by Mary
Shomon
July 7, 2003 -- According to research reported on in the American Journal of Clinical Oncology, general screening of the population for nonpalpable thyroid cancer (thyroid cancer that you can’t detect by feeling the neck area) is not justified. The argument against general screening is that nonpalpable thyroid nodules are quite common, yet the incidence of cancer in such nodules, or resulting disease and death is rare, and therefore makes the screening unjustified.
The issue of nonpalpable nodules has grown, because increasing use of ultrasound scans in the neck and head area have dramatically increased the number of nonpalpable nodules that are seen on such scans. Besides surgery, the only way to conclusively determine if a nodule is cancerous is using fine-needle aspiration (FNA). But whether or not this is necessary, given the cost and invasiveness of the procedure, compared to the extremely low incidence of cancer, is the key issue that was investigated.
One study looked at 450 nonpalpable thyroid nodules. They found that the risk of cancer, and the ability to get a diagnostic sample, was greatly increased with larger nodules. This led researchers to conclude that "systematic efforts to examine the general populations for this pathology are not justified." Instead, they recommend that tumors of "1.5 cm or greater represent an absolute indication to perform an ultrasound-guided FNA."
For smaller nodules, risk factors, age, and health status of the patient should be discussed beforehand, when determining whether to perform a FNA.
FOR MORE INFORMATION ON NODULES AND THYROID CANCER
Thyroid Nodules, Lumps, Enlarged Thyroid, Goiter
Thyroid Nodules: When It's Time for a Second Opinion
Source: "Nonpalpable thyroid carcinoma: clinical controversies on preoperative selection," Am J Clin Oncol 2003 Jun;26:3:232-5
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