MSK experts have found that their less-is-more strategy for thyroid cancer screening has been met with support by the USPSTF.
When it comes to thyroid cancer, routine screening may do more harm than good for many people. The US Preventive Services Task Force (USPSTF) has issued a report, published in the Journal of the American Medical Association, recommending against screening for the disease in adults without any signs or symptoms.
Memorial Sloan Kettering surgical oncologist Luc Morris applauds the recommendation in an editorial published in JAMA Otolaryngology — Head & Neck Surgery.
“As physicians guided by the principle of ‘first, do no harm,’ we should be relieved that the USPSTF reached this conclusion,” he writes with co-author Louise Davies of the VA Outcomes Group.
MSK already takes a conservative approach toward thyroid cancer, allowing many patients to avoid unnecessary treatment by closely monitoring tumor growth. Dr. Morris explains how screening can lead to over diagnosis of the disease and why, in many cases, active surveillance is often the best approach.
What is the significance of the USPSTF recommendation?
The USPSTF gave thyroid cancer screening a grade of D, meaning that there is a good chance it provides no net benefit or that the harms outweigh the benefits. The goal is to advise doctors not to routinely look for thyroid cancer in people without any symptoms by feeling for lumps on the neck, doing ultrasound imaging, or using other techniques. This sends a clear signal about something that may seem counterintuitive to many doctors and patients, who may assume that more information is always better.
Isn’t it good to screen for cancer so it can be caught early?
As we write in our editorial, screening tests can take healthy people who have no symptoms and turn them into “sick people” who have to undergo biopsies and then possibly surgery or other treatments. Screening for a cancer is helpful only if the test can effectively detect tumors that would go on to cause disease or death and are more treatable if found earlier.
