[Abstract] [Full Text HTML] [Full Text PDF] (in Japanese / 826KB) [PDF: Members Only]

J.Jpn. Surg. Soc.. 124(1): 12-17, 2023


Feature topic

STRATEGY FOR OVERDIAGNOSIS AND OVERTREATMENT OF THYROID CANCER

Department of Endocrine Surgery, Tokyo Women’s Medical University, Tokyo, Japan

Yusaku Yoshida

In recent years, the possibility of overdiagnosis and overtreatment has been pointed out in various malignant tumors. In thyroid cancer, overdiagnosis and overtreatment in association with the increasing incidence of papillary thyroid microcarcinoma are issues that need to be resolved. In Japan, the incidence of thyroid cancer has increased over the past half-century since the report of ultrasonography for thyroid nodules, but the mortality rate has decreased only slightly. It is believed that most of the increase may be due to overdiagnosis. To address this problem, endocrine surgeons in Japan have pioneered the management of papillary thyroid microcarcinoma since the 1990s, and the Japanese guidelines for the management of thyroid tumors published in 2010 recommend that active surveillance be an option for the management of papillary thyroid microcarcinoma. In 2015, the American Thyroid Association’s guidelines also endorsed it. Furthermore, the 2018 Japanese guidelines recommend active surveillance as one of the management strategies for papillary thyroid microcarcinoma, which is now becoming popular worldwide due to its favorable oncologic outcomes. Since active surveillance does not involve surgery for malignant tumors, it is important to use appropriate indications and methods. We discuss efforts for safe dissemination of this method and future issues.


<< To previous pageTo next page >>

To read the PDF file you will need Adobe Reader installed on your computer.