Overdiagnosis could be behind jump in thyroid cancer cases. Thyroid cancer early detection, diagnosis, and staging cancer. Jan 26, 2018 in fact, thyroid cancer is currently the third fastest rising cancer diagnosis in the us. The 20 year survival rate is greater than 90%, and approaches 100% for the smallest cancers. Arch pathol lab medvol 142, september 2018 thyroid cancer overdiagnosis and pathologistsschnadig 1019. Harm caused by overdiagnosis of thyroid cancer is more serious in the young, since it is difficult to perform active surveillance and. Overdiagnosis has also been associated with early detection in a variety of other cancers, including neuroblastoma, melanoma, and thyroid cancer. The countries with the highest prevalence had two common denominators. Thyroid cancer, in 2010, resulted in 36,000 deaths globally up from 24,000 in 1990. Oct 22, 2018 the incidence of differentiated thyroid cancers, especially the papillary subtype, has been increasing worldwide. Obesity may be associated with a higher incidence of thyroid cancer, but this relationship remains the subject of much debate.
Thyroid cancer is a malignant tumor or growth originating within the thyroid gland. Experience of us patients who selfidentify as having an. Pdf thyroid cancer epidemic also occurs in low and middle. For example, thyroid cancer incidence has been on the rise in north american for decades, but mortality rates have remained stablea discrepancy indicative of high percentages of overdiagnosis. The study found that thyroid cancer incidence rates increased in canada by five and six times in men and women respectively between 1970 and 2012 with unchanged mortality rates. Similar upward trends for thyroid cancer are found in the united states and europe, although not to the same degree. In the united states and australia, overdiagnosis accounted for about 45 percent of thyroid cancer in men over that fouryear period. Despite varied views towards the proposed strategy, there was a strong overarching desire for greater patient and public education around overdiagnosis and overtreatment in both thyroid cancer and.
Thyroid cancer is commonly diagnosed at a younger age than most other adult cancers. Thyroid cancer overdiagnosis raises questions about. High dose radiation exposure, especially during childhood, increases the risk of developing thyroid cancer. Overdiagnosis of thyroid cancer is often cited as a reason for the increases in. Therefore, the current study aimed to estimate the prevalence of incidental dtc in published autopsy series and determine whether this prevalence has been increasing over time.
Nov 30, 2016 nonlethal cancers picked up by screening are probably responsible thyroid cancer incidence has increased dramatically in many countries in the developed world over the past three decades. Some early cancers may have signs and symptoms that can be noticed, but that is not always the case. Prior to the 1960s, xray treatments were often used for. Because thyroid cancer screening did not have association with a decrease in thyroid cancer mortality, the observed rise in thyroid cancer incidence has raised concerns around overdiagnosis.
Key questions types of thyroid cancer papillary thyroid cancer most common type about 7080% of all cases develops from the follicular cells tends to grow slowly follicular thyroid cancer about 25% of thyroid cancer cases develops from the follicular cells includes. The american thyroid association recognizes that the recent increase in incidence of thyroid cancer in the united states and other countries is, in large part, due to the diagnosis of indolent papillary microcarcinomas that will never result in symptoms or death, and which only rarely will enlarge or spread beyond the thyroid gland. Density to discover novel mammogrambased predictors of breast cancer risk. Back in 2012, the national cancer institute convened an expert panel to evaluate the problem of cancers misclassification and subsequent overdiagnosis and overtreatment, determining that millions may have been wrongly diagnosed with cancer of the breast, prostate, thyroid, and lung, when in fact their conditions were likely harmless. Aug 17, 2016 the american thyroid association recognizes that the recent increase in incidence of thyroid cancer in the united states and other countries is, in large part, due to the diagnosis of indolent papillary microcarcinomas that will never result in symptoms or death, and which only rarely will enlarge or spread beyond the thyroid gland. This article describes thyroid cancer overdiagnosis for radiologists in the format of five questions. A populationbased trend study in switzerland from 1998 to 20122 showed that the agestandardized annual incidence of thyroid cancer increased. Sep 02, 2016 over the past few decades, theres been a significant increase in the incidence of thyroid cancer throughout the world. Thyroid cancer is one of the few cancers that has increased in.
Sep 06, 2016 purpose differentiated thyroid cancer dtc incidence has been reported to have increased three to 15fold in the past few decades. It is the most common of all thyroid cancers and is among the most curable cancers. Studies show low levels of physician awareness about overdiagnosis. Furthermore, despite the dramatic increase in incidence, mortality from thyroid cancer remains stable a combination that is pathognomonic for overdiagnosis. Estimating the magnitude of cancer overdiagnosis in.
Making people sick in the pursuit of health and millions of other books are available for. If the diagnosis of thyroid cancer is certain or highly likely, the usual approach is to remove both sides of the thyroid gland. Thyroid cancer overdiagnosis raises questions about overtreatment. Increased detection due to screening results in more harm than benefit in terms of psychological stress, unnecessary surgery, and financial burden. Dramatic increases have been seen over recent decades in the reported incidence of thyroid cancer, but owing to new modes of screening, hundreds of thousands of cases may be overdiagnoses. Thyroid cancers overdiagnosed in canada for in 75 percent. Pdf estimating the magnitude of cancer overdiagnosis in australia. However, as the number of new cases of thyroid cancers climbed, the death rate from the cancers remained stable, as other researchers reported. Dramatic increases are projected for thyroid cancer, however, there are no established risk factors for this cancer. Overdiagnosis is a major driver of the thyroid cancer epidemic iarc. We are dedicated to support, education, and communication for thyroid cancer survivors, their families and friends. Study points to overdiagnosis of thyroid cancer the new. Overdiagnosis and screening for thyroid cancer in korea.
