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No Symptoms? No Screening. - US Medical Task Force



The US Preventive Services Task Force (USPSTF) concluded that screening for thyroid cancer for asymptomatic adults is not recommended. 

Screening for thyroid cancer presents no evidence in boosting survival and  can lead to over-diagnosis and complications, the task force concluded with moderate certainty. This is an update on its guidelines that last released in 1996.

Although the rate of thyroid cancer has increased in rate faster than any other type of cancer in the US during the last decade with an increase of 4.5% annually, the mortality rate has not changed substantially according to the Journal of the American Medical Association (JAMA).

Based on the study, thyroid cancer patients have a survival rate of 98% in the first five years. Studies by exports with regards to the accuracy of screening done by 2 methods, ultrasound or feeling for lumps in the neck vis-à-vis the benefits and potential harm caused by treatment of thyroid cancer detected via screening, it was found that there is inadequate evidence to conclude which screening technique is conclusive.

It also disclosed that there is  “inadequate direct evidence to determine whether screening for thyroid cancer in asymptomatic persons using neck palpation or ultrasound improves health outcomes.”

The task force found that there is “adequate evidence of serious harms of treatment of thyroid cancer and evidence that over-diagnosis and overtreatment are likely consequences of screening.”

Citing a research done in South Korea where low-cost ultrasonography was offered for thyroid cancer screening it was determined that  “Since then, thousands of thyroid carcinomas have been detected, resulting in a 15-fold increase in the diagnosis.”  Importantly, the number of deaths from thyroid carcinoma in South Korea during this period has remained unchanged at 300 to 400 per year.

While a relatively small number of patients at  2% experienced complications of thyroid surgery, including vocal cord paralysis; and 11 percent emerged with damaged glands which is not trivial in itself.





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