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 Table of Contents  
LETTER TO EDITOR
Year : 2019  |  Volume : 10  |  Issue : 1  |  Page : 80-81

Author Reply


Professor Emeritus, Kagoshima University, Kagoshima, Japan

Date of Web Publication22-May-2019

Correspondence Address:
Suminori Akiba
Professor Emeritus, Kagoshima University, Kagoshima
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrcr.jrcr_8_19

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How to cite this article:
Akiba S. Author Reply. J Radiat Cancer Res 2019;10:80-1

How to cite this URL:
Akiba S. Author Reply. J Radiat Cancer Res [serial online] 2019 [cited 2019 Dec 7];10:80-1. Available from: http://www.journalrcr.org/text.asp?2019/10/1/80/258722



Dear Sir,

We appreciate the comments made by Dr. Reiners et al. Our responses are as follows.

In the introduction of the study by Hayashida et al., which was cited by the comment, it reads that their surveys used “the same procedures for the ultrasound screenings as used in the Fukushima Health Management Survey.” However, as pointed out in the comments, two surveys used different probes. Be that as it may, it is difficult to tell whether this difference alone can cause a significant difference in detecting nodules with their long axis 5.1 mm or more. Some procedures might also have been different. In our study, the estimated O/E ratio in the first-round survey was 0.9 in both evacuated zone and the remaining areas. Those findings suggest that the technical differences between the two surveys were not serious enough to make our expected values “badly off the mark.” In addition, the relative risk estimation is unlikely to be affected seriously by this problem. Such a problem alone is difficult to explain the increased relative risk in the evacuation zone in the second-round survey.

Changes in dietary habits after the nuclear accident might have affected the iodine intake of children. However, it is difficult to tell whether the magnitude of change was large enough to affect the prevalence of thyroid nodularity. Certainly, iodine intake is likely to be from the traditional foods and is related to each family's dietary habits. Evacuation might have increased nontraditional food intake and resulted in obesity and other health-related problems. However, it is difficult to tell whether traditional food intake was gone or not. Even if an evident reduction takes place, it might be tentative. Once evacuees were settled in new locations, traditional foods might have come back quickly while nontraditional food consumption remained elevated. Anyway, the information on iodine intake is potentially important point when examining the thyroid nodule prevalence and thyroid cancer risk. In the secondary screening (confirmatory examinations) of the Fukushima Thyroid Survey, urine iodine concentrations and the serum concentrations of thyroid hormones and thyroid-stimulating hormone were measured. In-depth analyses, including area-specific analysis, may shed light on this important problem.

The small number of cases, particularly for the youngest age group, is our concern, too. That is one of the reasons why we used statistical models to estimate the age-dependent prevalence of the control areas (the data presented in the report by Hayashida et al.). However, this approach might have not been good enough to solve this problem completely. Having said that, because the number of cases in the youngest age group in the Fukushima Survey was also relatively small, when compared to those in older age groups; therefore, this problem is unlikely to seriously affect the RR calculation.

We hope our humble report on preliminary results, as well as comments made by Dr. Reiners et al. and our responses, draw due international attention to this important endpoint.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.






 

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