appearance of thyroid nodules since in ten children thyroid nodules appeared near the expected or actual time of puberty. In five other children (two boys andthree girls) in this group, the nodules appeared one to three years after puberty and in the girls were associated with pregnancies, In evaluating the influence of puberty and pregnancy it should be pointed out that the latent period between exposure and the development of thyroid abnormalities was fairly constant in all of a these children, varying between 10 and 13 years, so that these findings may have been fortuitous. In the four women who developed carcinoma of the thyroid the possible influence of the stress of pregnancy must be considered since all had multiple pregnancies in the years preceding the development of lesions. = The sex ratio of benign thyroid lesions occurring in the Rongelap population was females 1.3 to males ang uJ o 2 . < — & tl —i = a, t Sex Incidence - « iw ° > SKELETAL AGE 8 O===0 HEIGHT AGE — SUBJECTNO.3. ---- SUBJECT NO.5 5 a 7. i: 1.0. The findings may be misleading since all of the females in the group exposed at less than 10 years of age had lesions whereas two males in the group did not. Thefact thatall three malignant lesions of the thyroid were in females is consistent ‘with reported statistics showing preponderance of such lesions in females.* Comment At the time of appearance of the first malignant thyroid lesion in the more heavily exposed Rongelap group several years ago numerous benign adenomatous thyroid nodules had appeared which were.suspected of being related to the radiation exposure. However, such an etiological relationship to the single isolated malignant lesion found at that time was speculative. With the findings of two aditional!individuals carcinoma this oT a ¢ | 8 l " me L — THYROID HORMONE STARTED L. pot lOasa a e roe ae14 Aueer 7 16 J gs SPS RONGIDGICALASE,(YEARS) Oss Sed Sa aLe ; ae) Sa. gt EeKe. bat 9. Relative patterns of skeletal maturation and statural growth (connected to developmental ages) in two boys who had marked hypothyroidism. Comparison is with unexposed boys. Note dramatic change in slope of growth curves after thyroid hormoneadministration. group (three among 21 thyroid Iesions in 67 Rongelap people exposed) makes the etiological role of radiation exposure increasingly probable. It seems less likely that the single malignant lesion found in the thyroid of the woman from ° Utirik is due to radiation exposure with thyroid 322 JAMA, Oct 12, 1970 @ Vol 214, No 2 I01 2842 in / 34 because of the low dose of radiation received by the people from that atoll. The significance of radiation exposure of the thyroid glands in the Rongelap people had not been fully appreciated until the actual appear- ance of thyroid lesions. More care- | Thyroid Neoplasia—Conard et al