TAILIEUCHUNG - GEOGRAPHIC VARIATION IN U.S. THYROID CANCER INCIDENCE, AND A CLUSTER NEAR NUCLEAR REACTORS IN NEW JERSEY, NEW YORK, AND PENNSYLVANIA

A similar effort may well be in order targeting the gay and bisexual men who are most at risk, particularly those who are living with HIV. Further research is needed to determine the prevalence and incidence of ASIL in the general population of gay and bisexual men outside of major urban centers. Programs are needed to train colposcopists in the skills of identifying and biopsying ASIL; training of colorectal surgeons is needed to optimize identification and treat- ment of ASIL. Further research is also needed on newer, medical therapies for ASIL so that costly and painful surgery can be avoided | GEOGRAPHIC VARIATION IN . THYROID CANCER INCIDENCE AND A CLUSTER NEAR NUCLEAR REACTORS IN NEW JERSEY NEW YORK AND PENNSYLVANIA Joseph J. Mangano Thyroid cancer incidence is increasing more rapidly than any other malignancy in the . along with liver cancer rising nearly threefold from 1980 to 2006. Improved diagnosis has been proposed as the major reason for this change by some while others contend that other factors also account for the increase. Among . states 2001-2005 age-adjusted thyroid cancer incidence rates vary from to per 100 000. Countyspecific incidence data available for the first time document that most . counties with the highest thyroid cancer incidence are in a contiguous area of eastern Pennsylvania New Jersey and southern New York. Exposure to radioactive iodine emissions from 16 nuclear power reactors within a 90 mile radius in this area as a potential etiological factor of thyroid cancer is explored these emissions are likely a cause of rising incidence rates. From 1980 to 2006 annual . thyroid cancer incidence rose nearly threefold from to cases per 100 000 age adjusted to the 2000 . standard population . This increase has been steady rising in 22 of 26 years and has been most pronounced since the early 1990s 1 . Along with liver bile duct cancer incidence of thyroid cancer has experienced the greatest increase of any type of malignancy Appendix 1 . Temporal trends during this period were consistent between 137 and 181 for males females blacks and whites. Rates have risen markedly for all age groups except for children and the very old Appendix 2 . The expected annual number of newly diagnosed . thyroid cancer cases has reached 37 340. Improvements in treatment have raised survival rates by 2006 the prevalence of . thyroid cancer survivors was 410 404 and is increasing by more than 20 000 each year. 1 This significant and largely unexpected rise in . thyroid cancer incidence is consistent with .

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