CONCLUSIONS Thescientific and technical literature relating to the exposure ofthe inhabitants of the Marshall Islands to ionizing radiation in 1954 was reviewed to evaluate the appropriateness of the follow-up of the population from 1954 to the present, and as a basis for recommendations for its follow-up from the present through the year 2000. The following conclusions were drawn: 1. The scope and nature of the early medical management and subsequent monitoring and care of the exposed Marshall Istands’ inhabitants, are judged appropriate by current Standards. 2. Medical follow-up since 1954 has been sufficient. 3. There are humanitarian and ethical needs to monitor the exposed population to assure early detection of diseases, particularly cancer, that may occur as the population ages and that are possibly (though unlikely), associated with the exposure to radiation in 1954. 4. Continued follow-up by a comprehensive medical surveillance program using established medical practices and procedures on an annualbasis, is recommended to meet the needs identified above. 3. Quality control of all aspects of the medical surveillance program should be assured by the use of standardized and peer-reviewed procedures of professional organizations, such as the American Cancer Society and the College of American Pathologists. 6. The value to this population of high resolution ultrasonography to screen for thyroid tumors is debatable. If it is so used, it is recommended that only palpable nodules be biopsied. 5012640 49