40% of the surgeries performed for this type of nodule are asymptomatic.
Some of these nodules are found incidentally during testing for other purposes. Photo: Shutterstock.
Many cases of thyroid nodules present without symptoms, and represent at least small cancers that can be controlled by active surveillance or surgery; But the findings and the medical literature show the need to be able to prevent these cases by raising awareness of the risks and talking about treatments.
40% of these nodules are found incidentally while the patient is being evaluated for other purposes; According to a new study, it was discovered cancer In only 46% of these cases.
“The results of this study suggest that thyroid nodules The actual incidence of thyroid surgery in asymptomatic patients continues to be attributable to a substantial number of rather than increased thyroid surgeries. cancer thyroid,” says Mirabelle Sajisevi, MD, of the Department of Surgery, Department of Otolaryngology, University of Vermont Medical Center, Burlington, Vermont.
Similarly, it has been established that, “despite the lack of symptoms, it is found that thyroid pathology occurs more frequently in patients”. thyroid nodulesOne who begins a process that often ends with surgery and diagnosis cancer thyroid,” say Tyler Drake, MD, and Emiro Cassado-Granados, MD, of the Department of Medicine at the University of Minneapolis, Minnesota.
In this study, Mirabel Sajesevi, MD, and colleagues evaluated data from 1,328 patients who had thyroid-guided surgery at 16 centers in four countries, including 12 centers in the US and one center in Denmark, South Africa, and Canada. Included.
In each centre, these patients represented the first 100 patients, with a mean age of 52 years of whom 75% were female; Of them, 34% (448 patients) had experienced thyroid-related symptoms, while 41% (542 patients) were asymptomatic.
The remaining 21% of patients had surgery or were under observation for endocrine conditions such as hyperthyroidism and were unaware of the original screening procedure.
cancer Found in 46% of patients:
cancer was found in 46% (613 patients), of which only 30% (83 patients) were symptomatic, and 51% (310 cases) had no thyroid-related symptoms. Most cancers in asymptomatic patients were smaller than in the symptomatic group, with a mean of 2.1 cm versus 3.2 cm.
Given that in asymptomatic patients, 60% of tumors were smaller than 2 cm, while 39% were larger than 2 cm; While the detection of large nodules in asymptomatic patients is remarkable, the rate is in line with historical data, say the researchers.
“These findings are consistent with population-based studies showing that most newly detected thyroid cancers are small cancers, although large cancers are also found in people without symptoms,” the study said. On the other hand, the percentage of tumors larger than 4 cm was much lower in the asymptomatic group (9%) than in the symptomatic group (29%).
Further evaluation of the manner in which the nodule was detected showed that for asymptomatic nodules, 6% were detected as a result of the diagnostic cascade, 20% were radiological or incidental findings, 1% at patient-requested screening and 13% was detected. clinical examination.
Of the incidental findings, the main sources of detection were CT of the chest (31%; 82 cases) and MRI of the neck (16%; 42 cases), with a geographic evaluation showing that South Africa and Denmark had the highest rates of nodules. . Discovered at rates of 79% and 54%, respectively, in symptomatic patients, compared to only 30% in the US and 30% in Canada.
Investigations increase, but not death rates:
It has been presented three times in tracing the occurrences of cancer Thyroid cancer in the US and has been linked primarily to the detection of small, subclinical cancers. This increase is not associated with improved mortality.
detection rate cancer The current study of 46% represents an increase from the 34% reported in a previous study, which also evaluated the detection method, which may be a favorable sign, “possibly to select the nodules in the molecular structure over the last decade.” reflects the increasing use of the tests for surgeries that are likely to be fatal,” the authors conclude.
Source consulted here.
