Thyroid cancer screening in South Korea increases detection of papillary cancers with no impact on other subtypes or thyroid cancer mortality.

Thyroid cancer screening in South Korea increases detection of papillary cancers with no impact on other subtypes or thyroid cancer mortality.

Thyroid. 2016 Sep 14;

Authors: Ahn HS, Kim HJ, Kim KH, Lee YS, Han SJ, Kim Y, Ko MJ, Brito JP

Abstract
Introduction The incidence of thyroid cancer has increased worldwide. The country where the incidence has increased most is South Korea. The goal of this study is to understand the magnitude of association between opportunistic thyroid cancer screening and thyroid cancer incidence, thyroid cancer subtype and disease specific mortality. Data source We used the 2012 Korea Community Health Survey which asked 229,229 individuals if they had been screened for TC in the last two years. Thyroid cancer incidence data from were obtained from the Korea Cancer registry data, and mortality data from were obtained from the Statistics Korea database. The association between thyroid screening and thyroid cancer incidence, and mortality by age and sex were examined by general linear regression models Results Between 2010 and 2012 the incidence of thyroid cancer was 80.2 per 100,000 people: in females 132.3 and males 28.3. There was a very high and positive correlation between thyroid cancer screening and the incidence of thyroid cancer (r2=0.9, p<0.01). The magnitude of correlation was higher for females (r=0.9 , p,0.01) ) than in males ( r=0.78, p0.01) in any age group. Thyroid screening was only associated with increased detection of papillary thyroid cancer only (r=0.77, p<0.01); and not associated with mortality due to thyroid cancer. Conclusions The magnitude of association between thyroid cancer screening in South Korea and the incidence of thyroid cancer strongly suggests that screening is the most important driver of the epidemic of thyroid cancer, particularly among females. Thyroid cancer screening, however, was only associated with the increase of one tumor histology, papillary thyroid cancer, and it did not have any association with thyroid cancer mortality. The extent to which opportunistic thyroid cancer screening is converting thousands of asymptomatic persons to cancer patients without any known benefit to them needs to be examined carefully.

PMID: 27627550 [PubMed - as supplied by publisher]

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