Session 1 (tutorial session): Radiation and Thyroid Cancer Summary

1. Session 1 (tutorial session): Radiation and Thyroid CancerSummary • Many patients with thyroid cancer were found in the Fukushima Health Management survey and people are worried about the effects of radiation from the accident. • The global incidence of thyroid cancer has been increasing sine approximately 30 years. • In the Chernobyl accident young children, zero to 9 years are at higher risk of thyroid cancer, with the incidence of thyroid cancer appearing in increase beginning at 0.1 Gy at ages zero to 17 years. • 94.9% of people in Fukushima Prefecture at the time of the accident (except site workers) received a dose of <2.0 mSv and 66% received a dose of <1 mSv. (as of December 2013)

2. Session 1 (tutorial session): Radiation and Thyroid CancerSummary - Continued • Even advanced stages of thyroid cancer after radiation exposure can be treated effectively with surgery, radioidine therapy and thyroid hormone supplements. • The current high prevalence of in thyroid cancer recently found in Fukushima Prefecture is highly likely attributable to screening. • Thyroid canceroccuranceis influenced by: • Change in risk factors • Change in diagnosis and detection • Methodology considerations

3. Session 1 (tutorial session): Radiation and Thyroid CancerSummary - Continued • Perception by stakeholders is everything. • Risk communications and dialogue is better locally oriented than centrally managed. Recommendations – • Continue and strengthen the Fukushima Health Management Survey. • Develop a population based Cancer Registry. • Enable linkage of data over time and end-points. • Implement a Primary Prevention Program. • Use of observation, for low risk papillary patients was found to be an effective treatment therapy. • Establish an effective, locally based Risk Communications Program.