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Tytuł pozycji:

Cancer screening activity results in overdiagnosis and overtreatment of papillary thyroid cancer: A 10-year experience at a single institution.

Tytuł :
Cancer screening activity results in overdiagnosis and overtreatment of papillary thyroid cancer: A 10-year experience at a single institution.
Autorzy :
Kaliszewski K; Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland.
Diakowska D; Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
Wojtczak B; Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland.
Rudnicki J; Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland.
Pokaż więcej
Źródło :
PloS one [PLoS One] 2020 Jul 21; Vol. 15 (7), pp. e0236257. Date of Electronic Publication: 2020 Jul 21 (Print Publication: 2020).
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms :
Early Detection of Cancer*
Medical Overuse*
Thyroid Cancer, Papillary/*diagnosis
Thyroid Cancer, Papillary/*therapy
Thyroid Neoplasms/*diagnosis
Thyroid Neoplasms/*therapy
Female ; Humans ; Male ; Middle Aged ; Thyroid Cancer, Papillary/diagnostic imaging ; Thyroid Cancer, Papillary/pathology ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology
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Entry Date(s) :
Date Created: 20200722 Date Completed: 20200922 Latest Revision: 20200922
Update Code :
20210301
PubMed Central ID :
PMC7373277
DOI :
10.1371/journal.pone.0236257
PMID :
32692768
Czasopismo naukowe
Background: It is estimated that one of the potential cause of the increasing prevalence of thyroid cancer (TC) is the easier and widespread access to diagnostic tools. If an individual evaluates the thyroid gland due to a mentioned mechanism without considering TC risk factors or symptoms, we can describe this phenomenon as cancer screening activity (CSA).
Aim of the Study: We 1) estimated what types of TC were diagnosed due to CSA, 2) analyzed what clinicopathological features were characteristic of TCs diagnosed by CSA, 3) determined if these features were characteristic of indolent cases, and finally we 4) assessed whether CSA could have resulted in the increasing incidence of potentially indolent papillary thyroid cancer (PTC).
Materials and Methods: A retrospective review of 4,701 medical records of patients admitted and surgically treated at one surgical center between 2008 and 2017 was performed. Among the enrolled patients, 569 (12.1%) had thyroid malignancy, and 514 (10.9%) were diagnosed with PTC. We divided these patients into two groups: 1) patients in whom TC diagnostics were performed without considering any TC risk factors or symptoms (CSA-yes) and 2) those in whom TC was diagnosed due to TC risk factors or symptoms (CSA-no). We then compared the clinicopathological features of these two groups.
Results: The most common type of TC diagnosed in the CSA-group was PTC (p = 0.024). CSA-yes patients showed a significantly lower degree of Tumor-Node-Metastasis (TNM) staging and demonstrated a significantly lower rate of multifocality, but not of bilaterality (p<0.0001 and p = 0.198, respectively). In the CSA-yes group, the number of TC foci was significantly lower than that in the CSA-no group (p<0.0001). All clinicopathological features characteristic of aggressive cases of TC were absent in CSA-yes patients (p<0.0001), while all features observed in CSA-yes patients were characteristic of indolent cases (p<0.0001).
Conclusions: The use of CSA results in the diagnosis of indolent cases of PTC and may be one of the potential causes of overdiagnosis and overtreatment of this malignancy.
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