{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:44:42Z","timestamp":1765835082886,"version":"3.48.0"},"reference-count":35,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Health Fund for Children and Adults Affected by the Nuclear Incident"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,4,25]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In October 2011, the Fukushima prefectural government started a thyroid ultrasound examination (TUE) as part of the Fukushima Health Management Survey following the Fukushima Daiichi Nuclear Power Plant accident. The proportion of examinees is an important factor when interpreting the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To construct models that assess the relationship between the proportion of non-examinees and the characteristics of eligible participants in the first-round to third-round TUEs. Using these models, estimate the number of thyroid cancer cases in the entire population for each survey, considering non-examinees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Model-based estimation using cohort survey data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>Fukushima Health Management Survey from 2011 to 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Children and adolescents aged 18 years or younger (363\u2009342 individuals) who were identified through resident registration records, resided in Fukushima Prefecture at the time of the accident, and were eligible for each TUE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Modelling the relationship between non-examinee status and individual characteristics, and estimating the number of cases in the entire population for each survey round.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The area under the receiver operating characteristic curve of the constructed models ranged from 0.815 to 0.905. In the first-round, second-round and third-round TUEs, 115, 70 and 30 cases were observed among 294 921, 258 771 and 208\u2009955 examinees, respectively, whereas the estimated number of cases in the entire population including the non-examinees was 177.3 (95% CI 167.0 to 188.0), 126.3 (95% CI 106.3 to 150.2) and 49.7 (95% CI 35.8 to 71.9), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These estimates were higher than the actual number of observed cases because they considered non-examinees. Our model for non-examination showed a high discriminant accuracy and was considered to capture well the factors that resulted in non-examinees. This study\u2019s findings provide valuable information for studies considering the number of potential thyroid cancer cases among non-examinees and may facilitate appropriate interpretation of reports and prospective survey outcome management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084885","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T15:25:14Z","timestamp":1749050714000},"page":"e084885","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Model-based estimation of thyroid cancer incidence from ultrasound examinations in the Fukushima Health Management Survey: estimated results considering the non-examinees in the first, second and third rounds of the cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2387-7772","authenticated-orcid":false,"given":"Kunihiko","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Biostatistics, M&D Data Science Center, Institute of Integrated Research, Institute of Science Tokyo, Tokyo, Japan"},{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiji","family":"Yasumura","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideto","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Teikyo Heisei University, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3827-1012","authenticated-orcid":false,"given":"Tomoki","family":"Nakaya","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Graduate School of Environmental Studies, Tohoku University, Sendai, Japan"},{"name":"Department of Earth Science, Graduate School of Science, Tohoku University, Sendai, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1073-2996","authenticated-orcid":false,"given":"Tatsuhiko","family":"Anzai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, M&D Data Science Center, Institute of Integrated Research, Institute of Science Tokyo, Tokyo, Japan"},{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Ohira","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Department of Epidemiology, Fukushima Medical University, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Shimura","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Department of Laboratory Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Iwadate","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan"},{"name":"Department of Surgery, Minamisoma Municipal General Hospital, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Yokoya","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Ohto","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan"},{"name":"Radiation Effects Research Foundation, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"2025121513405206000_15.6.e084885.1","unstructured":"Kamiya K , Ohto H , Yasumura S , eds. Report of the Fukushima health management survey 2011-2020. Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, ISBN 978-4-9911932-1-7."