March 2011 is an extreme position which contradict highly qualified authorities. Including Yamashita, pre March 2011.

I further conclude that the stance taken by Yamashita and the Fukushima Medical University is contrary to the direct observation made by all the authorities cited above. Yamashita et al 1998 report a direct observation of the Chernobyl experience in this matter and cite as their source the Chernobyl-Sasakawa Health and Medical Cooperation Project. The relevant public document issued by this source is : Chernobyl A Decade – Proceedings of the Fifth Chernobyl Sasakawa Medical Cooperation Symposium, Kiev, Ukraine, 14-15 October 1996 (International Congress S.)
Shunichi Yamashita (Edited by), Yoshisada Shibata (Edited by)

I conclude that I am dumbfounded at the fact that at a time when Dr Yamashita was directly involved in the Fukushima Medical University’s health survey of radiation exposed children in Fukushima, and while that organisation was engaged in examining the children, as it still is, for thyroid disease, it cited Chernobyl as proof of a five year latent period for the disease screened for when in fact it knew that the Chernobyl findings directly contradict the statements being made and which continue to be made, by Fukushima Medical staff.

I am further dumbfounded by the fact that a key leader in the Fukushima health survey conducted by the Fukushima Medical University was the same Dr Yamashita who was indeed involved in the creation and publication of the relevant Chernobyl source data and in it’s subsequent academic study and publication. A key finding of which was “tumors
arising in the Chernobyl population began developing with surprising rapidity and short latency.
” (Yamashita et. al., 1998, pdf page 2, journal page 204). The authors consider this rapid onset of disease to be notable compared to thyroid cancers which occurred prior to the Chernobyl nuclear accident. (Childhood thyroid cancer: comparison of Japan and Belarus,Yamashita et al,First Department of Internal Medicine, Nagasaki University School of Medicine, Japan. pdf page 2, journal page 204).

This 1998 finding in relation to radio-genic Thyroid cancer is further supported by the following 2004 finding:

Latency Period of Thyroid Neoplasia After Radiation Exposure
Shoichi Kikuchi, MD, PhD, Nancy D. Perrier, MD, Philip Ituarte, PhD, MPH, Allan E. Siperstein, MD, Quan-Yang Duh, MD, and Orlo H. Clark, MD

From the From Department of Surgery, UCSF Affiliated Hospitals, San Francisco, California.

Latency Period of Benign and Malignant Thyroid Tumors

Although some sporadic tumors unrelated to radiation may be included among our patients, the shortest latency period for both benign and malignant tumors was 1 year as occurred in 3 patients, whereas the longest time was 69 and 58 years, respectively (Fig. 1).” As published in Journal List nAnn Surg v.239(4); Apr 2004 PMC1356259, available full text at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356259/

Medico-legal opinions may be appropriate in court, but at the moment, the children of Fukushima require rapid diagnosis and treatment, not legal argument.

2. The Delay in Follow Up Examinations and Surgery Experienced by the Fukushima Children

On the 5th of September 2013, a press article in Japanese was published by by SHUEISHA on the WPB News site.

Stephen Walker, living in Japan, provides an English translation of this article which is located at https://nuclearhistory.wordpress.com/2013/09/05/fukushima-child-thyroid-cancer-august-2013/

The article reads as follows:

The Fukushima Prefectural Health Management Survey—set up to examine the impact of radiation exposure from the Fukushima Daiichi nuclear accident—is being conducted on children who were aged 18 or younger when the accident occurred.

In the survey, children undergo ultrasound throat examinations, which look for such thyroid abnormalities as nodules and cysts. The results of these examinations are announced periodically.

On August 20, at a meeting of the Fukushima Prefectural Health Management Survey Review Committee in Fukushima city, an interim report was presented on the results of the survey during the year ended March 31, 2013. At the previous committee meeting in June, it was reported that 12 children had confirmed diagnosis of thyroid cancer. At the August 20 meeting, the number had risen by six, to 18 cases. What does this number actually mean? One of the lawyers acting for litigants in the Fukushima group evacuation lawsuit, Kenichi Ido, explains.

