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Peningkatan deteksi tumor risiko rendah “driving up”  tingkat kanker tiroid 

Date:

September 8, 2015

Source:

Mayo Clinic

Summary:

Kanker berisiko rendah yang tidak memiliki gejala apapun dan mungkin tidak akan menimbulkan masalah di masa depan bertanggung jawab untuk peningkatan secara pesat dalam jumlah kasus baru kanker tiroid didiagnosis selama dekade terakhir , menurut sebuah penelitian . Menurut penulis penelitian , hampir sepertiga dari kasus-kasus baru didiagnosis ketika dokter menggunakan pencitraan berteknologi tinggi bahkan ketika tidak ada gejala penyakit tiroid yang hadir .

"bercak lebih kanker , tetapi mereka adalah kanker yang tidak mungkin untuk menyebabkan kerusakan , " kata pemimpin penulis studi  , Juan Brito Campana , MBBS , asisten profesor kedokteran di Mayo Clinic . " Pengobatan mereka, bagaimanapun , cenderung menyebabkan kerugian , karena kebanyakan kanker tiroid diperlakukan dengan pembedahan yang menghilangkan  semua atau sebagian dari kelenjar tiroid . Ini adalah prosedur berisiko yang dapat merusak pita suara pasien atau membuat  mereka dengan kekurangan kalsium seumur hidup . ".............more

Increased
detection of low-risk tumors driving up thyroid cancer rates, study finds

Date:

September 8, 2015

Source:

Mayo Clinic

Summary:

Low-risk cancers that do not have any symptoms and presumably will not
cause problems in the future are responsible for the rapid increase in the
number of new cases of thyroid cancer diagnosed over the past decade, according
to a study. According to the study authors, nearly one-third of these recent
cases were diagnosed when clinicians used high-tech imaging even when no
symptoms of thyroid disease were present.

...................

Low-risk cancers that do not have any symptoms and presumably will not
cause problems in the future are responsible for the rapid increase in the
number of new cases of thyroid cancer diagnosed over the past decade, according
to a Mayo Clinic study published in the journalThyroid. According to the study authors, nearly one-third of these recent cases
were diagnosed when clinicians used high-tech imaging even when no symptoms of
thyroid disease were present.

"We are spotting more cancers, but they are cancers that are not
likely to cause harm," says the study's lead author, Juan Brito Campana,
M.B.B.S., an assistant professor of medicine at Mayo Clinic. "Their
treatment, however, is likely to cause harm, as most thyroid cancers are
treated by surgically removing all or part of the thyroid gland. This is a
risky procedure that can damage a patient's vocal cords or leave them with
lifelong calcium deficiencies."

Dr. Brito says harm is not limited to physical suffering. "Treatment
can cause financial hardship for patients and their families and for society as
a whole, as millions of dollars are spent for unnecessary and problematic
surgeries," he says.

According to Dr. Brito, the aggregate national cost these procedures in the
U.S. was $1.6 billion in 2013 and likely will exceed $3.5 billion by 2030. At
the same time, the incidence of thyroid cancer is increasing more rapidly than
that of any other cancer and is on track to become the third most common cancer
in women.

In this study, Dr. Brito and his colleagues drew on data from the Rochester
Epidemiology Project. They analyzed the records of 566 men and women who were
diagnosed with thyroid cancer in Olmsted County, Minnesota, between 1935 and
2012. Specifically, they examined the number of new cases of thyroid cancer,
the deaths due to the disease, and the method of diagnosis.

Researchers found that the number of new cases of thyroid cancer doubled in
recent years -- from 7.1 per 100,000 people from 1990 to 1999 to 13.7 per
100,000 people from 2000 to 2012. Over the same period, the number of new
patients with thyroid cancer presenting with symptoms of thyroid cancer
remained the same. In contrast, the number of new cases of silent thyroid cancer
-- the kind where patients have no symptoms -- almost quadrupled. The
proportion of patients with thyroid cancer who die of the disease has not
changed since 1935.

The study found that the most frequent reasons for identifying silent
thyroid cancer were review of thyroid tissue removed for benign conditions (14
percent); incidental discovery during an imaging test (19 percent); and
investigations of patients with symptoms or palpable nodules that were clearly
not associated with thyroid cancer, but triggered the use of imaging tests of
the neck (27 percent).

"We are facing an epidemic of diagnosis in thyroid cancer," says
Dr. Brito. "Now that we know where all these new cases are coming from, we
can design strategies to identify patients with thyroid cancer who can benefit
from our treatment without condemning other patients to unnecessary tests,
treatment, suffering, and costs."

Researchers say one approach to curtail the detection of these lesions
would be to limit the use of certain imaging technologies. Another tactic would
be to engage patients in deliberating their treatment options. In many cases,
active surveillance may be preferred over surgery by patients with small,
relatively benign cancers that could take decades to grow to any appreciable size
or cause life-threatening problems.

Dr. Brito thinks something as simple as not using the word
"cancer" to refer to these small and silent thyroid lesions could
reduce the number of unnecessary treatments for patients with a more favorable
prognosis. Rather than calling these lesions thyroid cancer, he would recommend
a less emotionally charged term, such as papillary lesions of indolent course.







Story Source:

The above post is reprinted from materials provided
by Mayo Clinic. Note: Materials may be edited
for content and length.







Journal Reference:

1.   
Juan P. Brito, Alaa Al Nofal, Victor M. Montori, Ian D. Hay, John C.
Morris. The Impact of Subclinical Disease and Mechanism of Detection on
the Rise in Thyroid Cancer Incidence: A Population-Based Study in Olmsted
County, Minnesota During 1935 Through 2012. Thyroid, 2015; 25
(9): 999 DOI:10.1089/thy.2014.0594

http://www.sciencedaily.com/releases/2015/09/150908135135.htm

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