title: Overdiagnosis of thyroid cancer: answers to five key questions.
abstract: Thyroid cancer fulfills the criteria for overdiagnosis by having a reservoir of indolent cancers and practice patterns leading to the diagnosis of incidental cancers from the reservoir. The occurrence of overdiagnosis is also supported by population-based data showing an alarming rise in thyroid cancer incidence without change in mortality. Because one of the activities leading to overdiagnosis is the workup of incidental thyroid nodules detected on imaging, it is critical that radiologists understand the issue of overdiagnosis and their role in the problem and solution. This article addresses 1) essential thyroid cancer facts, 2) the evidence supporting overdiagnosis, 3) the role of radiology in overdiagnosis, 4) harms of overdiagnosis, and 5) steps radiologists can take to minimize the problem.
authors.affiliation: Department of Radiology and Radiation Oncology, Duke University Medical Center, Box 3808, Erwin Rd, Durham, NC 27710. Electronic address: jennykh@gmail.com.
authors.forename: Jenny K
authors.initials: JK
authors.lastname: Hoang
authors.affiliation: Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Xuan V
authors.initials: XV
authors.lastname: Nguyen
authors.affiliation: VA Outcomes Group, Department of Veterans Affairs Medical Center, Hanover, NH; The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH; Section of Otolaryngology, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Louise
authors.initials: L
authors.lastname: Davies
mesh_terms: D003952:Diagnostic Imaging / Q000706:statistics & numerical data* / Q000639:trends; D055088:Early Detection of Cancer / Q000706:statistics & numerical data* / Q000639:trends; D019317:Evidence-Based Medicine; D005189:False Positive Reactions; D006801:Humans; D015994:Incidence; D000069342:Medical Overuse / Q000517:prevention & control* / Q000706:statistics & numerical data* / Q000639:trends; D015995:Prevalence; D011859:Radiography; D018570:Risk Assessment; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
keywords: Thyroid cancer; incidental thyroid nodule; incidentaloma; overdiagnosis; screening