“The prevalence of child thyroid cancer is said to be one in one million. However, Fukushima has a population of around two million, and the current survey covers approximately 360,000 children. Just looking at these results, we can clearly see that the number of cases is much higher than should be expected. Would it not be reasonable to assume that some abnormal situation has occurred?

However, at the Review Committee meeting, Professor Shinichi Suzuki of Fukushima Medical University, which is leading the survey, said that a characteristic of thyroid cancer is that it develops slowly. Based on the size of the melanomas of those diagnosed with thyroid cancer, he stated, “I believe these (cancers) did not form within the last two or three years.” To date, the committee has consistently denied any linkage between the nuclear accident and the 18 confirmed child thyroid cancer cases.

The Prefectural Health Management Survey has the explicit aim of “resolving the health-related anxiety of Fukushima residents”. However, many mothers in the prefecture are voicing their concerns over the way the survey is being conducted. “At the examinations, we are not told any results at all. Some time later, all we receive is a letter saying whether or not a second exam is necessary. If we were to take our children for a thyroid examination at an ordinary clinic, the doctor would tell us immediately if there were any abnormality, such as a nodule, and the size of the nodule.” (Mother of two, resident in Fukushima city)

Lawyer Ido believes that the survey results reports themselves are also leading to distrust. “The interim report on survey results for the year ended March 31, 2013, has been released. According to this, 953 children required secondary examinations. Of these, 30 children were reported to have ‘malignancies or suspected malignancies’. But if we look at the fine print of the report, we find that of the 953 children who required secondary exams, only 594 children have actually undergone these exams. In other words, 359 children have yet to receive these secondary examinations. Statistically speaking, there are almost certainly going to be cases of ‘malignancies or suspected malignancies’ among those children”.

However, at the Review Committee, the results announcement gave the impression that all secondary examinations had been completed. What, in fact, is the likely number of children with thyroid cancer?

Ido says, “In the survey to date, a total of 43 children have been diagnosed with ‘malignancies or suspected malignancies’—13 in the year ended March 31, 2012, and 30 in the year ended March 31, 2013. Among those still to receive secondary exams, if the rate of thyroid caner is the same as those who have undergone the exams, my calculations estimate a total of 79 children. The survey for the current year ending March 31, 2014, covers another 160,000 children. So potentially I think around 100 children have already developed thyroid caner.”

One hundred—but that includes “suspected malignancies”, doesn’t it?

Ido explains, “Although some cases are presented as “suspected”, when cytological diagnosis has been carried out following the second exam—this is the basis for the final judgment on whether the cyst or nodule is malignant—in all but a single case cancer has been confirmed. Hence, even though the initial results may be stated as “suspected”, there is an extremely high probability that the final diagnosis will be caner. The 18 cases reported on August 20 are only those who have completed the cytological diagnosis”.

While it is shocking that 18 children have already been confirmed to have thyroid caner, it is likely that many times that number will also be diagnosed with cancer. How are the people of Fukushima reacting to this reality?

“Parents with a high awareness of the risks are taking it very seriously. They are saying things like, ‘My kids were in the clear this time, but who knows about the next exam?’ Just recently, there was a family who moved to Kobe (in western Japan). The father had been against moving, but he changed his mind when he realized the risk to his children of staying. But there are a lot of people who say. ‘It’s a worry, but what can you do?’ For those in their 50s or 60s, a lot just give up and say ‘It’s too late anyway’”. (Housewife, 50s, resident in Koriyama city)

The results announced on August 20 should have grabbed the headlines and stirred heated debate. In fact, the announcement received only minimal coverage in newspapers and on television. The news barely reached the general public. It seems that even worse news will be needed before people start paying attention.

Reporting: Naoto Tonsho
© SHUEISHA INC. Thanks to Stephen Walker for this translation of the report.

The official release of information without full explanation for the public:

http://www.fmu.ac.jp/radiationhealth/results/20130820.html

The parents of the children involved in the health survey report delays in receiving examination results, what the results mean, delays in follow up examination.

