Stable Iodine Distribution Among Children After the 2011 Fukushima Nuclear Disaster in Japan: An Observational Study

Abstract Context Intake of stable iodine helps prevent childhood thyroid cancer in nuclear emergencies, but there is limited case information. Objective We identified the intake rate and the factors associated with no intake among children who did not take stable iodine after the Fukushima disaster. Design Retrospective observational study. Setting Data were obtained from thyroid cancer screenings performed from August through November 2017. Participants Children in Miharu Town, Fukushima, Japan. Intervention No intervention. Main Outcome Measures We performed multilevel logistic regression analysis at the regional and individual levels. We qualitatively examined the reasons for no intake of stable iodine based on closed- and open-ended questions. Results The rate of distribution was 94.9%, but the intake rate was only 63.5%. Intake was lower in those aged 0 to 2 years compared with those aged ≥3 years (OR, 0.21; 95% CI, 0.11 to 0.36). Parents’ intake was positively associated with their children’s intake (OR, 61.0; 95% CI, 37.9 to 102.9). The variance partition coefficient for regions was 0.021, suggesting that the intake of stable iodine was more likely affected by individual than by regional factors. Closed-ended questions showed that the main reason for avoiding intake was concern about safety. Open-ended questions for other reasons revealed issues related to the distribution method, information about the effects and adverse effects of iodine, and instructions for iodine intake. There were no symptomatic adverse effects claimed to the town. Conclusions The distribution and consumption of stable iodine occurred in Miharu Town after the Fukushima disaster. To prepare for future nuclear emergencies, it is important to explain to both children and parents the need for intake of stable iodine, particularly among young children.

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No significant association between stable iodine intake and thyroid dysfunction in children after the Fukushima Nuclear Disaster: an observational study

Journal of Endocrinological Investigation ◽

10.1007/s40618-020-01454-8 ◽

2020 ◽

Author(s):

Y. Nishikawa ◽

C. Suzuki ◽

Y. Takahashi ◽

T. Sawano ◽

H. Kinoshita ◽

...

Keyword(s):

Thyroid Cancer ◽

Observational Study ◽

Children And Adolescents ◽

Thyroid Function ◽

Multivariable Analysis ◽

Iodine Intake ◽

Iodine Prophylaxis ◽

Nuclear Disaster ◽

Fukushima Nuclear Disaster ◽

Stable Iodine

Abstract Purpose Stable iodine prophylaxis helps prevent childhood thyroid cancer in nuclear emergencies; however, there is limited information on its effect on thyroid function. This study aimed to examine thyroid function and autoimmunity among children and adolescents that took stable iodine after the Fukushima Nuclear Disaster. Methods For this observational study, data were obtained from children and adolescents that underwent thyroid cancer screening at Hirata Central Hospital from April 2012 to March 2018. Participant characteristics, including possible hypothyroidism and hyperthyroidism, were compared between the prophylaxis and no-prophylaxis groups. Multivariable logistic regression models were used to assess for possible hypothyroidism, autoantibodies positive, and hyperthyroidism. Results A total of 1,225 participants with stable iodine prophylaxis and 3,946 without prophylaxis were enrolled. Of those participants, blood samples were available for 144 and 1,201 participants in the prophylaxis and no-prophylaxis groups, respectively. There were 17 (11.8%) and 146 cases (12.2%) of possible hypothyroidism or autoantibodies positive cases in the prophylaxis and no-prophylaxis groups, respectively, and there were no cases and 3 cases (0.2%) of possible hyperthyroidism in those two groups, respectively. Multivariable analysis for possible hypothyroidism revealed no association between stable iodine intake and possible hypothyroidism or autoantibodies positive [odds ratio 0.716 (95% confidence interval 0.399–1.284)] (p = 0.262). We did not perform multivariable analysis for hyperthyroidism due to the limited number of cases. Conclusion Significant adverse effects of stable iodine intake on thyroid function were not observed among children and adolescents 7 years after the Fukushima Nuclear Disaster.

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Trends in Childhood Thyroid Cancer incidence in Korea and Its Potential Risk Factors

Frontiers in Endocrinology ◽

10.3389/fendo.2021.681148 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jun Park ◽

Hyunju Park ◽

Tae Hyuk Kim ◽

Sun Wook Kim ◽

Hye Won Jang ◽

...

Keyword(s):

Thyroid Cancer ◽

Alcohol Consumption ◽

Iodine Intake ◽

Screening Tests ◽

Obesity Prevalence ◽

Related Factors ◽

Korean Children ◽

Consumption Rates ◽

Potential Risk Factors ◽

Childhood Thyroid Cancer

BackgroundAlthough the incidence of thyroid cancer had been increasing until a few years ago, a decrease has been observed in the last years, probably due to the reduction of the screening tests in Korea. Childhood thyroid cancer has been increasing in the past with the same trend as in adults, but there have been few reports on recent trends. We analyzed the trends of thyroid cancer in Korean children and related factors.MethodsFrom national statistics and cancer register database, the data of age-specific incidence rate in Korean childhood thyroid cancer from 1999 to 2017 was obtained, and levels of seaweed intake, the number of computed tomography (CT) and neck ultrasonography (US), obesity prevalence rate, and smoking and alcohol consumption rates in children were analyzed.ResultsThe age-specific incidence of thyroid cancer in Korean children has increased in both genders between 1999 and 2017 (2.0 in 1999 vs. 7.2 in 2017, per population of 100,000), especially in the age group of 14-18 years (1.5 in 1999 vs. 5.5 in 2017, per population of 100,000). During the same period, levels of seaweed intake, number of CT scans and neck US, and prevalence of obesity in children increased significantly, while childhood smoking and alcohol consumption rates decreased.ConclusionUnlike the adult thyroid cancer in Korea, childhood thyroid cancer continues to increase, and the cause might be accompanied by actual increases due to the environmental factors such as excessive iodine intake, exposure to medical radiation, and increased obesity prevalence as well as the screening effect.

