The Effects of Over-diagnosing Thyroid Cancer
Thyroid cancer diagnosis and treatment has nearly tripled since 1975. The treatment includes removal of the hormone-releasing gland in the neck followed by lifelong daily hormone pills.
A recent study predicts this dramatic rise has resulted from over diagnosis and treatment of tumors too small to ever cause harm. This raises the question; do all cancers need aggressive treatment? Research suggests certain cancers of the prostate, lungs and breast as well as thyroid grow so slowly they will never become deadly.
“Our old strategy of looking as hard as possible to find cancer has some real side effects,” said Dr. Gilbert Welch, co-author of the thyroid study and a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice.
Welch said patients “can no longer assume” that labeling a disease as cancer means treatment is necessary. “It’s a challenging rethinking,” he added.
What Has Recent Research Uncovered?
Welch and Dartmouth colleague Dr. Louise Davies analyzed government data from 1975 to 2009 and found: thyroid cancers jumped from 5 cases per 100,000 people to 14 per 100,000. Most of that increase was in papillary thyroid cancers, the most common and least deadly kind; those cases jumped from about three cases per 100,000 to more than 12 per 100,000.
“There is an ongoing epidemic of thyroid cancer in the United States. The epidemiology of the increased incidence, however, suggests that it is not an epidemic of disease but rather an epidemic of diagnosis. The problem is particularly acute for women, who have lower autopsy prevalence of thyroid cancer than men but higher cancer detection rates by a 3:1 ratio.”
This study was published online Thursday in JAMA Otolaryngology.
Facts on Thyroid Cancer:
Relatively uncommon despite the recent increase
Risk factors include diets low in iodine and radiation exposure
Women are more commonly diagnosed than men
Treated Thyroid cancer has a fairly high recurrence rate even it it doesn’t kill
Experts know that better detection methods including CT scans and ultrasound, have led to more thyroid cancers being diagnosed, but they don’t know which ones will become aggressive, Burkey said.
Advice From the Authors of This Study:
Physicians could “openly share with patients the uncertainty surrounding small thyroid cancers — explaining that many will never grow and cause harm to a patient,” but that it’s not possible to know for certain which ones are harmless.
That would allow patients to make better informed decisions, and some might opt for close monitoring instead of treatment, the authors said.
Harmless Tumors Painfully Mistaken For Thyroid Cancer
The facts of this article are courtesy of Associated Press
Feature image courtesy of Mayo Foundation for Medical Education and Research