The Fukushima Medical University maintains that newly diagnosed cancers were not related to the radiation exposure the children suffered from March 2011 on. Even though the survey has been ongoing for some time. To quote the article:
“Professor Shinichi Suzuki of Fukushima Medical University, which is leading the survey, said that a characteristic of thyroid cancer is that it develops slowly. Based on the size of the melanomas of those diagnosed with thyroid cancer, he stated, “I believe these (cancers) did not form within the last two or three years.”

Does thyroid cancer develop slowly?

As we have already seen, thyroid cancer developed in the case of the Chernobyl cohort very rapidly. It surprised both international and local medical authorities, including Dr Yamashita. ( Childhood thyroid cancer: comparison of Japan and Belarus.
Shirahige Y, Ito M, Ashizawa K, Motomura T, Yokoyama N, Namba H, Fukata S, Yokozawa T, Ishikawa N, Mimura T, Yamashita S, Sekine I, Kuma K, Ito K, Nagataki S., First Department of Internal Medicine, Nagasaki University School of Medicine, Japan. Endocr J. 1998 Apr;45(2):203-9. : “tumors
arising in the Chernobyl population began developing with surprising rapidity and short latency.” (ibid, pdf page 2, journal page 204).

Yamashita edited the source data relating to the Chernobyl exposed cohort which is published as Chernobyl A Decade – Proceedings of the Fifth Chernobyl Sasakawa Medical Cooperation Symposium, Kiev, Ukraine, 14-15 October 1996 (International Congress S.)
Shunichi Yamashita (Edited by), Yoshisada Shibata (Edited by)

There are several questions to ask about the speed of growth of Thyroid cancer. The Latency of the disease is one factor. The rate at which the tumor grows is another. Both of these factors depend upon expert observation of vulnerable individuals in this case.

The delay in examinations, whether primary examinations, follow up examinations, subsequent periodic examinations or whatever the nature of the examination the FMU chooses to undertake determines when changes in individuals take place. Medical observation is an act. Multiple sources state that early onset thyroid cancer may grow rapidly. Fukushima Medical University claims the relevant Chernobyl data supports their repeatedly stated view. The Chernobyl data for the early period – from the event and with in the immediate period after – shows rapid latent period, and rapid development of disease. One of the sources for this data is Yamashita et. al 1998.

What do other authorities say about the speed of growth of tumor size in the case of the Chernobyl cohort? Did the tumors all grow at the same slow rate as claimed by Dr Suzuki and FMU? Dr Yamnashita, Dr Suzuki and other Fuskushima Medical University staff have repeatedly cited the Chernobyl experience and data as a basis for their actions and determinations. We have seen that these individuals and the FMU have claimed a 5 year latency period occurred in cases of Thyroid cancers arising from exposures due to the Chernobyl accident. And we have seen that this 5 year latency period does not in fact exist. There are minimum and maximum latency periods, and it has been shown above that the latency period can be very short. As Dr Yamashita himself reported in 1998. It can as little as 12 months or less. The heightened risk of contracting thyroid cancer as a result of radiation exposure in fact follows the exposed person for the rest of their lives. This is the fundamental conclusion from Latency Period of Thyroid Neoplasia After Radiation Exposure
Shoichi Kikuchi, MD, PhD, Nancy D. Perrier, MD, Philip Ituarte, PhD, MPH, Allan E. Siperstein, MD, Quan-Yang Duh, MD, and Orlo H. Clark, MD, From the From Department of Surgery, UCSF Affiliated Hospitals, San Francisco, California.

These researchers state: “the shortest latency period for both benign and malignant tumors was 1 year as occurred in 3 patients, whereas the longest time was 69 and 58 years, respectively”. end quote.

Further, Yamashita et al in 1998 found that ““tumors
arising in the Chernobyl population began developing with surprising rapidity and short latency.” (Childhood thyroid cancer: comparison of Japan and Belarus. Shirahige Y, Ito M, Ashizawa K, Motomura T, Yokoyama N, Namba H, Fukata S, Yokozawa T, Ishikawa N, Mimura T, Yamashita S, Sekine I, Kuma K, Ito K, Nagataki S. First Department of Internal Medicine, Nagasaki University School of Medicine, Japan. Endocr J. 1998 Apr;45(2):203-9. pdf page 2.

