Kirsten Bibbins-Domingo, MD, PhD
AS REPORTED in JAMA, the U.S. Preventive Services Task Force (USPSTF) has recommended against thyroid cancer screening in asymptomatic individuals.1 The current USPSTF statement is an update of a 1996 USPSTF recommendation statement. The recommendation was based on Task Force review of evidence on the benefits and harms of screening, diagnostic accuracy of screening (including neck palpation and ultrasound), and the benefits and harms of treatment of screen-detected disease.
Kirsten Bibbins-Domingo, MD, PhD, of the University of California, San Francisco, is the corresponding author of the JAMA article.
Task Force Findings
THE USPSTF STATED: “[The Task Force] found inadequate direct evidence on the benefits of screening but determined the magnitude of the overall benefits of screening and treatment can be bounded as no greater than small, given the relative rarity of thyroid cancer, the apparent lack of difference in outcomes between patients who are treated vs monitored (for the most common tumor types), and observational evidence showing no change in mortality over time after introduction of a mass screening program.”
They further stated: [“The Task Force] found inadequate direct evidence on the harms of screening but determined the overall magnitude of the harms of screening and treatment can be bounded as at least moderate, given adequate evidence of the harms of treatment and indirect evidence that overdiagnosis and overtreatment are likely to be substantial with population-based screening…. The [Task Force] therefore determined the net benefit of screening for thyroid cancer is negative.”
The summary of the USPSTF statement is reproduced here.
The task force concluded: “The USPSTF recommends against screening for thyroid cancer in asymptomatic adults (grade D recommendation).” ■
DISCLOSURE: For full disclosures of the authors, visit www. jama.jamanetwork.com.
1. U.S. Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al: Screening for thyroid cancer. U.S. Preventive Services Task Force recommendation statement. JAMA 317:1882-1887, 2017.
Cari M. Kitahara, PhD, MHS
THE REPORTED INCIDENCE of thyroid cancer has markedly increased in the United States in recent decades, largely reflecting an increase in reported rates of papillary thyroid cancer. It has been unclear whether the increase in incidence is reflected in mortality...
Lori J. Wirth, MD
Manisha H. Shah, MD
THYROID CANCER diagnoses are increasing at a rate faster than any other malignancy in the United States. In 2017, there will be 56,870 new cases, accounting for 3.4% of all cancers, and 2,010 people will die of thyroid cancer.1 This represents a...