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Draft Recommendation Statement: Thyroid Cancer Screening

Mar
04

Date: March 4th, 2017

Do Not Screen For Thyroid Cancer in Asymptomatic Adults

The National Cancer Institute goes on to estimate that 1,980 people will die as a result of the disease. Generally, there is a 98.1 percent five-year survival rate for the thyroid cancer patients. By using the newly released statistics, the U.S. Preventive Services Task Force (USPSTF) opted to update a recommendation of what it had issued in 1996 on the same topic.

New draft recommendation issued

The USPSTF published a daft recommendation on November 22nd, alongside a draft evidence review on screening adults for thyroid cancer. By using the examined evidence, the USPSTF recommended that asymptomatic patients should not be screened for thyroid cancer.

To come up with the recommendation, the task force went through the merits and demerits of screening for thyroid cancer. They found that asymptotic patients faced much greater harms. Some of the harms identified include permanent surgical damage to the nerves responsible for controlling breathing and speaking as well as to the thyroid function.

USPSTF member Karina Davison, Ph.D., M.A.Sc., said in a news release that “While there is very little evidence of the benefits of screening for thyroid cancer, there is considerable evidence of the significant harms of treatment…. And in the places where universal screening has been tried, it hasn’t helped people live longer, healthier lives.”

The data that the task force based on in this review created the impression that over diagnosis posed a grave danger.

USPSTF Chair Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., said that their studies showed that with increased screening, there was the danger of over diagnosis. He went on to explain that “People who are treated for small or slow-growing tumors are exposed to risks from surgery or radiation, but do not receive any benefit because the tumors are unlikely to affect the person’s health during their lifetime.”

What do the physicians say about this?

While speaking to AAFP News, ennifer Frost, M.D., medical director for the AAFP Health of the Public and Science Division said that scientists are yet provide evidence that thyroid cancer treatment lowers mortality.

She said that “If treatment doesn’t improve outcomes, then early diagnosis through screening doesn’t have value. Treatment, however, almost always has risks. In this case, the most common serious harms of treatment include hyperparathyroidism and laryngeal nerve palsy.”

Frost said that it is vital to carefully consider over diagnosis when it comes to any cancer screening program.

“This means diagnosing a cancer that would never have caused medical problems for the individual,” she said. “This means they would not have died from the cancer or even had symptoms. So you diagnose a cancer that would never have caused a problem, then expose the patient to treatments that can cause significant harms.”

The USPSTF has allowed up to 26th December for the public to give a recommendation on the draft recommendation statement and draft evidence review.

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