Thyroid cancer is overdiagnosed and overtreated

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Since 1970s, the statistics expose that Thyroid cancer cases have appeared to triple. However, according to a new study, the increasing incidence of thyroid cancer is likely due to increasing diagnosis, particularly of the less aggressive papillary thyroid cancer.

From 1975 to 2009, the incidence rate tripled from 4.9 to 14.3 per 100,000 people, driven by a jump in papillary thyroid cancer during that time (from 3.4 to 12.5 per 100,000), according to Gilbert Welch, co-author of the thyroid study and a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, and Louise Davies, MD, of Dartmouth.

Papillary thyroid cancer is the more common and less aggressive form of thyroid cancer.

Research suggests some of cancers that affect the prostate, breast, lung, and thyroid, are too slow-growing to be hazardous.

Eighty-five percent of thyroid cancer patients have the gland removed, even though course of action propose less-insistent treatments in many cases.

“Our old strategy of looking as hard as possible to find cancer has some real side effects,” Welch, told.

“We have to be really cautious that we don’t create more problems than we solve. We will be looking hard at the question of watchful waiting for small papillary thyroid cancers, and we are going to be asking hard questions about whether we should even be looking for them,” Welch said.

Welch believed patients should have the option of “watchful waiting” as prostate cancer patients do.

Stephanie Lee, MD, a thyroid specialist at Boston Medical Center, called the examination “too simple,” and took subject with the series of papers that have been done by this group of researchers.

“It is a disservice to our patients to tell them that we are over diagnosing all small thyroid cancers that have no impact on their lives because until the surgery is done, you cannot be sure there is no invasion or local metastatic disease,” Lee said in an email.

“We have all seen multiple bulky metastatic neck nodes with only a 0.5 cm cancer in the thyroid,” she continued. “Future research needs to be done and verified to determine if there are molecular markers such as wild-type BRAF that predicts when a small papillary thyroid cancer has a low risk of invasion or nodal metastases.”