Cancerphobia and Radiophobia Are Harming the Children of Fukushima

Radiophobia had the Fukushima region by the throat, so it was decided that all 360,000 or so children and teens would be offered screening for thyroid irregularities.

The thyroid gland is a little butterfly shaped thing inside that soft spot in your throat just above your chest bone. Doctors can feel it just by rubbing, which is how initial exams for possible thyroid cancer are usually done, sort of like digital prostate exams or self breast exams: feel around for bumps, and go from there.

But like breasts and prostates, thyroids can have bumps that are just bumps, nothing more: not cancer, and nothing that will harm you or kill you. Experts say that if you autopsy anybody’s thyroid, you can find cysts or nodules, or even cancerous cells themselves, that would never have caused harm or death. You and I probably have some of those bumps or cells in our thyroids right now.

But while those cells or cysts might not hurt us, the fear of radiation and the fear of cancer certainly could, as an unfolding tragedy for children living around in the prefecture of Fukushima in Japan illustrates.

Following the nuclear accident there, fear of radiation was off the charts, even after it was well established that the levels of radiation released by the accident weren’t. In most areas those levels were low, well below the levels that the Life Span Study of atomic bomb survivors has taught us are worth serious concern.

Nonetheless, radiophobia had the Fukushima region by the throat, so it was decided that all 360,000 or so children and teens would be offered screening for thyroid irregularities, since high enough doses of radiation, particularly the isotope Iodine 131, can increase the risk of thyroid cancer (the thyroid sucks up iodine like a sponge), and iodine 131 was released by the nuclear accident. And to be extra careful, the decision was made to screen the kids with ultrasound, not those normal clinical ‘feel for the bumps’ exams.

Unsurprisingly, given the prevalence of suspicious cysts or nodules in everyone’s thyroids, the screening turned up thousands of abnormalities. And unsurprisingly, the first assumption was that these were cancers caused by radiation from Fukushima, a fear aggressively promoted by anti-nuclear activists. Only, that’s not what the evidence says:

+ Testing in non-exposed kids in Japan found the same rate of abnormalities, and so did the testing of south Korean kids 15 years ago when the health care system switched from physical exam to ultrasound. Radiation couldn't have cause those abnormalities.

+ The risk from the tiny dose of radiation received by most area residents was tiny.

+ Genetic tests of suspicious cells taken in biopsies from several thousand kids found that the genes matched the kind of thyroid abnormalities common in Japanes people as a whole, but did not match the abnormal thyroid cells taken from those exposed to radiation from Chernobyl.

“The evidence suggests that the great majority and perhaps all of the cases so far discovered are not due to radiation,” says Dillwyn Williams, a thyroid cancer specialist at University of Cambridge in the United Kingdom.

Still, tens of thousands of Japanese kids had biopsies, medical exams that can lead to infection or other complications. One of the outcomes of biopsies for cancer can be really serious: removal of the entire thyroid if cancerous cells are found, even though such cells are common in many thyroids and are unlikely to ever cause harm or death. In the end, more than 100 Fukushima-area kids have had their thyroids removed, with significant health implications for the rest of their lives.

Is something causing an abnormal spike in thyroid cancers in all the kids in Japan? (Remember, ultrasound screening found elevated rates of abnormalities in non-exposed non-Fukushima kids.) Or is this a case of overdiagnosis and overtreatment of a disease that scares us into doing things that are not medically called for? That’s what experts are calling what happened to the Fukushima kids. As Dennis Normile reported recently in Science magazine

Even though the vast majority of thyroid abnormalities are safe to ignore, “finding small lesions causes patients anxiety,” says Seiji Yasumura, vice director of the Fukushima Prefecture Health Management Survey. Virtually all of those diagnosed with thyroid cancer have had the glands removed, even though accumulating evidence suggests in many cases it might have been better to wait, the University of Tokyo’s Shibuya adds. “Careful observation would be the best option.” 

And if you need evidence that excess screening to increase early detection of a scary disease doesn’t necessarily lead to any health benefit, consider what happened in South Korea, according to the article in Science. When the government made ultrasound testing available, 

[T]hyroid cancer diagnoses exploded. In 2011, the rate of thyroid cancer diagnosis was 15 times what it was in 1993, yet there was no change in thyroid cancer mortality (my emphasis).

There are good physical and emotional reasons to fear nuclear radiation. At high enough doses it can cause more than 20 different kids of cancer. Emotionally, human-made risks scare us more than natural ones (radiation from the sun doesn't scare us as much though it kills many more) and any risk we can’t detect with our senses leaves us feeling vulnerable and powerless and more afraid. There are certainly good physical and emotional reasons to fear cancer, a disease that often causes great suffering, and against which we feel have no control – many still think a cancer diagnosis is a death sentence – even though more and more forms of cancer are treatable, and even curable.

But when we let our emotions override an objective review of the evidence – which as this column notes we do all the time - it’s not radiation we should fear, or cancer. It’s our fears that we have to fear most. Those poor kids in Japan have offered us a profound lesson. We should listen.

