Complex Approach to Thyroid Screening In Regions Adjacent to the Semipalatinsk Test Site Area

It has been well documented that the thyroid gland is one of the most radiosensitive of organs, especially when exposure occurs during childhood. It is known as well that childhood exposure to radioactive iodine increases thyroid cancer risk. Conducting thyroid screening in regions adjacent to the Semipalatinsk Test Site (STS) area is very important for medical examination, data management and thyroid dose reconstruction. Our experience of thyroid screening based on our screening projects in Kurchatov and several regions adjacent to STS (more than 4,000 screened patients) allowed to work out the most appropriate screening protocol. A retrospective analysis of the results of surgical treatment of the 7,271 patients with thyroid abnormalities in the Semipalatinsk, Pavlodar and Ust-Kamenogorsk regions of Kazakstan and study the histological staging of 7,271 surgically removed thyroid glands was preceded by our thyroid screening projects. Ours is the first study in the Semipalatinsk region that covers the period 1966-1998.Taking into account the onset of population effective doses during 1962, it was decided to distinguish 6 periods of observation. It is known that basic effective equivalent doses for the majority of the region's population were established by radioactive events in the period 1949-1962. This explains our focus on the year 1962, but thyroid dose reconstruction matter as well as other radiation related problems are still in the progress. We need to get the accurate dosimetry data. Selection of study subjects based on the appropriate criteria needed to be adjusted and clarified in accordance with the main goal of the project and radiation related information. All specialists involved in the thyroid screening project, data management, data analyses and interpretation of the results must be trained and must be highly qualified specialists in this field of science and practice. The experiences in Nagasaki, Hiroshima and Chernobyl, and discussions with experts from the United States, Japan led to necessity to establish the thyroid screening center and endocrine surgery unit in Semipalatinsk. Our study will serve as a basis for future descriptive analyses regarding the association between thyroid cancer and radiation exposure from STS