1. Session 1 (tutorial session): Radiation and Thyroid Cancer Summary Many patients with thyroid cancer were found in the Fukushima Health Management survey and people are worried about the effects of radiation from the accident. The global incidence of thyroid cancer has been increasing sine approximately 30 years. In the Chernobyl accident young children, zero to 9 years are at higher risk of thyroid cancer, with the incidence of thyroid cancer appearing in increase beginning at 0.1 Gy at ages zero to 17 years. 94.9% of people in Fukushima Prefecture at the time of the accident (except site workers) received a dose of <2.0 mSv and 66% received a dose of <1 mSv. (as of December 2013)

2. Session 1 (tutorial session): Radiation and Thyroid Cancer Summary - Continued Even advanced stages of thyroid cancer after radiation exposure can be treated effectively with surgery, radioidine therapy and thyroid hormone supplements. The current high prevalence of in thyroid cancer recently found in Fukushima Prefecture is highly likely attributable to screening. Thyroid cancer occurance is influenced by: Change in risk factors Change in diagnosis and detection Methodology considerations

3. Session 1 (tutorial session): Radiation and Thyroid Cancer Summary - Continued Perception by stakeholders is everything. Risk communications and dialogue is better locally oriented than centrally managed. Recommendations – Continue and strengthen the Fukushima Health Management Survey. Develop a population based Cancer Registry. Enable linkage of data over time and end-points. Implement a Primary Prevention Program. Use of observation, for low risk papillary patients was found to be an effective treatment therapy. Establish an effective, locally based Risk Communications Program.