What is overdiagnosis and why should we take it seriously in cancer. Overdiagnosis of thyroid cancer8 is attributable to incidental detection during. Revisiting overdiagnosis and fatality in thyroid cancer. Thyroid cancer accounts for less than 1% of cancer cases and deaths in the uk. Being just diagnosed with thyroid cancer, i keep telling myself to be careful with what i read online and in books as every situation is different. Michael tuttle, md, describes the problem of overdiagnosis in thyroid cancer and the trend toward observing small thyroid nodules. Thyroid cancer fulfills the criteria for overdiagnosis by having a reservoir of indolent cancers and practice patterns leading to the diagnosis of incidental cancers from the reservoir. Studies have shown that hashimotos patients are three times more likely to develop thyroid cancer, so its important to increase your thyroid cancer awareness, as most thyroid cancers can be treated successfully if diagnosed early. Thyroid cancermuch of the observed increase in incidence may be overdiagnosis 28 for an urgent debate before the new expanded definition is more widely adopted, because they fear many women may be overmedicalised and overdiagnosed, that the screening test has poor reproducibility for mild cases, the evidence of benefit for the newly. From 1999 to 2008, the incidence of thyroid cancer increased 6. Statistics on survival rates for thyroid cancer are discussed in survival rates for thyroid cancer1. The thyroid cancer rate in the united states has more than doubled since 1994.
In fact, some degree of overdiagnosis in cancer early detection is probably the rule, not the exception. Jan 01, 2014 prognosis and survival for most carcinomas of the thyroid has long been known to be excellent. Their warning about an epidemic of thyroid cancer overdiagnosis comes from an analysis of cancer registry data from 12 countries published august 17 in the new england journal of medicine. The annual incidence rate of ptc in different parts of the world varies from 0. We address 1 essential thyroid cancer facts, 2 the evidence supporting overdiagnosis, 3 the role of radiology in overdiagnosis, 4 harms of overdiagnosis, and 5 steps radiologists can take to minimize the problem. If the diagnosis of thyroid cancer is much less certain.
The seer database from the united states showed a threefold increase in thyroid cancer incidence from 1975 to 2010, with a relatively stable thyroid cancerspecific mortality rate. Papillary thyroid carcinoma ptc belongs to welldifferentiated thyroid cancers. Request pdf overdiagnosis of thyroid cancer thyroid cancer fulfills the criteria for overdiagnosis by having a reservoir of indolent cancers and practice patterns leading to the diagnosis of. Age standardised thyroid cancer incidence and mortality rates per 100 000 males females in australia.
And women are 3 times more likely to develop thyroid cancer than men. A complex web of factors has created the phenomenon of overdiagnosis. Because most thyroid cancers are primarily treated by surgery, i. Rates of thyroid cancer diagnosis have tripled in the past 3 decades, but death rates from the disease have remained the same. From overdiagnosis to overtreatment of lowrisk thyroid cancer.
Prevalence of differentiated thyroid cancer in autopsy. Thyroid cancer following childhood low dose radiation. The rise of thyroid cancer by overdiagnosis american. Pdf thyroid cancer incidence varies greatly between and within high. However, for most patients, we do not know the specific reason or reasons why thyroid cancer develops. In cancer screening, overdiagnosed cancers are those that did not. Nov 06, 2014 similar upward trends for thyroid cancer are found in the united states and europe, although not to the same degree.
Nov 19, 2014 thyroid cancer appears to be on the rise in many areas of the world, although recent research suggests this may be more due to overdiagnosis than an actual increase in incidence. Denver the epidemic in thyroid cancer recently reported by a number clinical journals has raised questions about overdiagnosis of thyroid cancer and overtreatment of papillary. Thyroid cancer early detection, diagnosis, and staging. Ct screening that could detect incidental thyroid and renal. Overdiagnosis is the detection of a disease that does not do any harm to the patient throughout the lifetime.
We identified all patients over 18 years of age with a diagnosis of thyroid cancer icd 193 in the ontario cancer registry between january 1, 1999 and december 31, 2008 who had a surgical treatment for thyroid cancer between january 1, 2000 and december 31, 2008 n 724. Koreas thyroidcancer epidemic screening and overdiagnosis. The same trend applied to men, but to a lesser degree. It is unclear whether this represents overdiagnosis or a true increase in incidence. Until recently, thyroid cancer was the most rapidly increasing cancer in the us, largely.
Basic facts thyroid cancer is the most common endocrine cancer. Reclassifying thyroid cancer and the willful misunderstanding. Over the past few years, experts have reported an epidemic of thyroid cancer. Making people sick in the pursuit of health 2012 by h gilbert welch describes how diagnosing people without symptoms is a serious problem with modern health systems. Overdiagnosisofthyroidcancer nonlethal cancers picked up by screening are probably responsible louisedaviesassociateprofessorofotolaryngologyheadandnecksurgery123. Shots health news the number of people diagnosed with thyroid cancer has tripled since 1975, but more lives havent been saved as. This entire increase can be attributed to the detection of papillary thyroid cancer. Prostate screening and over diagnosis is accepted by many, perhaps most medical researchers as a serious problem. Overdiagnosis of juvenile thyroid cancer fulltext european. In the us, the rate of thyroid cancer has doubled since 1994. Screening for thyroid cancer has been shown to result in enormous overdiagnosis. Consider the example of thyroid cancer in south korea. The occurrence of overdiagnosis is also supported by populationbased data showing an alarming rise in thyroid cancer incidence without change in mortality.