USPSTF: Do Not Screen For Thyroid Cancer in Asymptomatic Adults

The United States Preventive Services Task Force (USPSTF) has recommended against screening asymptomatic individuals for thyroid cancer (grade D recommendation) in a new draft statement.

The incidence rate of thyroid cancer in the United States has risen from 4.9 cases per 100,000 persons in 1975 to 14.3 cases per 100,000 persons in 2014. Despite this, however, the mortality rate has remained stable at about 0.5 deaths per 100,000 persons each year.
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In order to update its 1996 recommendation, the USPSTF conducted a systematic evidence review of the benefits and harms of screening for thyroid cancer in adults. Overall, they found inadequate direct evidence to determine whether screening in asymptomatic individuals improved outcomes, but that the magnitude of benefit “can be bounded as no greater than small.”

For this reason, the USPSTF has recommended against screening for thyroid cancer in asymptomatic adults. This, however, does not apply to individuals at increased risk of thyroid cancer due to a history of high radiation exposure, inherited genetic syndromes, or hisotry of thyroid cancer.

“The USPSTF found inadequate direct evidence on the benefits of screening but bounded the overall benefits of screening and treatment as no greater than small, given the relative rarity of thyroid cancer, the apparent lack of difference in outcomes between treatment and surveillance for the most common tumor type, and ecologic evidence showing no change in mortality over time after introduction of a mass screening program,” they concluded. “Therefore, the USPSTF determined with moderate certainty that the net benefit of thyroid cancer screening is negative.”

—Michael Potts

Reference:

USPSTF. Draft recommendation statement: thyroid cancer: screening. https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement169/thyroid-cancer-screening1#Pod8. November 2016. Accessed November 23, 2016.