Endocrine Abstracts

Chernobyl accident was followed by numerous publications overestimating its medical consequences, where spontaneous diseases have been without sufficient reasons classified as radiogenic. Among medical consequences of the accident, cause-effect relationship between ingestion of radioiodine and thyroid cancer in patients exposed at a young age is regarded to be proven. Significant incidence increase of pediatric thyroid cancer started 4 years after the accident, coinciding with the onset of large-scale screening programs. High percentage of advanced thyroid cancers among the cases found shortly after the accident can be explained by the screening effect with detection of neglected tumors and by the fact that patients from non-contaminated areas were registered as Chernobyl victims. Older neglected tumors, larger in size and less differentiated, prevailed early after the accident, being gradually replaced by smaller cancers detected by means of improving diagnostic methods. Accordingly, features of supposedly radiogenic post-Chernobyl cancers can be related to the disease duration and a later stage of tumor progression. Iodine deficiency in some of the contaminated areas contributed to a higher yield of thyroid nodules, found by the screening and offering an opportunity of overdiagnosis. In conclusion, mass screening in the areas, where pediatric thyroid cancer had been rarely diagnosed before, in conditions of outdated equipment of histopathological laboratories, shortage of modern literature, and high tumor expectancy after the accident, should predictably have resulted in the incidence overestimation.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector