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October 12, 1970, Vol 214, No. 2 >
ARTICLE | October 12, 1970

Thyroid Neoplasia as Late Effect of Exposure to Radioactive Iodine in Fallout FREE

Robert A. Conard, MD; Brown M. Dobyns, MD; Wataru W. Sutow, MD
[+] Author Affiliations

Reprint requests to Brookhaven National Laboratory, Upton, NY 11973 (Dr. Conard).


JAMA. 1970;214(2):316-324. doi:10.1001/jama.1970.03180020036007
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References

Accidental exposure of people of Rongelap Island to radioactive fallout and particularly to radioactive iodines in the fallout has resulted in the development of thyroid abnormalities in 21 of 67 of these people, 3 with malignant lesions, 16 with benign adenomatous nodules, and 2 with atrophy of the gland with hypothyroidism. The preponderance of lesions occurred in children exposed at less than 10 years of age who had received a greater thyroid exposure. Growth retardation associated with hypothyroid tendency was noted in some children who appear to be responding favorably to thyroid hormone medication. Thyroidectomy, partial to complete, has been carried out on 18 patients. Risk for thyroid cancer from radioactive iodine exposure in this group does not appear to be very different from that reported following x-irradiation.

REFERENCES

1 +
Conard RA, Rall JE, Sutow WW:  Thyroid nodules as a late sequela of radioactive fallout in a Marshall Island population exposed in 1954 . New Eng J Med 274: 1392-1399, 1966;.
2 +
Robbins J, Rall JE, Conard RA:  Late effect of radioactive iodine in fallout: Combined clinical staff conference at the National Institutes of Health . Ann Intern Med 66:1214-1242, 1967;.
3 +
Sutow WW, Conard RA, Griffith KM:  Growth status of children exposed to fallout radiation on Marshall Islands . Pediatrics 36:721-731, 1965;.
4 +
Rall JE, Conard RA:  Elevation of serum protein-bound iodine level in inhabitants of Marshall Islands . Amer J Med 40:883-886, 1966;.
5 +
Sloan LW, Frantz VK:  Thyroid cancer: Clinical aspects , In Werner SC (ed): The Thyroid , ed 2. New York, Harper & Row, Publishers Inc, 1962;, pp 445-468.
6 +
Maloof F, Dobyns BM, Vicery A:  The effects of various doses of radioactive iodine on the function and structure of the thyroid of the rat . Endocrinology 50:612-638, 1952;.
7 +
Doniach I:  Comparison of carcinogenic effect of x-irradiation with radioactive iodine on rat's thyroid . Brit J Cancer 11:67-76, 1957;.
8 +
Lindsay S, Chaikoff IL:  Effects of irradiation on thyroid gland with particular reference to induction of thyroid neoplasias: Review . Cancer Res 24:1099-1107. 1964;.
9 +
Sheline GE, Lindsay S, McCormack KR, et al:  Thyroid nodules occurring late after treatment of thyrotoxicosis with radioiodine . J Clin Endocr 22:3-18, 1962;.
10 +
Hollingsworth DR, Hamilton HB, Tamagaki H, et al:  Thyroid disease: A study in Hiroshima, Japan . Medicine 42: 47-71, 1963;.
11 +
Pincus RA, Reichlin S, Hempelmann LH:  Thyroid abnormalities after radiation exposure in infancy . Ann Intern Med 66:1154-1164, 1967;.
12 +
Tayooka ET, Pifer JW, Hempelmann LH:  Neoplasms in children treated with x-rays for thymic enlargement: III. Clinical description of cases . J Nat Cancer Inst 31:1379-1405, 1963;.
13 +
Hempelmann LH:  Risk of thyroid neoplasms after irradiation in childhood . Science 160:159-163, 1969;.
14 +
