From WisPolitics.com/WisBusiness.com …
— UW-Madison researchers have published a study showing up to 94% of papillary thyroid cancers were “likely overdiagnosed” over a 30-year period.
That means they were detected and addressed with surgery without reducing rates of death from these cancers, according to today’s announcement from the UW School of Medicine and Public Health.
One of the lead authors on the study is Dr. Louise Davies, a professor of otolaryngology-head and neck surgery at the school. Davies says overdiagnosis can “lead to unnecessary surgery or other interventions, with side effects of needing lifelong thyroid hormone therapy” as well as unnecessary psychological and financial harm.
Through autopsy studies, about 10% of adults have been found to have small papillary thyroid cancer nodules that didn’t contribute to their death. This kind of cancer is relatively common and “usually” doesn’t progress, according to the school.
The study focused on data from 1991 to 2019, finding 72% to 94% of these cancers found during that period were likely overdiagnosed.
A major factor driving this problem is widespread imaging such as ultrasound finding these cancers, Davies says.
By modeling the impact of reducing the use of ultrasounds for nodules that can’t be felt in a physical exam, researchers found a one-third reduction would lower diagnosis by 17% and a two-thirds reduction would lower diagnoses by 41%. But even with those reductions, mortality rates were impacted by less than 0.1% in the model.
Meanwhile, the study also found women were overdiagnosed more than men. Over the study period, up to 574,000 women and up to 155,000 men were overdiagnosed, the scientists found.
Dr. David Francis, study author and professor of otolaryngology-head and neck surgery at the UW SMPH, says small changes to referrals could cut overdiagnosis by tens of thousands of cases each year without increasing deaths.
“This is a powerful opportunity to create guidelines that would help align practice with evidence and reduce overtreatment,” Francis said in the release.
See the release below.
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