Oncology

Does Asymptomatic Thyroid Cancer Really Need Surgery?

Updated: 26 August , 13:21
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A Jama Otolaryngology - Head & Neck Surgery expert team conducted a special study to evaluate the adequacy of thyroid cancer treatment recommendations. The scientists from Vermont, USA, analyzed data of over 1300 patients who had had thyroid surgery, collected by 6 hospitals. Most of them had got their diagnoses as an incidental finding in the course of various exams. The experts concluded that their therapy had been redundant.

Various independent health care organizations, such as, for example, the U.S. Preventive Services Task Force, even oppose using ultrasound scans for asymptomatic patients, arguing that it rather does harm than brings any clinical benefit.

University of Minnesota scientists think that redundant exams lead to unnecessary diagnoses and treatment.

According to statistics, thyroid cancer cases have triplicated in the USA since 1980. Meanwhile, it’s not that tumors occur more often, they are just diagnosed more frequently.  Germany has even more vivid numbers: thyroid cancer surgery is five times as frequent there as in nearby Holland.

In South Korea, the thyroid malignancy cases have grown from 4 to 70 per 100000 since the launch of a large-scale screening program in the 1990-s. The annual incidence of this type of cancer in South Korea constitutes 45000 cases and is extremely high. However, the treatment effect vs mortality rate statistics are the same as they used to be before the commencement of the preventing testing program, while the number of side effects, such as palsy, seizures and thyroid function deficiency, multiply. 

On the whole, the researchers conclude: the risk of grave consequences of thyroid cancer exists only in 10% of diagnosed cases.

References:

Mirabelle Sajisevi, MD; Lisa Caulley, MD, MPH; Antoine Eskander, MD, ScM; et al. Evaluating the Rising Incidence of Thyroid Cancer and Thyroid Nodule Detection Modes

A Multinational, Multi-institutional Analysis. JAMA Otolaryngol Head Neck Surg. Published online July 14, 2022. doi:10.1001/jamaoto.2022.1743

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