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Purportedly High Cancer Risk among US Sailors on Nuclear-Powered Ships

I was surprised to see the recent paper published in a reputable scientific journal like Cancer Investigation claiming to have found a “high cancer risk in US naval personnel serving in nuclear powered ships” (the title of the paper) (1). The data used in the paper on the numbers of “cancer cases” in two groups of sailors, data that are fundamental to this claim, cannot be found in the reference given as the source of these data, but I understand from the Editor-in-Chief of this journal that the data were actually derived from Appendix A of a report published in 2014 by the Office of the Assistant Secretary of Defense for Health Affairs (2), which did not appear in the list of references in the paper as published (1). This report (2) provides information on “disease/ symptom incidence rates”, including of all malignant neoplasms combined, during May 12, 2011 to December 31, 2013, for personnel serving on the USS Ronald Regan when it was present off the east coast of Japan during the release to atmosphere in March 2011 of radionuclides from the damaged Fukushima Dai-ichi nuclear reactors. These rates are compared with those for a control group of sailors who were deployed at some point in the two years before March 11, 2011 (the date of the start of the radioactive releases), but were not in the area affected by the radioactive contamination. The paper (1) compares the observed number of incident malignant neoplasm disease/symptom cases in the control group with the number of cancer cases expected from age-group-specific SEER male cancer incidence rates for the US general population and reports an observed to expected case ratio of 9.2 (95% confidence interval: 8.48, 9.96). This is a dramatically high ratio that demands an explanation, but it would be remarkable if this represents a genuine excess of confirmed cases of cancer, rather than “malignant neoplasm disease/ symptom” cases, if only because such a high rate of cancer in naval personnel would have been readily detected previously. Quite apart from this, the assertion (1) that the sailors in the control group served on nuclear-powered ships and that the high number of cases in this group is due to consequent exposure to radiation is pure speculation – it is not stated in the report (2) that the control group was drawn from nuclear-powered ships and no evidence is offered in the paper (1) to support this claim. Further, that the level of radiation exposure on nuclear-powered ships could be high enough to produce such a pronounced adverse health effect is just not credible. Moreover, the age-, sex-, ethnicityand occupationadjusted malignant neoplasm disease/symptom incidence rate for the sailors from the USS Ronald Regan was 0.55 (95% confidence interval: 0.40, 0.73) of that for the control group (2). In a truly bizarre twist, it is proposed (1) that the sailors on the USS Ronald Regan were at a substantially increased risk of cancer as a result of radioactive fallout from the releases from the Fukushima Daiichi reactors, despite the malignant neoplasm disease/ symptom incidence rate for these sailors being around half of that for the sailors not exposed to this fallout. What sort of Wonderland do we inhabit where a paper can be published claiming that radioactive fallout from the Fukushima Dai-ichi reactors is much more carcinogenic than inferred by expert groups when the information presented in the paper shows exactly the opposite?