——— with lymph node metastases. All these new findings have been incorporated in the summary of thyroid lesions found throughoutthehistory of the medical program (Table6). An analysis of thyroid cancerrisk as it relates to the exposed Marshallese was recently presented, and asummaryis given in Appendix A. (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. Of the five Utirik patients, only four had significant thyroid pathology. Two of the four had occult papillary carcinomas. This is a neoplastic lesion oflittle clinical significance and is 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 thyroid cancers, one of which was associated 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. Table 5 Thyroid Surgery Patients, 1983-1984 Identification Number Age at Diagnosis Sex Consensus Diagnosis 2248 944 2149 44 58 38 F M F Occult papillary carcinoma Adenomatous nodule No tumor 2167 2171 44 33 M F Occult papillary carcinoma Papillary carcinoma 2152 38 M Papillary carcinoma Table 6 Thyroid Lesions Diagnosed at Surgery Through 1984 Adenomatous Nodules Adenomas Papillary Carcinomas Follicular Carcinomas Oceult Papillary Carcinomas — Rongelap (67)* 17 2 4 — Ailingnae (19)* 4 —_ — — 1 Utirik (167)* 10 2 4 1+ 3 Comparison (227)** 4 1 2 — 2tt | NOT INCLUDED are the following unoperated (and therefore unconfirmed) nodules: Rongelap -1; Ailingnae - 1; Utirik - 1; Comparison - 5, INCLUDED areall consensus diagnosesof a panel of consultant pathologists; two different lesions were detected in one person each from Rongelap, Ailingnae, and Utirik. * Number of persons (including those tn utero) who were originally exposed. ** This numberincludesall persons who have been in the comparison group since 1957. Some have not been seen for many years; others were added as recently as 1979. + Equally divided opinion in one case; follicular carcinoma vs atypical adenoma. tt Majority opinion in one case; occult papillary carcinoma vs follicular carcinoma. The same patient had a lymphocytic thyroiditis. 12