When Dr Yamashita, Dr Suzuki and Fukushima Medical University regularly refer to their stated long minimum latent period and slow growth of thyroid cancer observed, they claim, in the Chernobyl cohort, did they really expect that noone would go and check the literature?

The staff engaged in the FMU thyriod survey, including Dr Yamashita and people who worked in the survey with him, and cite research from Chernobyl which Yamashita helped create and study, claim, in this case, that the growth of thyroid cancer was slow in the case of the Chernobyl. And we can see that Yamashita et al in 1998, on studying the data report in a learned paper that “tumors arising in the Chernobyl population began developing with surprising rapidity and short latency.” The source data, and there are numerous authors beside Yamashita, states the opposite of what Yamashita and Fukushima Medical University claim for it.

Again, I am dumbfounded. “Surprising rapidity” in development as actually found in the Chernobyl cohort is the exact opposite of what the FMU staff, which previously included Dr Yamashita, are now claiming for that data.

But the data they cite was and remains published. And so anyone who knows of the published papers can look at it to compare if the claims made of it by Fukushima Medical University and its staff are true or false. One can find many authors who support Yamashita et al 1998. All these authors of the Chernobyl data state that in the immediate period after Chernobyl latent period was very short, and that growth of disease was rapid in these early onset cases. And that for those who are not early onset cases, risk remains high throughout life of developing the disease.

Dr Suzuki claims in 2013 that the Chernobyl data says thyroid cancer develops slowly. The actual Chernobyl data, which Dr Yamashita helped create and then helped study, says that “tumors arising in the Chernobyl population began developing with surprising rapidity and short latency.”

The reader of my conclusions here does not have to merely believe or disbelieve me. This is not a matter of belief. One can check what was written about these things. When an expert cites a source, then people listening or reading that expert must be able to go and check the source. It is not about belief, it is about the accuracy of the report. The reports made by Fukushima Medical University and its staff to the public about the speed of growth of thyroid cancer tumors at Chernobyl is false. That is not my judgement, that is what the source says. And the source authors include Dr Yamashita. He contradicts himself and the Fukushima Medical University contradicts the 1998 reports and other published reports of latency and speed of growth of the disease.

Dr Yamashita is an expert in the early onset cases of Thyroid cancer suffered by the Chernobyl children, a disease characterized in learned journals by Yamashita, et al, and others as a disease which develops rapidly. Yet he and other staff engaged in the Fukushima Medical University Thyroid Health survey completely contradict what is known about the relevant disease in the early period post exposure. And this contradiction is stated and is the basis for the actions and determinations of the staff involved in the survey.

If a doctor says to another doctor “this tumor grows fast” , (as happened with the published work in 1998 and with other sources) but then says to potential patients and other parties “this tumor grows slow” , who is being informed of the truth?

It is not true that early onset thyroid cancer grows slowly. The opposite has been reported by diverse authorities to be the case.

Is working slowly and with delayed action really imbuing the community with trust in authorities? Is the lack of explanation of examination results really informing the community of reality?

Dr Yamashita has repeatedly asked the people involved in the health survey to ” feel safe”. On what basis ? That fast in Chernobyl is slow in Japan?

Is Thyroid cancer “Fast” or “Slow”? Can it be both?
Yamashita et al 1998 finds it to be fast, Yamashita et al 2011-2013 claims it to be slow. On the basis of the findings reported earlier.

Professor Sir E Dillwyn Williams MA, Mb, BChir
Christ’s College Cambridge.
Christ’s College, St Andrew’s Street, Cambridge, CB2 3BU, UK

Citation: Thyroid cancers after the Chernobyl accident;
Chernobyl accident; lessons learnt, an update. 2010.
Sir Dillwyn Williams

Cambridge
http://ec.europa.eu/energy/nuclear/radiation_protection/doc/scientific_seminar/2010/sir_d_williams_thyroid_cancers_after_chernobyl_accident.pdf

“Tumours are becoming less aggressive” Williams, as above, 2010. (ie late onset)

