43
Table 25
Thyroid Lesions in Marshallese, December 1974
Group
Rongelap exposed (175 rads)
Ailingnae exposed (69 rads)
Age at
exposure
Est. thyroid
dose,* rads
“ Subjects® with
thyroid lesions
No. subjects
with surgery
“e Subjects® with
malignant lesions
< {0
10--18¢
>18
All
810-1150
333-810
335
356®
89.5 (17, 19}
16.6 (2/12)
9.1 (3 (3334
34.4 (22,64)
15
1
3
19
5.3 (1, 19)
<10
275-450
33.3 (2 '6)
1734?
33.3 (1/3)
10-18
>18
All
in utero exposed
Utirik exposed (14 rads
69+?
<10
10-18
>18
All
Rongelap unexposed
190
135
217e
60-958
27-60
27
30¢
<10
10-18
1
0
3
4
1
0.0 (0/1)
0
0.0 (0/58)
4.8 (1/21)
0
1
6.4 (3/78)
3.8 (6/157)
1.6 (1/61)
7.7 (1/193)
3
4
5.8 (7/120)
< 10
0.0 (0/3 1)
0
>10
4.7 (3/106)
0
All
4.6 (9/194)
3.6 (5/137)
4.8 (1/21)
0.6 (1-157)
0
|
> 18
All
Likiep unexposed
0.0(0/1)
36.3 (4/11)
33.3 (6. 18)
6.1 (2 33)
4.7 (3 64)
2
3
0
4 Dose from 1311, 132], 133], and 135] plus gamma; mean dose extrapolated from calculations?® for adults and 3-vear-olds
(see Section IT).
> Based on numberof people exposed, excluding those in utero (numberof cases/total numberin group).
¢The thyroid is considered to be fully developed by about age 18.
4QOne additional case of adenoma, found at autopsy, not included here.
*Weighted mean dose.
' Pathologists differed as to whetherthis lesion was malignant; it was scored as benign.
© The more energetic, shorter-lived isotopes of iodine contributedless to the total thyroid dose in the Utirik people because the fallout occurred later there. It might be surmised also that the biological effectiveness of the thyroid dose per
rad would be less in the Utirik group.
roid surgery has been carried out on 24 of the ex-
woman(age 6 at exposure). A fourth case of cancer
of the lesions (20 were subtotal and 4 total thyroid-
exposure.23 Three of 196 unexposed Rongelap people have had surgery with removal of benign adenomas. All three were women. Hospital summariesof
cases admitted at BNL are presented in Appendix 10.
posed Rongelap people with removal of varying
amounts of thyroid tissue depending on the extent
ectomies with parathyroidectomy inadvertently in
one of the latter who was thought to have cancer
at the time of surgery). Of these cases, 3 were
found to have carcinomaofthe thyroid and 21 to
have benign lesions of the thyroid.
The first case of carcinoma of the thyroid oc-
curred in a 40-vear-old woman (29 at the time of
exposure) in the heavily exposed group. Theinterval between exposure and diagnosis was 11
vears.°0.23 The second and third cases in this group
occurred 15 years after exposure, in a 36-year-old
woman (age 21 at exposure) and in a 22-year-old
was found, 14 years after exposure,in a 36-year-old
Utirik woman whohad received considerablyless
1. Gross Appearance
Since the discovery of the first thyroid lesion 9
years after radiation exposure, clinicians particularly interested in the thyroid haveparticipated in
the annual examinations. As a result, any slight
irregularities discovered by palpation drew special
attention. This high degree of scrutiny and suspicion led to the detection and removal of nodules