with lymph node metastases. All these new (Table 5). Five were from the Utirik-exposed group and one was from the comparison group. The latter was judged to have an adenomatous nodule. Ofthe five Utirik patients, only four had significant thyroid pathology. Two of the four findings have been incorporated in the summary of thyroid lesions found throughoutthe history of the medical program (Table 6). An analysis of thyroid cancer risk as it relates to the exposed Marshallese wasrecently presented, and asum- had occult papillary carcinomas. This is a neoplastic lesion oflittle clinical significance and is mary is given in Appendix A. not considered the equivalent of papillary thyroid cancer. It is usually an incidental finding during thyroid surgery, and the prevalence of occult thyroid carcinomas has not been found to be increased in Japanese atomic bombing survivors (Wakabayashiet al. 1983). The other two patients did have papillary INDIVIDUAL LABORATORY DATA Asin the last report, a computerizedlisting of laboratory test results obtained in 1983-84 and entered by identification numberis presented in Appendix B. thyroid cancers, one of which was associated Table 5 Thyroid Surgery Patients, 1983-1984 . Identification Number Age at Diagnosis Sex Consensus Diagnosis 2248 944 2149 2152 2167 2171 44 58 38 38 44 33 F M F M M F Occult papillary carcinoma Adenomatous nodule No tumor Papillary carcinoma Occult papillary carcinoma Papillary carcinoma Table 6 Thyroid Lesions Diagnosed at Surgery Through 1984 Adenomatous Nodules Occult Papillary Carcinomas —_ 17 2 4 — Ailingnae (19)* 4 — = —_ 1 Utirik (167)* Comparison (227)** 10 4 2 1 4 2 1t — 3 2tt t tt I Follicular Carcinomas Rongelap (67)* * ** f, Adenomas Papillary | Carcinomas NOT INCLUDEDare the following unoperated (and therefore unconfirmed) nodules: Rongelap -1; Ailingnae - 1; Utirik - 1; Comparison - 5. INCLUDEDare all consensus diagnoses of a panel of consultant pathologists; two different lesions were detected in one person each from Rongelap, Ailingnae, and Utirik. Number of persons (including those in utero) who were originally exposed. This numberincludesall persons who havebeen in the comparison group since 1957. Some havenot been seen for many years; others were added as recently as 1979. Equally divided opinion in one case; follicular carcinoma vs atypical adenoma. Majority opinion in one case; occult papillary carcinoma vs follicular carcinoma. The samepatient had a lymphocytic thyroiditis.