“regional lymph node metastasis, extension to surrounding tissues or lung metastasis did not differ significantly (between children in Belarus and in Japan)”. Yamashita et al. 1998 (Childhood thyroid cancer: comparison of Japan and Belarus.
Shirahige Y, Ito M, Ashizawa K, Motomura T, Yokoyama N, Namba H, Fukata S, Yokozawa T, Ishikawa N, Mimura T, Yamashita S, Sekine I, Kuma K, Ito K, Nagataki S. First Department of Internal Medicine, Nagasaki University School of Medicine, Japan. Endocr J. 1998 Apr;45(2):203-9. Abstract

I conclude that Williams in 2010 finds that new cases of thyroid cancer in the Chernobyl cohort were becoming less aggressive.

I conclude that this implies that thyroid cancer which occurred earlier in the Chernobyl cohort were more aggressive.

I conclude that Dr Yamashita was aware in 1998 that thyroid cancer in children in both Chernobyl affected areas and in Japan did suffer thyroid cancer which, in some cases, resulted in the spread of cancer to lymph and lung tissue.

I conclude that Dr Yamashita is aware that the Chernobyl affected children in the immediate aftermath of that event suffered thyroid cancers which could develop quickly and grow rapidly. Yamashita et al. reported this in 1998.

I conclude on the basis of multiple sources that there is no basis for the statement that thyroid cancers have a long latency period only.

I conclude on the basis of multiple sources that there is no basis for the statement that thyroid cancers develop and grow slowly. Yamashita et al 1998 reported an observed rapid onset and rapid development of disease in the case of Chernobyl

I conclude that individuals within a cohort, while sharing a causative event, remain individuals who experience individual disease development and progression. The situation is not either / or , it is both/and. In Chernobyl, the case repeatedly by FMU, both early and later onset occurred, and both rapid and slow disease progression occurred.

I further conclude that there will be a range of latency periods within the Fukushima cohort, as there continues to be within the Chernobyl cohort. A child of the Chernobyl cohort who does develop thyroid cancer as a child carries an increased risk of developing thyroid cancer as an adult.

Fukushima Medical University holds to the view of a singular disease onset period and a singular disease rate of development and a singular health outcome in the case of a large population of children who have many individual characteristics. These children face increased risk due to a common and acknowledged exposure to a causative agent.

It appears that the Fukushima Medical University seeks to impose the experience of the late onset Chernobyl cohort onto the Children of Fukushima. 2010 was 24 years after Chernobyl. 2013 is only 2.5 years after Fukushima Diiachi.

There is great need for openness and correct reporting by medical authorities in Japan.

Public trust will not be gained by official omission, misrepresentation and delays.

3. Are Children the sole part of the Fukushima cohort exposed to increased risk?

Williams, Cambridge, 2010 reports the following:
A study of the risk to adults is also urgently needed, because of conflicting data.
The evidence in relation to dietary iodine strengthens the need to eliminate I deficiency,
and to consider long term iodine supplementation after exposure.”

Malko points out the confounding influence of the aging of members of exposed cohorts. If diagnosis is delayed until a child is a teenager or until a teenager is an adult, due to the changes of risk with age, cause and effect linkage may be lost.

Even though, had the child been diagnosed as a child rather than as a teen etc, the cause and effect linkage would remain intact.

I have included a graph created within an excel spreadsheet from data provided by : Center for Cancer Control and Information Services,
National Cancer Center, Japan

Matsuda A, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H and The Japan Cancer Surveillance Research Group. Cancer Incidence and Incidence Rates in Japan in 2007: A Study of 21 Population-based Cancer Registries for the Monitoring of Cancer Incidence in Japan (MCIJ) Project. Japanese Journal of Clinical Oncology, 43: 328-336, 2013

This graph shows the rapid change in incidence of thyroid cancer in various age ranges, female, Japan. National data. The rapid change began in 1986- 1987 and continued for some years. The data shows the numbers of cases diagnosed in each year in each age range.

The data shows that childhood is not the only age group which is vulnerable to thyroid cancer in Japan.

Other authors, such as Baba et. al. have published papers in this regard in the pre Fukushima era.


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