Patients from Belarus constantly talk about how local endocrinologists explain to them that their diseases of the thyroid gland are caused by the consequences of the accident at the Chernobyl nuclear power plant. But is it? It turns out that the picture is different from the ideas of residents of cities and villages of Belarus.
Two types of thyroid disease
All diseases of the thyroid gland can be divided into two parts. One will make benign diseases. The other is malignant. Benign diseases are much more. Usually, they account for almost 99% of all thyroid diseases.
Radiation is able to create mutations in the genotype and thus lead to the appearance of other cancer cells. And this fact is confirmed by a real increase in the detection of malignant nodules in the thyroid gland in residents of regions close to the Chernobyl nuclear power plant.
But can excessive radiation provoke benign diseases?
Sufficient strength radiation can damage tissue. Especially actively functioning, making intensive capture of substances from blood. These organs include glands (salivary, liver, thyroid ...). In this case, some parts of the thyroid gland are damaged.
Radioactive isotopes of iodine, pertechnetate, etc., can be captured by some cells of the thyroid gland and limit their functioning (production of hormones). As a result, the load on other cells of the gland increases, which can lead to adaptive changes - goiter, diffuse or nodal transformations.
A brief review of research conducted in our Clinic on the effects of excess radiation on Belarusians showed that:
1) indeed, research has revealed a significant increase in the malignancy of thyroid nodules in Belarus after the accident at the Chernobyl nuclear power plant,
2) the dependence of the frequency of benign thyroid gland pathology on the events at the Chernobyl nuclear power plant and the background radiation in the regions of Belarus has not been studied.
As can be seen from the figure, the incidence rates of thyroid cancer in the Gomel region and the Republic of Belarus are characterized by monotonous growth over the period 1986-2008. At the same time, in some years, peak increases were observed in the incidence rates in the Gomel region compared to the Republic of Belarus (3.005 and 1.412 in 1987; 6.655 and 2.947 in 1991; 9.252 and 4.301 in 1993; 160808 in 2001 and 8,007 cases per 100 thousand population, respectively).
30 years later ... thyroid
Pay attention to the important circumstance. The fact is that mutations in the genome can persist for years and be inherited. It is a source of increased frequency of thyroid cancer as a result of the Chernobyl accident.
But benign diseases of the thyroid gland are not transmitted in this way. They arise either as a result of recent radiation damage, or as a result of sufficient influence of other causes. It is these other reasons that are the source of diffuse and benign nodules.
Modern residents of Belarus do not have benign changes in the thyroid gland with an optimal radiation background.
An increase in the frequency of benign thyroid diseases is associated with improved diagnostics!
Even leading endocrinologists of Belarus indicate that the frequency of detecting benign changes in the thyroid gland is caused by nothing other than an improvement in medical diagnostics.
This includes not only the equipment of ultrasound and other equipment of medical institutions, not only an increase in the level of specialists, but also medical examinations.
According to the chief freelance endocrinologist of the Ministry of Health of the Republic of Belarus, Professor of the Department of Endocrinology of the Belarusian State Medical University, Doctor of Medical Sciences Alla Shepelkevich, a statistical increase in primary hypothyroidism and autoimmune thyroiditis in Belarus is associated with enhanced laboratory diagnostics of these thyroid conditions.
If we take into account that since the beginning of the 90s, ultrasound diagnostics and cytological examination of thyroid nodules, as well as the lack of absolute accuracy (sensitivity and specificity in detecting signs of cancer) of these methods, have begun to be actively introduced, then the frequency of real cancer (including as a curve on charts) should be even less.
Iodine prophylaxis has led to a decrease in benign thyroid diseases in the Republic of Belarus.
“The results of the implementation of the iodine deficit elimination strategy in the Republic of Belarus allowed the International Committee for the Control of Iodine Deficiency Disorders and the Global Iodine Network to include Belarus in the list of countries that have reached the target levels of iodine nutrition. 97.5% 000 in 2000; 88.14% 000 in 2015) and more than 2 times the primary incidence of endemic goiter (from 318.9% 000 in 2000 to 146.81% 000 in 2015) ...
The results of screening for primary congenital hypothyroidism indicate that the level reached adequate to the average European indicators: in 2014, 1 case of hypothyroidism was detected in 4,216 newborns".
Most benign thyroid disorders are treatable!