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Evolution in the management of thyroid cancer: an observational study in two Belgian referral centres

Endocrine Abstracts ◽

10.1530/endoabs.49.ep1393 ◽

2017 ◽

Author(s):

Bernard Peene ◽

den Bruel Annick Van ◽

Carolien Moyson ◽

Brigitte Decallonne

Keyword(s):

Thyroid Cancer ◽

Observational Study

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Correction to: Safety and Effectiveness of Lenvatinib in 594 Patients with Unresectable Thyroid Cancer in an All-Case Post-Marketing Observational Study in Japan

Advances in Therapy ◽

10.1007/s12325-021-01829-0 ◽

2021 ◽

Author(s):

Shunji Takahashi ◽

Makoto Tahara ◽

Koichi Ito ◽

Masayuki Tori ◽

Naomi Kiyota ◽

...

Keyword(s):

Thyroid Cancer ◽

Observational Study ◽

Post Marketing

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Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02302-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Ziyang Zeng ◽

Kang Li ◽

Xianze Wang ◽

Siwen Ouyang ◽

Zimu Zhang ◽

...

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Protective Factor ◽

Urinary Iodine ◽

Iodine Intake ◽

Clinicopathological Features ◽

Papillary Thyroid ◽

Central Lymph Node ◽

High Iodine ◽

Central Lymph

Abstract Background An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine and clinicopathological features of PTC has not been well-characterized. This study aimed to investigate the associations between iodine intake and the clinicopathological features of PTC patients. Methods Three hundred and fifty-nine PTC patients who received surgical treatment in Peking Union Medical College Hospital from May 2015 to November 2020 were retrospectively reviewed. The associations between urinary iodine (UI), urinary iodine/creatinine ratio (UI/U-Cr), and the clinicopathological features of PTC were analyzed. Univariate and multivariate analysis were performed to investigate the relationship between UI level and central lymph node metastasis (CLNM). Results There were no significant differences in UI in different groups according to the variables studied, except that patients with CLNM had higher UI level than CLNM(−) patients. No associations were found between UI/U-Cr and clinicopathological features except variant subtypes (classic/follicular). After dividing patients into high-iodine group and low-iodine group, more patients were found to have CLNM in the high-iodine group (p = 0.02). In addition, younger age, larger tumor size, and classic variant were positively correlated with CLNM (p < 0.05). Univariate analysis showed that insufficient iodine intake (≤ 99 μg/L) was associated with decreased CLNM risk in PTC. And after defining insufficient iodine intake as ≤ 109 μg/L and above requirements as ≥ 190 μg/L, multivariate analysis showed that lower iodine was associated with CLNM in total population of PTC (OR 0.53, 95% CI 0.31–0.91) and in PTC < 1 cm (papillary thyroid microcarcinoma, PTMC) (OR 0.43, 95% CI 0.21–0.87). Conclusions Low iodine was a protective factor for CLNM in papillary thyroid cancer, particularly in those < 1 cm. These results indicated that iodine may not only be an initiator of tumorigenesis, but also a promoter of the development of PTC.

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Target Hemoglobin May Be Achieved with Intravenous Iron Alone in Anemic Patients with Cardiorenal Syndrome: An Observational Study

Cardiorenal Medicine ◽

10.1159/000433564 ◽

2015 ◽

Vol 5 (4) ◽

pp. 246-253 ◽

Cited By ~ 2

Author(s):

Eyal Ben-Assa ◽

Yacov Shacham ◽

Moshe Shashar ◽

Eran Leshem-Rubinow ◽

Amir Gal-Oz ◽

...

Keyword(s):

Platelet Count ◽

Adverse Effects ◽

Observational Study ◽

Treatment Strategy ◽

Intravenous Iron ◽

Cardiorenal Syndrome ◽

Combination Group ◽

Iron Treatment ◽

Significant Difference ◽

Iv Iron

Background: The treatment of anemia in patients with cardiorenal syndrome (CRS) is based mainly on intravenous (IV) iron therapy and/or erythropoiesis-stimulating agents (ESAs). There are concerns about the safety of ESAs due to a potentially higher risk for stroke and malignancy. Objective: We aimed to explore whether IV iron alone is sufficient to improve anemia in CRS patients and to define the predictors of treatment response. Methods: We retrospectively analyzed data of 81 CRS patient treated for anemia at our clinic. All patients received IV iron for 6 weeks. A subset of patients was additionally given subcutaneous ESAs. The end point was the improvement from baseline in hemoglobin (Hb) and ferritin levels at week 7. Results: We retrieved the files of 81 patients; 34 received IV iron alone and 47 were given IV iron and ESAs (the combination group). The Hb levels significantly increased in both groups (in the IV iron alone group: 10.6 ± 1.1 to 11.9 ±1.1 g/dl, p < 0.001; in the combination group: 10.2 ± 0.9 to 12.4 ± 1.3 g/dl, p < 0.001), but more pronouncedly in the combination group (2.17 vs. 1.24 g/dl; p = 0.001). The platelet count decreased significantly in the IV iron alone group but was unchanged in the combination group. Eighty percent of patients attained a Hb target of 11 g/dl, with no significant difference between the two groups (73.5 vs. 85.1%; p = 0.197). Low baseline Hb was the only predictor of a favorable outcome to treatment. Conclusion: Our observational study suggests that IV iron treatment without ESAs may substantially raise the Hb level to ≥11 g/dl in CRS patients. This treatment strategy may reduce the use of ESAs and hence its potential adverse effects.

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