In Fukushima, an extensive screening on thyroid cancer in children is running for almost 5 years now. Whereas the pro-nuclear Japanese government deliberately downplays the impacts of the multiple nuclear meltdowns, scientists, physicians and parents associations were at leastable to enforce this screening. Despite all justifiable criticism of this study like its limitation to Fukushima Prefecture, the lack of transparency or the influence of the nuclear lobby on Fukushima Medical University, which carries out the examination, this screening provides the possibility of early detection and therapy of thyroid cancer.
Furthermore, the study makes it possible to gain important insights about the impacts of a nuclear catastrophe for the exposed population.
But now, after five years and two completed investigation rounds, a significantly higher number of thyroid cancer is being found found in the examined population than initially expected. The Japanese authorities have now reacted in their very own way and suggested that families should quit the study voluntarily.
For weeks now, Prof. Sanae Midorikawa, endocrinologist and communication representative of Fukushima Medical University, has travelled to schools throughout Fukushima Prefecture, telling children about their right to reject the screening if they do not want an „unreasonable cancer diagnosis“. What the Fukushima Medical University means with this term becomes clear in their publications: According to their opinion, the 172 pediatric thyroid cancer cases found so far represent a so-called ”screening effect“. The university argues that these cases of cancer most likely cannot be attributed to the Fukushima nuclear disaster. Without the screenings, they would probably have never been detected – or at a later time. The university does not explain why the obvious causal relationship to the nuclear disaster was denied from the very beginning. Besides that, the university does not give an explanation for the high rate of aggressive courseswith early metastases, invasive growth and fast increase of tumor size. So far, 131 children have had to undergo operations, for the surgical removal of tumors and metastases. These patients have to take thyroid hormones for the rest of their lives and require continuous follow-up exams in order to recognize and treat relapses. Fukushima Medical University does not explaine how these numbers could arise from a simple ”screening effect“.
The representative of Fukushima Medical University proclaims during her school presentations that the will of children “who do not want a cancer diagnosis“ has to be respected. However, she does not mention the right of these very children and their families to receive neutral information on the risks of radioactive contamination, the scientific findings regarding thyroid cancer after nuclear accidents and the risks of late detection of aggressive malignancies. Instead she states: ““It is not surprising that residents thought, ‘Our children should participate in the examination” after the nuclear accident. It also makes sense they connected the results with radiation and felt anxious. However, looking back, all of that was an irrational experience.”
Now, the justified concern of many scientists, physicians and parents associations is that the study could be devalued by a reduction of the number of participants. Appearantly, Fukushima Medical University aims to encourage many young people to quit the study so that a scientifically significant relationship between radioactive contamination and the occurrence of thyroid cancer would not be confirmed. The number of detected thyroid cancer cases would be reduced as well. During the course of this screening, patient autonomy has hardly played any role so far. Families were informed too late and inadequately. Secondary opinions from independent physicians were refused and images and documents not handed out to the parents. Now, as the results of the study are beginning to show a correlation between thyroid cancer and the nuclear catastrophe, Fukushima Medical University is trying to generate a distorting systematic error in the name of patient autonomy. In the end, this could devalue the whole investigation. Already, the people in charge of the examinations, like former principal investigator Dr. Shunichi Yamashita, are announcing the end of the screening.
Demonstrations and demands for independent public information would be appropriate, but unfortunately, this is hardly realistic in the current political and economic climate in Japan. Hopefully, parents and children will understand the strategies of Fukushima Medical University and continue to participate in the screenings.
Dr. Alex Rosen