It is well known that science can be misused to hinder the resolution (i.e., the elimination and/or control) of a health problem. To recognize distorted and misapplied epidemiological science, a 33-item “Toolkit for detecting misused epidemiological methods” (hereinafter, the Toolkit) was published in 2021. Applying the Toolkit, we critically evaluated a review paper entitled, “Lessons learned from Chernobyl and Fukushima on thyroid cancer screening and recommendations in the case of a future nuclear accident” in Environment International in 2021, published by the SHAMISEN (Nuclear Emergency Situations - Improvement of Medical and Health Surveillance) international expert consortium. The article highlighted the claim that overdiagnosis of childhood thyroid cancers greatly increased the number of cases detected in ultrasound thyroid screening following the 2011 Fukushima nuclear accident. However, the reasons cited in the SHAMISEN review paper for overdiagnosis in mass screening lacked important information about the high incidence of thyroid cancers after the accident. The SHAMISEN review paper ignored published studies of screening results in unexposed areas, and included an invalid comparison of screenings among children with screenings among adults. The review omitted the actual state of screening in Fukushima after the nuclear accident, in which only nodules > 5 mm in diameter were examined. The growth rate of thyroid cancers was not slow, as emphasized in the SHAMISEN review paper; evidence shows that cancers detected in second-round screening grew to more than 5 mm in diameter over a 2-year period. The SHAMISEN consortium used an unfounded overdiagnosis hypothesis and misguided evidence to refute that the excess incidence of thyroid cancer was attributable to the nuclear accident, despite the findings of ongoing ultrasound screening for thyroid cancer in Fukushima and around Chernobyl. By our evaluation, the SHAMISEN review paper includes 20 of the 33 items in the Toolkit that demonstrate the misuse of epidemiology. The International Agency for Research on Cancer meeting in 2017 and its publication cited in the SHAMISEN review paper includes 12 of the 33 items in the Toolkit. Finally, we recommend a few enhancements to the Toolkit to increase its utility.

中文翻译：

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通过应用检测滥用流行病学方法的工具包来展示福岛核事故后科学和卫生政策受到的破坏

众所周知，科学可能被滥用来阻碍健康问题的解决（即消除和/或控制）。为了认识到流行病学科学的扭曲和误用，2021 年发布了包含 33 项的“检测滥用流行病学方法的工具包”（以下简称“工具包”）。应用该工具包，我们批判性地评估了一篇题为“从切尔诺贝利和福岛吸取的教训”的评论论文SHAMISEN（核紧急情况 - 改善医疗和健康监测）国际专家联盟在 2021 年《国际环境》中发表的“关于甲状腺癌筛查和未来核事故情况下的建议”的报告。该文章强调了这样一种说法，即 2011 年福岛核事故后，儿童甲状腺癌的过度诊断大大增加了超声甲状腺筛查中发现的病例数量。然而，三味线评论论文中引用的大规模筛查过度诊断的原因缺乏有关事故后甲状腺癌高发的重要信息。三味线审查论文忽略了已发表的关于未暴露区域筛查结果的研究，并且包括对儿童筛查与成人筛查的无效比较。该审查忽略了福岛核事故后的实际筛查情况，仅检查直径> 5毫米的结核。正如《三味线》综述论文所强调的那样，甲状腺癌的增长速度并不慢；有证据表明，在第二轮筛查中发现的癌症在两年内直径增长到超过 5 毫米。尽管福岛和切尔诺贝利周边地区正在进行甲状腺癌超声筛查，但三味线联盟仍使用毫无根据的过度诊断假说和误导性证据来反驳甲状腺癌发病率过高应归咎于核事故的说法。根据我们的评估，SHAMISEN 综述论文包含了工具包中 33 个项目中的 20 个项目，证明了流行病学的滥用。SHAMISEN 综述论文中引用的国际癌症研究机构 2017 年会议及其出版物包括工具包中 33 项中的 12 项。最后，我们建议对工具包进行一些增强，以提高其实用性。