ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket10086ketendo-10086Research ArticleКраткие сообщенияShort messagesК вопросу о гипердиагностике и гипертерапии карциномы щитовидной железы после аварии на ЧАЭСOn the overdiagnosis and overtreatment of thyroid carcinoma after the Chernobyl accidenthttps://orcid.org/0000-0003-4731-1853ЯргинСергей ВадимовичJarginSergei V.

кандидат медицинских наук, доцент кафедры патологической анатомии

PhD in medicine, associate professor, department of pathology

sjargin@mail.ru<p>ФГАОУ ВО Российский университет дружбы народов</p>Россия<p>RUDN University</p>Russian Federation201819042019144210213Copyright &#x00A9; Яргин С.В., 20182018Яргин С.В.Jargin S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/10086

После аварии на ЧАЭС на основании линейной беспороговой гипотезы предполагалось увеличение заболеваемости различными злокачественными опухолями. Фактически единственным доказанным онкологическим последствием аварии явилось увеличение частоты карцином щитовидной железы среди лиц, подвергшихся облучению в раннем возрасте. До аварии рак щитовидной железы у детей и подростков диагностировали относительно редко. Известно, что скрининг может многократно повышать зарегистрированную заболеваемость опухолями щитовидной железы. При скрининге после аварии выявляли не только ранние, но и старые запущенные опухоли, которые иногда интерпретировали как агрессивные радиогенные раки, что способствовало представлениям об их быстром росте и раннем метастазировании. Это имело последствия для практики: некоторые специалисты рекомендовали более радикальное хирургическое лечение опухолей, возникших после облучения. Подобные рекомендации в целом не соответствуют мировой практике. В заключение, с учетом имевшего место преувеличения роли радиационного фактора в патогенезе карцином щитовидной железы после аварии на ЧАЭС, а также преувеличенных представлений об агрессивности этих опухолей, тактика их лечения не должна отличаться от таковой при спонтанных раках.

On the basis of the linear no-threshold theory, the Chernobyl accident was predicted to result in an incidence increase of various malignancies. In fact, there has been no cancer increase proven to be a consequence of the radiation exposure after the accident except for thyroid carcinoma in people exposed at a young age. Prior to the accident, thyroid cancer had been rarely diagnosed in children and adolescents. The ability of screening to enhance the registered incidence of thyroid tumors is known. The screening after the accident detected not only small tumors but also large neglected ones, sometimes misclassified as aggressive radiogenic cancers, which contributed to the concept of their aggressive behavior and early metastasizing. This had consequences for the practice: some experts recommended a more radical surgical treatment of supposedly radiogenic thyroid cancers. Such recommendations are generally not in agreement with the international practice. In conclusion, the treatment of Chernobyl-related thyroid carcinoma should not be different from that of sporadic one.

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The authors declare that there are no conflicts of interest present.