W. H. ADAMS: LATE MEDICAL CONSEQUENCES OF EXPOSURE TO RADIOACTIVE

body radiation is now thought by manyto reflect the frequency of the different types of cancer
normally occurring in a population. There is no known marker for radiation-induced cancer.
Noncancerous Thyroid Morbidity
The late somatic effects of exposure to ionizing radiation have been equated with cancer
induction, the ultimate measure of those effects being expressed in mortality. Since cancer
Table 8
Late thyroid morbidity unrelated to diagnosis and treatment
of thyroid cancer in 253 radiation-exposed Marshallese

Morbid event

.

Numberof cases

Thyroid surgery for benign lesions

44

Hypothyroidism, radiogenic
Hypothyroidism, postsurgical

15
21

Hypoparathyroidism, postsurgical
Recurrent laryngeal nerve palsy

2
1

Pituitary tumor*

2

Total morbid events

84

moftality from radiation exposure is low when comparedto naturally occurring cancer mortality,it
is not surprising that there is no observed increase in mortality among the radiation-exposed

Marshallese. Nevertheless, much attention has been addressed to their cancer risk. On the other
hand,limited attention has been given to morbidity from nonmalignant disease, principally of the
thyroid, as a late consequence of radiation exposure, and yet these lesions have been of great
clinical importance (Table 8).
Thyroid Surgery
Thirty percent of the Rongelap group and 11% of the Utirik group have had surgery for

thyroid nodules that were ultimately found to be benign. The types of thyroid nodules found in the
exposed population since 1963 can be grouped into cancers, adenomas, and adenomatous nodules.
Cancers and adenomasare neoplasms. Adenomatous nodules, like adenomas, are benign, and are
not properly categorized as neoplasms. Histologically, they are hyperplastic lesions. In the exposed
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