Thyroid Cancer Is Overdiagnosed and Overtreated, Say Mayo Doctors

By Perry, Susan | MinnPost.com, August 28, 2013 | Go to article overview

Thyroid Cancer Is Overdiagnosed and Overtreated, Say Mayo Doctors


Perry, Susan, MinnPost.com


Dr. Juan Brito discusses the Mayo findings.

New imaging technologies have led to the overdiagnosis of thyroid cancer, exposing thousands of people to unnecessary, costly, and potentially harmful treatments, according to a new analysis from three doctors at the Mayo Clinic in Rochester.

The problem is especially acute here in the United States.

Because of their concern, the Mayo doctors are recommending that a new term be used to describe low-risk thyroid lesions -- a term that will better convey the minimal risk that such lesions pose to a patient's health and that will steer both patients and doctors away from unnecessarily treating them.

"We need to rename them," said Dr. Juan Brito, an endocrinologist and one of the authors of the analysis, in a phone interview Monday. "We need to put them in a different category."

The analysis was published Tuesday in the journal BMJ.

A perplexing rise in diagnoses

During the past 30 years, the incidence of diagnosed cases of thyroid cancer has tripled in the United States, from 3.6 cases per 100,000 people in 1973 to 11.6 cases in 2009.

"It's become one of the fastest-growing cancer diagnoses," said Brito.

The rising incidence rate has been observed worldwide, but not uniformly, he added. Sweden, Japan and China, for example, have experienced a minimal increase in the incidence of this particular cancer.

Furthermore, almost all of the new cases of thyroid cancer being diagnosed -- 90 percent -- involve small papillary tumors, which studies have shown are very slow-growing and highly unlikely to go on to cause symptoms much less death.

That factor most likely explains why the death rate for thyroid cancer has remained the same while the diagnosis of new papillary thyroid cancers as skyrocketed.

Key factors behind the rise

As Brito and his colleagues, Dr. John Morris and Dr. Victor Montori, explain in their paper, more papillary lesions are being diagnosed because of advances in high-tech imaging technologies, such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI), which can now detect thyroid nodules as small as 2 millimeters.

Another factor are reimbursement policies that reward physicians for the use of those technologies, the Mayo doctors add. The routine use of neck ultrasonography has increased at least 80 percent since 1980.

Research has also shown that higher-income Americans -- particularly those with good health insurance -- are much more likely to be diagnosed with thyroid cancer than those in lower income brackets.

"The access to technology as well as the use and sometimes the abuse of that technology is driving the overdiagnosis," said Brito. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Thyroid Cancer Is Overdiagnosed and Overtreated, Say Mayo Doctors
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.