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[Thyroid cancer screening: is it useful?].

Françoise Borson-Chazot1, Claire Bournaud

  • 1Fédération d'endocrinologie et centre de médecine nucléaire, groupement hospitalier Lyon-Est, 69677 Bron cedex, France. francoise.borson-chazot@chu-lyon.fr

Presse Medicale (Paris, France : 1983)
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PubMed
Summary
This summary is machine-generated.

Thyroid cancer incidence is rising, mainly due to detecting small microcarcinomas. However, large thyroid cancers persist, necessitating intensified screening for better patient outcomes.

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Area of Science:

  • Oncology
  • Endocrinology
  • Diagnostic Imaging

Background:

  • Differentiated thyroid cancer generally has a good prognosis, but advanced stages can lead to unfavorable outcomes.
  • Thyroid cancer incidence has increased in Western countries over the past two decades, with stable mortality rates.
  • Increased detection of small thyroid cancers, particularly incidental microcarcinomas (≤10mm), accounts for this rise.

Purpose of the Study:

  • To analyze trends in differentiated thyroid cancer diagnosis and stage at presentation.
  • To evaluate the implications of increased microcarcinoma detection on overall thyroid cancer statistics.
  • To assess the necessity of intensified screening for advanced thyroid cancer forms.

Main Methods:

  • Retrospective analysis of thyroid cancer incidence and stage at diagnosis.
  • Review of diagnostic procedures and their impact on cancer detection rates.
  • Evaluation of mortality data in relation to cancer stage at diagnosis.

Main Results:

  • Microcarcinomas (≤10mm) now represent approximately 40% of thyroid cancer cases, often discovered incidentally.
  • The proportion of large thyroid cancers (≥10mm) at diagnosis remains stable at around 20%.
  • Large thyroid cancers are responsible for the majority of thyroid cancer-specific mortality.

Conclusions:

  • While microcarcinomas have an excellent prognosis, their increasing detection does not appear to reduce the incidence of advanced forms.
  • Intensified clinical screening for large thyroid cancers is warranted due to their association with mortality.
  • The cost-benefit of systematic ultrasonographic screening for all thyroid nodules requires careful evaluation to avoid overdiagnosis of indolent cancers.