},{"key":"2025121513405206000_15.6.e084885.2","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20120105"},{"key":"2025121513405206000_15.6.e084885.3","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.2188\/jea.JE20210390","article-title":"Achievements and current status of the fukushima health management survey","volume":"32","author":"Yasumura","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1507\/endocrj.EJ15-0726","article-title":"The protocol and preliminary baseline survey results of the thyroid ultrasound examination in Fukushima [Rapid Communication]","volume":"63","author":"Suzuki","year":"2016","journal-title":"Endocr J"},{"key":"2025121513405206000_15.6.e084885.5","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/EDE.0000000000000385","article-title":"Thyroid cancer detection by ultrasound among residents ages 18 years and younger in Fukushima, Japan","volume":"27","author":"Tsuda","year":"2016","journal-title":"Epidemiology (Sunnyvale)"},{"key":"2025121513405206000_15.6.e084885.6","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyv191"},{"key":"2025121513405206000_15.6.e084885.7","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000008631","article-title":"Simulation of expected childhood and adolescent thyroid cancer cases in Japan using a cancer-progression model based on the National Cancer Registry: Application to the first-round thyroid examination of the Fukushima Health Management Survey","volume":"96","author":"Takahashi","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"2025121513405206000_15.6.e084885.8","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-35971-7","article-title":"Spatial analysis of the geographical distribution of thyroid cancer cases from the first-round thyroid ultrasound examination in Fukushima Prefecture","volume":"8","author":"Nakaya","year":"2018","journal-title":"Sci Rep"},{"key":"2025121513405206000_15.6.e084885.9","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1089\/thy.2015.0564","article-title":"Comprehensive survey results of childhood thyroid ultrasound examinations in fukushima in the first four years after the fukushima daiichi nuclear power plant accident","volume":"26","author":"Suzuki","year":"2016","journal-title":"Thyroid"},{"key":"2025121513405206000_15.6.e084885.10","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000004472","article-title":"Comparison of childhood thyroid cancer prevalence among 3 areas based on external radiation dose after the Fukushima Daiichi nuclear power plant accident: The Fukushima health management survey","volume":"95","author":"Ohira","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"2025121513405206000_15.6.e084885.11","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1097\/EDE.0000000000001058","article-title":"External radiation dose, obesity, and risk of childhood thyroid cancer after the Fukushima Daiichi nuclear power plant accident: the Fukushima health management survey","volume":"30","author":"Ohira","year":"2019","journal-title":"Epidemiology (Sunnyvale)"},{"key":"2025121513405206000_15.6.e084885.12","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1001\/jamaoto.2018.3121","article-title":"Incidence of thyroid cancer among children and young adults in Fukushima, Japan, screened with 2 rounds of ultrasonography within 5 years of the 2011 Fukushima Daiichi nuclear power station accident","volume":"145","author":"Ohtsuru","year":"2019","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2025121513405206000_15.6.e084885.13","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000017165","article-title":"Association between the detection rate of thyroid cancer and the external radiation dose-rate after the nuclear power plant accidents in Fukushima, Japan","volume":"98","author":"Yamamoto","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"2025121513405206000_15.6.e084885.14","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000020440","article-title":"Nested matched case control study for the Japan Fukushima Health Management Survey\u2019s first full-scale (second-round) thyroid examination","volume":"99","author":"Takahashi","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"2025121513405206000_15.6.e084885.15","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-60999-z","article-title":"Relationship between environmental radiation and radioactivity and childhood thyroid cancer found in Fukushima health management survey","volume":"10","author":"Toki","year":"2020","journal-title":"Sci Rep"},{"key":"2025121513405206000_15.6.e084885.16","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1093\/jrr\/rrz104","article-title":"Absorbed radiation doses in the thyroid as estimated by UNSCEAR and subsequent risk of childhood thyroid cancer following the Great East Japan Earthquake","volume":"61","author":"Ohira","year":"2020","journal-title":"J Radiat Res"},{"key":"2025121513405206000_15.6.e084885.17","doi-asserted-by":"crossref","first-page":"i7","DOI":"10.1093\/jrr\/rraa097","article-title":"Communicating with residents about 10 years of scientific progress in understanding thyroid cancer risk in children after the Fukushima Dai-ichi Nuclear Power Station accident","volume":"62","author":"Suzuki","year":"2021","journal-title":"J Radiat Res"},{"key":"2025121513405206000_15.6.e084885.18","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.2188\/jea.JE20210165","article-title":"Revisiting the geographical distribution of thyroid cancer incidence in Fukushima prefecture: analysis of data from the second- and third-round thyroid ultrasound examination","volume":"32","author":"Nakaya","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.2188\/jea.JE20180247","article-title":"Factors influencing the proportion of non-examinees in the Fukushima health management survey for childhood and adolescent thyroid cancer: results from the baseline survey","volume":"30","author":"Takahashi","year":"2020","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.20","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-23896-1","article-title":"Loss