A thyroid ultrasound examination program has been conducted in the aftermath of the Fukushima Daiichi Nuclear Power Plant accident to address concerns about the increased risk of thyroid cancer similar to those experienced by local residents after the 1986 Chernobyl accident. This is the second-largest thyroid cancer screening in younger age ever, following only that conducted after Chernobyl. As the natural history of thyroid cancer in younger populations is not well characterized, large-scale screening using thyroid ultrasound could result in overdiagnosis, even with careful planning, as has been experienced in South Korea. Awareness regarding the thyroid gland is generally low among residents, who tend to directly associate examination results with radiation exposure and are likely to develop newfound anxiety and feelings of self-condemnation and guilt. We reviewed the dilemma surrounding cancer screening and particularly underscored the need to address psychosocial issues associated with possible overdiagnosis. We modified our approach to address individual and social anxiety induced by results of screening conducted after the Fukushima accident. These findings and our experiences regarding the psychosocial issues related to thyroid examination should assist residents in their lifelong decision making and help them prepare for future disasters.
Keywords: anxiety; cancer screening; decision making; overdiagnosis; radiation disaster; risk communication; self-condemnation; thyroid cancer.