Silver S: Radioactive Isotopes in Medicine and Biology , ed 2. Philadelphia, Lea & Febiger, 1962;, pp 138-148.
15 +
Upton AC:  The dose-response relation in radiation-induced cancer . Cancer Res 21:717-729, 1961;.
16 +
Shellabarger CJ, Bond VP, Cronkite EP:  Studies on radiation-induced mammary gland neoplasia in the rat: VII. The effects of fractionation and protraction of sublethal total-body irradiaton . Radiat Res 17:101-109, 1962;.
17 +
Marks S, Bustad LK:  Thyroid neoplasms in sheep fed radioiodine . J Nat Cancer Inst 30:661-673, 1963;.
18 +
Goolden AWG:  Carcinoma of the thyroid following irradiation . Brit Med J 2:954-955, 1958;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Conard RA, Rall JE, Sutow WW:  Thyroid nodules as a late sequela of radioactive fallout in a Marshall Island population exposed in 1954 . New Eng J Med 274: 1392-1399, 1966;.
2 +
Robbins J, Rall JE, Conard RA:  Late effect of radioactive iodine in fallout: Combined clinical staff conference at the National Institutes of Health . Ann Intern Med 66:1214-1242, 1967;.
3 +
Sutow WW, Conard RA, Griffith KM:  Growth status of children exposed to fallout radiation on Marshall Islands . Pediatrics 36:721-731, 1965;.
4 +
Rall JE, Conard RA:  Elevation of serum protein-bound iodine level in inhabitants of Marshall Islands . Amer J Med 40:883-886, 1966;.
5 +
Sloan LW, Frantz VK:  Thyroid cancer: Clinical aspects , In Werner SC (ed): The Thyroid , ed 2. New York, Harper & Row, Publishers Inc, 1962;, pp 445-468.
6 +
Maloof F, Dobyns BM, Vicery A:  The effects of various doses of radioactive iodine on the function and structure of the thyroid of the rat . Endocrinology 50:612-638, 1952;.
7 +
Doniach I:  Comparison of carcinogenic effect of x-irradiation with radioactive iodine on rat's thyroid . Brit J Cancer 11:67-76, 1957;.
8 +
Lindsay S, Chaikoff IL:  Effects of irradiation on thyroid gland with particular reference to induction of thyroid neoplasias: Review . Cancer Res 24:1099-1107. 1964;.
9 +
Sheline GE, Lindsay S, McCormack KR, et al:  Thyroid nodules occurring late after treatment of thyrotoxicosis with radioiodine . J Clin Endocr 22:3-18, 1962;.
10 +
Hollingsworth DR, Hamilton HB, Tamagaki H, et al:  Thyroid disease: A study in Hiroshima, Japan . Medicine 42: 47-71, 1963;.
11 +
Pincus RA, Reichlin S, Hempelmann LH:  Thyroid abnormalities after radiation exposure in infancy . Ann Intern Med 66:1154-1164, 1967;.
12 +
Tayooka ET, Pifer JW, Hempelmann LH:  Neoplasms in children treated with x-rays for thymic enlargement: III. Clinical description of cases . J Nat Cancer Inst 31:1379-1405, 1963;.
13 +
Hempelmann LH:  Risk of thyroid neoplasms after irradiation in childhood . Science 160:159-163, 1969;.
14 +
Silver S: Radioactive Isotopes in Medicine and Biology , ed 2. Philadelphia, Lea & Febiger, 1962;, pp 138-148.
15 +
Upton AC:  The dose-response relation in radiation-induced cancer . Cancer Res 21:717-729, 1961;.
16 +
Shellabarger CJ, Bond VP, Cronkite EP:  Studies on radiation-induced mammary gland neoplasia in the rat: VII. The effects of fractionation and protraction of sublethal total-body irradiaton . Radiat Res 17:101-109, 1962;.
17 +
Marks S, Bustad LK:  Thyroid neoplasms in sheep fed radioiodine . J Nat Cancer Inst 30:661-673, 1963;.
18 +
Goolden AWG:  Carcinoma of the thyroid following irradiation . Brit Med J 2:954-955, 1958;.

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