of participation among evacuees aged 20-37 years in the disaster cohort study after the Great East Japan Earthquake","volume":"12","author":"Yamamoto","year":"2022","journal-title":"Sci Rep"},{"key":"2025121513405206000_15.6.e084885.21","doi-asserted-by":"crossref","first-page":"i129","DOI":"10.1093\/jrr\/rraa134","article-title":"Relationship between physical activity\/exercise habits and the frequency of new onset of lifestyle-related diseases after the Great East Japan Earthquake among residents in Fukushima: the Fukushima Health Management Survey","volume":"62","author":"Hayashi","year":"2021","journal-title":"J Radiat Res"},{"key":"2025121513405206000_15.6.e084885.22","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19063399","article-title":"Lifestyle factors associated with undernutrition in older people after the great east japan earthquake: a prospective study in the Fukushima health management survey","volume":"19","author":"Okazaki","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025121513405206000_15.6.e084885.23","doi-asserted-by":"crossref","first-page":"10805","DOI":"10.1038\/s41598-022-14992-3","article-title":"Changes in the proportion of anemia among young women after the Great East Japan Earthquake: the Fukushima health management survey","volume":"12","author":"Yamamoto","year":"2022","journal-title":"Sci Rep"},{"key":"2025121513405206000_15.6.e084885.24","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.2188\/jea.JE20210386","article-title":"Trends in lifestyle-related diseases and their risk factors after the Fukushima Daiichi nuclear power plant accident: results of the comprehensive health check in the Fukushima health management survey","volume":"32","author":"Ohira","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.25","doi-asserted-by":"crossref","first-page":"S84","DOI":"10.2188\/jea.JE20210286","article-title":"Effects of external radiation exposure resulting from the Fukushima Daiichi nuclear power plant accident on the health of residents in the evacuation zones: the Fukushima health management survey","volume":"32","author":"Sakai","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.26","doi-asserted-by":"publisher","DOI":"10.5387\/fms.2014-1"},{"key":"2025121513405206000_15.6.e084885.27","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.14.146498"},{"key":"2025121513405206000_15.6.e084885.28","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.2188\/jea.JE20210178","article-title":"Long-term, community-based approach for affected people having problems with mental health and lifestyle issues after the 2011 Fukushima disaster: the Fukushima health management survey","volume":"32","author":"Maeda","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.29","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.2188\/jea.JE20210226","article-title":"Associations between external radiation doses and the risk of psychological distress or post-traumatic stress after the Fukushima Daiichi nuclear power plant accident: the Fukushima health management survey","volume":"32","author":"Miura","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.30","doi-asserted-by":"crossref","first-page":"122","DOI":"10.5387\/fms.2019-26","article-title":"Investigation of thyroid cancer cases that were not detected in the Thyroid Ultrasound Examination program of the Fukushima Health Management Survey but diagnosed at Fukushima Medical University Hospital","volume":"65","author":"Yokoya","year":"2020","journal-title":"Fukushima J Med Sci"},{"key":"2025121513405206000_15.6.e084885.31","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.2188\/jea.JE20210271","article-title":"A comprehensive review of the progress and evaluation of the thyroid ultrasound examination program, the Fukushima health management survey","volume":"32","author":"Shimura","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.32","first-page":"402","article-title":"The latest update on individual external doses in an early stage after the Fukushima nuclear accident","volume":"187","author":"Ishikawa","year":"2019","journal-title":"Radiat Prot Dosimetry"},{"key":"2025121513405206000_15.6.e084885.33","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.2188\/jea.JE20210166","article-title":"External doses available for epidemiological studies related to the Fukushima health management survey: first 4-month individual doses and municipality-average doses for the first year","volume":"32","author":"Ishikawa","year":"2022","journal-title":"J Epidemiol"},{"key":"2025121513405206000_15.6.e084885.34","unstructured":"Ministry of The Environment . Incidence rate of thyroid cancer: Japan. In: BOOKLET to provide basic information regarding health effects of radiation. 2nd edn. 2022. Available: https:\/\/www.env.go.jp\/en\/chemi\/rhm\/basic-info\/1st\/03-07-20.html"},{"key":"2025121513405206000_15.6.e084885.35","doi-asserted-by":"crossref","first-page":"25","DOI":"10.16956\/jes.2019.19.1.25","article-title":"Analysis of correlation between thyroid cancer incidence and socioeconomic status using 10-year sample cohort database","volume":"19","author":"Yang","year":"2019","journal-title":"J Endocr Surg"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-084885","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:41:01Z","timestamp":1765834861000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-084885"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,4]]},"published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1136\/bmjopen-2024-084885"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-084885","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}