Hyperdiagnosis of thyroid cancer?Half the cases plummet, the death rate rises
Oct 08, 2024
A team of professors Kim Shin-gon and Kim Kyung-jin of the Department of Endocrinology at Korea University Anam Hospital analyzed changes in thyroid cancer mortality after controversy over thyroid cancer diagnosis. Although the treatment strategy for thyroid cancer has changed significantly due to the controversy over over diagnosis and overtreatment that began in Korea more than a decade ago, the impact of this issue on the prognosis, such as death of thyroid cancer patients, has not been evaluated.
Professor Kim Shin-gon and Professor Kim Kyung-jin's team, together with Professor Park Young-joo's team at Seoul National University, presented new implications for thyroid cancer diagnosis and treatment through a paper titled 「Aftermath of thyroid cancer overdiagnosis issue, changes in mortality from thyroid cancer between 2005 and 2018.」
The research team analyzed changes in thyroid cancer-related mortality in a total of 434,228 thyroid cancer patients using data from the National Health Insurance Service from 2005 to 2018. As a result, the incidence of thyroid cancer increased from 2005 to 2012, but after plunging from 91.9 per 100,000 in 2012 to 50.6 in 2015 after the overdiagnosis issue, it remained stable until 2018.
On the other hand, thyroid cancer mortality decreased from 1.94 per 1,000 people in 2005 to 0.76 in 2013, but increased again to 2.70 in 2018. In particular, mortality in patients who did not undergo thyroidectomy or underwent total resection has increased since 2013, and mortality in patients who underwent hematectomy or partial resection remained low throughout the entire period.
The research team said "The increase in thyroid cancer-related mortality since 2015 suggests that there is something to complement to the criteria applied to diagnosis and treatment after the overdiagnosis controversy."
He then stated that `It is necessary to accurately determine the risk of thyroid cancer and provide appropriate diagnosis and active treatment for high-risk patients, while at the same time, academic efforts will be needed to reduce overtreatment and ensure accurate follow-up in low-risk patients.' In light of the uniqueness of thyroid cancer, which has a very good prognosis for most, but rarely has a very poor prognosis, both over- and under-treatment should be noted.
The results of the study were recently published in the International Journal of Surgery, one of the top journals in the surgical field.
Professor Kim Shin-gon and Professor Kim Kyung-jin's team, together with Professor Park Young-joo's team at Seoul National University, presented new implications for thyroid cancer diagnosis and treatment through a paper titled 「Aftermath of thyroid cancer overdiagnosis issue, changes in mortality from thyroid cancer between 2005 and 2018.」
The research team analyzed changes in thyroid cancer-related mortality in a total of 434,228 thyroid cancer patients using data from the National Health Insurance Service from 2005 to 2018. As a result, the incidence of thyroid cancer increased from 2005 to 2012, but after plunging from 91.9 per 100,000 in 2012 to 50.6 in 2015 after the overdiagnosis issue, it remained stable until 2018.
On the other hand, thyroid cancer mortality decreased from 1.94 per 1,000 people in 2005 to 0.76 in 2013, but increased again to 2.70 in 2018. In particular, mortality in patients who did not undergo thyroidectomy or underwent total resection has increased since 2013, and mortality in patients who underwent hematectomy or partial resection remained low throughout the entire period.
The research team said "The increase in thyroid cancer-related mortality since 2015 suggests that there is something to complement to the criteria applied to diagnosis and treatment after the overdiagnosis controversy."
He then stated that `It is necessary to accurately determine the risk of thyroid cancer and provide appropriate diagnosis and active treatment for high-risk patients, while at the same time, academic efforts will be needed to reduce overtreatment and ensure accurate follow-up in low-risk patients.' In light of the uniqueness of thyroid cancer, which has a very good prognosis for most, but rarely has a very poor prognosis, both over- and under-treatment should be noted.
The results of the study were recently published in the International Journal of Surgery, one of the top journals in the surgical field.
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