To diagnose thyroid cancer, doctors use a combination of physical exam, blood tests, imaging tests and a biopsy. Since 1975, the incidence of thyroid cancer has nearly tripled, from 4.9 to 14.3 in every 100,000 people.
To assess why there has been an increase in diagnoses of thyroid cancer, the authors behind the new study analyzed the medical records of patients between 1975 and 2009 in Atlanta. Despite the increase in diagnosis, the researchers did not find an increase in the rates of death from thyroid cancer. About 0.5 per 100,000 people die from this cancer, which has remained stable since 1975.
Because of this, the researchers suspected that "over diagnosis" may be responsible for rise in thyroid cancer incidence. Over diagnosis is when a patient is diagnosed with having a condition that has no symptoms and may never cause them any harm. The researchers found that increased detection of small papillary cancers - a less aggressive form of thyroid cancer - is responsible for the increase in thyroid cancer incidence.
As a response to this over diagnosis, the researchers make several suggestions. They think that some of the small papillary cancers may benefit from not being labeled as cancer, and instead of treating the small papillary cancers, monitoring them through active surveillance instead.
Doctors should explain to patients that many of these small cancers will never grow or cause them any harm, the researchers say. The researchers do concede, though, that it is not possible to know in advance which of these diagnosed cancers will continue to be small and not cause symptoms and which will grow to be a threat to the patient's health.