title: Follow-up on the problem of increased incidence of thyroid carcinoma from the effects of childhood irradiation.
abstract: There has been widespread concern in both the medical and lay community on how to deal with the problem of the increased incidence of thyroid cancer in patients irradiated in the head and neck during childhood, including the difficult question of whether all of these patients should be recalled and screened. Such an approach is not deemed logistically feasible and the desired benefits of the program which hinge on treatment through early detection are nullified by the protracted nature of the disease. The iatrogenic nature of the problem has raised ethical questions concerning professional duty and responsibility. The principle of "similar treatment for similar cases" seems fairest and most justifiable in pursuit of the goal of equal access to health care. The most effective plan appears to be a carefully devised public education campaign. Informing practicing physicians not already aware of the problem should be an important part of this effort. The responsibility for seeking treatment would be left to the patient who would see his personal physician or be recommended to a previously designated physician in his area.
mesh_terms: D000328:Adult; D002648:Child; D004992:Ethics, Medical; D005500:Follow-Up Studies; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D009333:Neck / Q000000981:diagnostic imaging*; D009381:Neoplasms, Radiation-Induced; D011859:Radiography; D011878:Radiotherapy / Q000009:adverse effects*; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D014481:United States