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Individual Dose Response and Radiation Origin of Childhood and Adolescent Thyroid Cancer in Fukushima II: Possibility of High I-131 Exposure as in Chernobyl

Background: Thyroid cancer incidence of individual dose groups in Fukushima residents exposed at ≤18 years of age demonstrated a linear response to thyroid dose estimated in the United Nations Scientific Committee on the effects of Atomic Radiation (UNSCEAR) 2020/2021. Increased childhood thyroid cancer in Fukushima was found to come dominantly from radiation exposure from the nuclear accident. The UNSCEAR 2020/2021 concluded that the apparent excess of thyroid cancers would not be expected at thyroid doses estimated by the UNSCEAR. The purpose of this paper is to solve the puzzle of the high childhood thyroid cancer incidence in Fukushima despite the estimated low thyroid dose.
Methods: The conversion coefficient k connecting thyroid doses estimated in UNSCEAR 2020/2021 and doses based on direct thyroid dose measurements in Chernobyl: 1 GyUN2021 = k × 1 Gy (gray), was estimated by comparing incidences and dose dependences of thyroid cancers in Fukushima and Chernobyl after nuclear disasters. 
Results: The ratio of the observed cases /expected cases from cancer registry: of about 60 in Fukushima prefecture, was higher than the ratios observed after the Chernobyl accident. The thyroid doses estimated by UNSCEAR were corrected by adding a baseline dose to recover the severely underestimated ingestion dose. The conversion coefficients were: k =60~70 from the comparison of the excess absolute risks (EAR) and their dose dependences in Fukushima and in Chernobyl, and k =10~180 from the comparison of excess relative risk per gray (ERR/Gy) in Fukushima with those in Chernobyl. The thyroid doses might have been underestimated by about 1/50~1/100 in UNSCEAR 2020/2021.
Conclusion: The dozens-fold increase of childhood thyroid cancer cases after the Fukushima nuclear accident was found to arise from radioactive iodine exposure comparable to that in Chernobyl.