title: Increasing Incidence of Thyroid Nodules and Thyroid Cancer: Does Increased Detection of a Subclinical Reservoir Justify the Associated Anxiety and Treatment?
abstract: The incidence of thyroid cancer has been increasing over the last few decades, and it is subject to debate regarding whether the incidence is reflective of better diagnostic techniques and therefore better detection or if it is a reflection of a true increase in incidence. This increase in incidence has been most clearly manifested by an exponential increase in the diagnosis of micropapillary thyroid carcinomas. This article reviews the diagnosis of thyroid cancers, the dilemmas facing clinicians in the management of these micropapillary thyroid carcinomas, and the advances in molecular diagnostics that are being used to assist in the decision-making process. We consider the possibility of overtreatment of a relatively indolent disease and propose a less aggressive management plan in the appropriate clinical scenario.
authors.affiliation: Division of Endocrinology, Diabetes & Metabolic Diseases, Sidney Kimmel Medical College at Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania. Electronic address: melinda.ukrainski@jefferson.edu.
authors.forename: Melinda B
authors.initials: MB
authors.lastname: Ukrainski
authors.affiliation: Department of Otolaryngology, Sidney Kimmel Medical College at Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania.
authors.forename: E A
authors.initials: EA
authors.lastname: Pribitkin
authors.affiliation: Division of Endocrinology, Diabetes & Metabolic Diseases, Sidney Kimmel Medical College at Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania.
authors.forename: J L
authors.initials: JL
authors.lastname: Miller
mesh_terms: D001007:Anxiety; D006801:Humans; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D016606:Thyroid Nodule / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy
keywords: overdiagnosis; papillary microcarcinomas; thyroid cancer; thyroid cancer epidemic