The always-perceptive Gary Schwitzer at HealthNewsReview.org shines his truth-telling light on what appears to be an epidemic of thyroid cancer, but turns out to be an epidemic of diagnosis.
As always, his interest is in careful analysis and context, not attention-getting statistics.
Schwitzer refers to a recent study in JAMA Otolaryngology – Head & Neck Surgery whose authors report that the incidence of thyroid cancer tripled in the last 40 years, but that the death rate from that cancer was stable. The researchers concluded that that nearly all of the increase was in less aggressive or small tumors that may never cause harm.
In just one example, we explained how finding a prostate tumor doesn’t necessarily mean you should treat it, and if you do, you often do more harm than good.
The JAMA authors expressed concern that the problem of thyroid overdiagnosis might get worse. Thyroid cancer is commonly found in autopsies, even if the deceased never had symptoms. You can say the same about prostate tumors. Thyroid nodules are common and don’t necessarily require treatment. But if you treat something that doesn’t require it, you open the door to all kinds of complications and added risk.
Schwitzer’s post includes a link to a video of a talk given by one of the study’s authors, Dr. Gilbert Welch, including his comments about a thyroid cancer awareness campaign with the slogan, “Confidence Kills.” Its point is that thyroid cancer doesn’t care how healthy you are, to which Welch responds, “What a horrible message: If you feel good about yourself, something is wrong with you.”
Schwitzer finds the same problem with a recent pancreatic cancer awareness campaign. “I think this entire field of advocacy/awareness campaigns deserves more scrutiny,” he writes, “as it is often guilty of fear-mongering, whipping the worried well into a frenzy, and becoming the health care equivalent of the search for weapons of mass destruction – if we haven’t found anything yet, it’s because we haven’t looked hard enough.”