Most nodules and tumors on the thyroid should be treated with a wait and see approach, but researchers say doctors are jumping to overdiagnose and overtreat them when found. Photo by CLIPAREA l Custom media/Shutterstock
LYON, France, Aug. 23 (合众国际社UPI) 最近越来越多的研究者和医生对甲状腺癌这种疾病的过度治疗表示关注，患者为避免低的健康风险反而受到损害。
世界卫生组织研究人员说：甲状腺癌的诊断和治疗的迅速扩展是新的扫描技术的产物，自20世纪80年代初以来新的扫描技术，如颈部超声检查，计算机断层扫描和磁共振成像能发现甲状腺很小的肿瘤或结节。过去的二十年中发现大多数患者的肿瘤不会对健康构成危险。
研究人员所称甲状腺癌是一种缓慢的，非致命性的疾病，可以用更好的处理方法或观望的态度处理，但一些医生常会将患者马上采用困难的，具有挑战性的治疗方案。
这些治疗通常包括切除甲状腺并让患者服用甲状腺激素，对于有些病情往往不需要这样做。
IARC的感染和癌症的流行病学研究组的研究员Silvia Franceschi在新闻发布会上说“对甲状腺癌过度的诊疗如甲状腺全切术和其他频繁有害的治疗，如颈淋巴结清扫术和放射治疗等，在提高生存率方面没有好处”。
研究人员发现，在澳大利亚，法国，意大利2003至2007年间有70%至80%的女性诊断为的甲状腺癌。与此相同在日本，英国和苏格兰发现也有约50%的妇女。在美国没有这情况。
对于男性也是相似的，在法国，意大利和韩国约70%被过度诊断，在美国和澳大利亚约45%。
该研究机构说，需要更多的研究来解释甲状腺癌的流行理论，以及如何防止患者过度治疗的伤害。
国际癌症研究机构的主任Christopher Wild说“在12个国家中超过一半，大约估计一百万的人被过度诊断为甲状腺癌”。甲状腺癌过度诊断和治疗的急剧增加成为许多高收入国家的一个严重的公共卫生问题。在低收入和中等收入国家中也有这样令人担忧的相同趋势和迹象”
LYON, France, Aug. 23 (UPI) -- Increasingly, researchers and doctors are expressing concern about over-treatment of diseases and the possibility patients are being harmed in the interest of avoiding low-risk adverse health conditions, with thyroid cancer being the latest.
Researchers at the World Health Organization say the huge explosion of thyroid cancer diagnoses and treatment is the product of new scanning techniques, but tumors found in most patients during the last two decades do not pose a risk to health.
The WHO's International Agency for Research on Cancer found new scanning technologies adopted since the early 1980s such as neck ultrasonography, computed tomography scanning and magnetic resonance imaging have found small tumors and nodules on patients' thyroid glands.
Even when doctors detect what researchers call indolent, non-lethal disease that would be better handled with a wait-and-see approach, they often jump to put patients through difficult, challenging treatment regimens.
Treatment often includes the removal of thyroid glands, requiring patients to take thyroid hormones for the rest of their lives -- as a result of treatment they most likely did not need.
"The majority of the overdiagnosed thyroid cancer cases undergo total thyroidectomy and frequently other harmful treatments, like neck lymph node dissection and radiotherapy, without proven benefits in terms of improved survival," Dr. Silvia Franceschi, a researcher in the IARC's infections and cancer epidemiology group, said in a press release.
According to the study, published in the New England Journal of Medicine, most developed countries the IARC looked at as part of its Cancer Incidence in Five Continents study have an overwhelming rate of overdiagnosis of the disease.
The researchers found that between 70 percent and 80 percent of women diagnosed from 2003 to 2007 with thyroid cancer in Australia, France, Italy and the United States should not have been diagnosed with the disease, with the same found for about 50 percent of women in Japan, the Nordic countries, England and Scotland.
For men, the numbers are similar: About 70 percent of cases in France, Italy and the Republic of Korea were overdiagnoses, as were 45 percent of cases in the United States and Australia.
The agency says more research is necessary on the best way to approach the theoretical epidemic of thyroid cancer and how to prevent harming patients with treatment they do not need.
"More than half a million people are estimated to have been overdiagnosed with thyroid cancer in the 12 countries studied," said Dr. Christopher Wild, director of the IARC. "The drastic increase in overdiagnosis and overtreatment of thyroid cancer is already a serious public health concern in many high-income countries, with worrying signs of the same trend in low- and middle-income countries."
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