Detection of medullary thyroid cancer: a focus on serum calcitonin levels

Medullary thyroid cancer (MTC) is a neuroendocrine tumor derived from the C cells of the thyroid. C cells are responsible for the production of calcitonin, a sensitive and specific marker for MTC. Early detection of MTC is essential; overall survival from MTC is related to patient age, stage of disease and extent of surgical resection. Elevated preoperative serum calcitonin levels have been shown to predict the likelihood of biochemical remission postoperatively. The use of routine serum calcitonin measurements as a screening measure for MTC in patients with thyroid nodules has been advocated in Europe. To date, routine calcitonin measurement has not been widely practiced in the USA; a recent cost-effectiveness analysis suggests routine serum calcitonin measurements in patients with thyroid nodules may be comparable to other widely accepted screening programs.