USPSTF Recommends Against Thyroid Cancer Screening in Draft Statement12/2016
The draft statement from the U.S. Preventive Services Task Force (USPSTF) recommends against thyroid cancer screening in patients who have no symptoms of the disease. USPSTF issued the statement on November 22, 2016 and is accepting public comments on the draft recommendation through December 26, 2016.
ThyCa: Thyroid Cancer Survivors’ Association, Inc., disagrees with the recommendation against neck checks using palpation: examining the neck with the fingers during routine health and dental checkups. A neck check is quick to do. It does not require a special appointment or equipment. Nodules larger than 1 - 1.5 centimeters then can be further analyzed to determine whether or not cancer is present, and whether it’s a high-risk type such as medullary or anaplastic, or a high-risk variant of papillary or follicular thyroid cancer.
Following that, a decision can be made whether or not to proceed to treatment. Thus, detection and diagnosis are not the same as treatment.
ThyCa agrees with the USPSTF recommendation against routine neck ultrasounds. At least one country, Korea, has used neck ultrasound extensively to screen for thyroid nodules. This has resulted in extremely high increases in thyroid cancer diagnoses, especially very small cancers.
Some other points:
- Thyroid cancer usually has no symptoms until it is very advanced. Thus, adopting the USPSTF recommendation against palpation would mean that most thyroid cancer would not be detected until it was past Stage 1, when treatment, if necessary, has the highest success rate. For patients with high-risk thyroid cancer, early detection is crucial.
- In the last 10 or more years in the United States, deaths from thyroid cancer have increased faster than the population increase, in percentage terms. In contrast, the USPSTF and some other sources used a rounded-off death rate to assert that the death rate has remained stable over several decades. However, the National Cancer Institute (NCI) and an article by Dana Farber Cancer Institute note that the death rate has actually increased in recent years.
NCI states that “Mortality from thyroid cancer has risen 0.8 % per year from 2002 to 2011.”
Similarly, a 2015 article on the Dana Farber Cancer Institute web site noted this issue. It says, “the mortality rate appears flat mainly because it was charted over a relatively long time – 35 years. Had it covered just the last 10 years, critics say, it would show that the death rate from thyroid disease is increasing faster than any other cancer except liver cancer.”
ThyCa plans to send a detailed response to the USPSTF. Individual thyroid cancer patients, caregivers, and medical professionals are encouraged to share their voices as well.
Read this page and use its links for the draft recommendation, background information, and how to comment.