(For a detailed summary of the thyroid issue around Fukushima, see this solid piece in The Hiroshima Syndrome, a blog that writes about the gap between the facts and our fears of nuclear radiation.)


image; GettyImages, Jeremy Sutton-Hibbert

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Image: The Pudding
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  • Replace city names with those of their most famous residents
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  • If you seek fame, become an actor, musician or athlete rather than a politician, entrepreneur or scientist

Chicagoland is Obamaland

Image: The Pudding

Chicagoland's celebrity constellation: dominated by Barack, but with plenty of room for the Belushis, Brandos and Capones of this world.

Seen from among the satellites, this map of the United States is populated by a remarkably diverse bunch of athletes, entertainers, entrepreneurs and other persons of repute (and disrepute).

The multitalented Dwayne Johnson, boxing legend Muhammad Ali and Apple co-founder Steve Jobs dominate the West Coast. Right down the middle, we find actors Chris Pratt and Jason Momoa, singer Elvis Presley and basketball player Shaquille O'Neal. The East Coast crew include wrestler John Cena, whistle-blower Edward Snowden, mass murderer Ted Bundy… and Dwayne Johnson, again.

The Rock pops up in both Hayward, CA and Southwest Ranches, FL, but he's not the only one to appear twice on the map. Wild West legend Wyatt Earp makes an appearance in both Deadwood, SD and Dodge City, KS.

How is that? This 'People's Map of the United States' replaces the names of cities with those of "their most Wikipedia'ed resident: people born in, lived in, or connected to a place."

‘Cincinnati, Birthplace of Charles Manson'

Image: The Pudding

Keys to the city, or lock 'em up and throw away the key? A city's most famous sons and daughters of a city aren't always the most favoured ones.

That definition allows people to appear in more than one locality. Dwayne Johnson was born in Hayward, has one of his houses in Southwest Ranches, and is famous enough to be the 'most Wikipedia'ed resident' for both localities.

Wyatt Earp was born in Monmouth, IL, but his reputation is closely associated with both Deadwood and Dodge City – although he's most famous for the Gunfight at the O.K. Corral, which took place in Tombstone, AZ. And yes, if you zoom in on that town in southern Arizona, there's Mr Earp again.

The data for this map was collected via the Wikipedia API (application programming interface) from the English-language Wikipedia for the period from July 2015 to May 2019.

The thousands of 'Notable People' sections in Wikipedia entries for cities and other places in the U.S. were scrubbed for the person with the most pageviews. No distinction was made between places of birth, residence or death. As the developers note, "people can 'be from' multiple places".

Pageviews are an impartial indicator of interest – it doesn't matter whether your claim to fame is horrific or honorific. As a result, this map provides a non-judgmental overview of America's obsession with celebrity.

Royals and (other) mortals

Image: The Pudding

There's also a UK version of the People Map – filled with last names like Neeson, Sheeran, Darwin and Churchill – and a few first names of monarchs.

Celebrity, it is often argued, is our age's version of the Greek pantheon, populated by dozens of major gods and thousands of minor ones, each an example of behaviours to emulate or avoid. This constellation of stars, famous and infamous, is more than a map of names. It's a window into America's soul.

But don't let that put you off. Zooming in on the map is entertaining enough: celebrities floating around in the ether are suddenly tied down to a pedestrian level, and to real geography. And it's fun to see the famous and the infamous rub shoulders, as it were.

Barack Obama owns Chicago, but the suburbs to the west of the city are dotted with a panoply of personalities, ranging from the criminal (Al Capone, Cicero) and the musical (John Prine, Maywood) to figures literary (Jonathan Franzen, Western Springs) and painterly (Ivan Albright, Warrenville), actorial (Harrison Ford, Park Ridge) and political (Eugene V. Debs, Elmhurst).

Freaks and angels

Image: Dorothy

The People Map of the U.S. was inspired by the U.S.A. Song Map, substituting song titles for place names.

It would be interesting to compare 'the most Wikipedia'ed' sons and daughters of America's cities with the ones advertised at the city limits. When you're entering Aberdeen, WA, a sign invites you to 'come as you are', in homage to its most famous son, Kurt Cobain. It's a safe bet that Indian Hill, OH will make sure you know Neil Armstrong, first man on the moon, was one of theirs. But it's highly unlikely that Cincinnati, a bit further south, will make any noise about Charles Manson, local boy done bad.

Inevitably, the map also reveals some bitterly ironic neighbours, such as Ishi, the last of the Yahi tribe, captured near Oroville, CA. He died in 1916 as "the last wild Indian in North America". The most 'pageviewed' resident of nearby Colusa, CA is Byron de la Beckwith, Jr., the white supremacist convicted for the murder of Civil Rights activist Medgar Evers.

As a sampling of America's interests, this map teaches that those aiming for fame would do better to become actors, musicians or athletes rather than politicians, entrepreneurs or scientists. But also that celebrity is not limited to the big city lights of LA or New York. Even in deepest Dakota or flattest Kansas, the footlights of fame will find you. Whether that's good or bad? The pageviews don't judge...

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