1 / 8

Guth S et al. Eur J Clin Invest 2009; 39 (8): 699–706

Prevalence of US-detected nodules. 13 MHz Scanner n=635 (33%F/67% M) Total=68% age 56.7 + 7.2 y (19-93). 55%< 5 mm!. Females=75%. Males=65%. Guth S et al. Eur J Clin Invest 2009; 39 (8): 699–706. Prevalence of US-detected nodules. 7.5MHz Scanner

evan-rivas
Download Presentation

Guth S et al. Eur J Clin Invest 2009; 39 (8): 699–706

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Prevalence of US-detected nodules 13 MHz Scanner n=635 (33%F/67% M) Total=68% age 56.7+7.2 y (19-93) 55%< 5 mm! Females=75% Males=65% Guth S et al. Eur J Clin Invest 2009; 39 (8): 699–706

  2. Prevalence of US-detected nodules 7.5MHz Scanner Papillion study n=96,278 (54%F/46% M) age 41.4+10.6 y (18-65) Total prevalence: 33.1% nodules > 5 mm Reiners et al. Thyroid 2004; 11:926-932

  3. Prevalence of Unsuspected Thyroid Nodules and Cancer at Autopsy • Over 50% in some series (Mayo Clinic 1955) • 19% in healthy young men (deceased US soldiers) • Occult thyroid cancer in the US 0.5-13% (mean 3.6%) • Spanish series OTC in 5.3% of visible nodules, but 22% microscopically • Up to 36% in some series (Finland)

  4. Thyroid Cancer Incidence and Mortality in the US, 1973-2002 Davies, L. et al. JAMA 2006;295:2164-2167.

  5. Thyroid Cancer Incidence in Israel ♀ 1998-2002 Kilfoy et al. Cancer Causes Control 2009

  6. Thyroid Cancer Incidence in the Middle East (1996-2001) ♀ Ronckers C, MECC monograph, 2006

  7. Management and Follow-up of DTC • Deleterious effects of treatment for DTC • Almost irreversible effect on QOL • Hypoparathyroidism with compartment neck dissection • Suppressive T4 Rx: angina, AF, osteoporosis • Side effects of RAI: • Sialoadenitis • Nasolacrimal duct obstruction • Increased risk for malignancy (>500-600 mCi) • Pulmonary fibrosis

  8. Managing the Tsunami of Thyroid Nodules and the Epidemic of Thyroid Cancer • Irresistible “appeal” to biopsy small non palpable nodules • 150 million Americans have nodules • 10% represent PTC/DTC • Potential for 15 million thyroidectomies, RAI and surveillance • Estimated 30 billion USD cost • Essentially no lives saved • Adverse effects of Rx • Impact on quality of life

More Related