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    Why Are Thyroid Cancer Diagnoses Up?

    Better Detection Is the Main Reason, Study Shows

    Better Detection

    "We believe increased diagnostic scrutiny is the most likely explanation for the apparent increase in incidence," write Davies and Welch.

    They note that "advances in imaging and diagnostic techniques" have made it easier to spot thyroid cancerthyroid cancer. The researchers also write that "many of these cancers would likely never have caused symptoms during life."

    Further studies should check if "a more cautious diagnostic approach ... is worthwhile," write Davies and Welch. They add that "papillary cancers smaller than one centimeter could be classified as a normal finding."

    By definition cancer is not normal, though the study indicates that papillary thyroid cancers may be common and not always show symptoms.

    Second Opinion

    The journal also contains an editorial by Ernest Mazzaferri, MD, of the endocrinology division of the University of Florida at Gainesville.

    "The natural history of papillary thyroid cancer plays out over decades," writes Mazzaferri. He adds that current scientific literature includes "reason to believe that not all small [papillary thyroid cancers] are indolent bystanders caught up in a frenzy of excessive diagnosis and unnecessary surgery on small malignant nodules."

    Removing the thyroid (with lifelong drug therapy afterward) can eliminate the chance that a tiny papillary thyroid cancer will return, Mazzaferri points out. "It is unlikely that many patients will forgo treatment after receiving this information," he writes.

    Mazzaferri is the 2005-2006 president of the American Thyroid Association. His editorial suggests using thyroid imaging and biopsy when thyroid cancer is suspected.

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