iH Mr. Richard D. Copaken July 23, 1980 Page 3 5. Ts, TSH and HTG determinaticns are not proposed as general screening parameters, but "as indicated to follow thyroid carcinoma". The implication is that qmly individuals with the established diagnosis of a carcinama of the thyroid ar suspected thyroid carcinara on clinical grounds, will be biochemically tested; this is unacceptable. 6. As proposed, the Department of Enercy will be responsible for the preparation, handling and transportaton of hioChemical analyses of the collected samples. Should hardil- ing, transportation and analysis be rather carried out, by an independent major laboratory? As you are aware, currently, such arrangements are being finalized and cost analyses are being prepared. Having outlined scme of my objecticns to the proposed Likiep study, I think that with aporooriate modification, it nevertheless, should be instituted with the clear understanding that it would represent an initial phase of screening and data collection in preparation for com pliance with Public Law 96-205. The preliminary conclusions gleaned from the procesed study could, add should, be used to direct further plaming and implementation of cam prehensive health care to the people of each Marshall Islands atoll 4 was exposed to radiation — which I gather from Dr. Wachholz' comments in our meeting of April 23, 1980, includes the entire population of the Marshall Islands. Since such care has been clearly mandated by Congress and the President, the proposed Likiep screening stacy could well be used as an initial step. Sey /pohd Robert G RGL: sk