Diagnoses of cancer of the thyroid are unnecessary

An association of doctors held a press conference yesterday in Mapo District, western Seoul, to demand an end to unnecessary and expensive tests conducted by their own colleagues for treatment of thyroid cancer and urged the government to take action to combat a “national cancer anxiety” epidemic.

The action came as statistics from the Health Ministry showed that Korea saw a 23 percent increase of thyroid cancer patients in 2011 from the previous year, a rate more than 10 times the world’s average.

Annual growth of thyroid cancer patients over the past decade was a little more than 25 percent. In 2011, more tests were done for thyroid cancer than any other type of cancer.

“The only explanation for this preposterous rise, considering the country hasn’t gone through any fatal natural hazard or radiation leakage, is doctors’ overdiagnoses,” the Doctors’ Association for Deterring Thyroid Cancer Overdiagnosis argued in a press release.

“The number of patients dying from the illness is identical to that of 30 years ago, which further proves that overdiagnosis and an exaggerated need for tests are the causes [of the increase],” the release said.

Thyroid cancer is a type of cancer that forms in the thyroid gland, located at the base of the neck. The first symptom in most cases is a nodule in the neck and then an enlarged lymph node. Symptoms can develop into neck pain and vocal alterations. The precise cause is unknown, but overexposure to radiation increases the risk of the disease.

Thyroid ultrasound scans are customary in yearly checkups in Korea. Nodules are found in roughly half the people tested, according to Professor Shin Sang-won of the oncology and hematology department of Korea University Anam Hospital. Five to 10 percent are categorized as malignant tumors, or what doctors call cancer, explained Shin.

But the 10-year survival rate of thyroid cancer patients surpass 95 percent, and only one in 100,000 people die on average, Shin said.

“Using state-of-the-art technology to detect and exterminate the tiniest forms of cancer, those that are mostly harmless until the age of 80, is wrong,” Shin said. “Thyroid cancer is mild; it’s highly curable even when detected a little late.”

Ultrasound scans detect nodules, and doctors order early cancer treatment even when they are not malignant tumors, which is how the number of thyroid cancer patients is topping 20,000 each year.

Hospitals make money on the tests and the treatment. The national health insurance system suffers along with patients paying fees.

“An enormous amount of patients are burdened with astronomical costs,” the doctors’ association warned. They have to “withstand the mental anguish of being cancer patients their entire lives,” it said.

Hospitals should halt the automatic thyroid ultrasound scans because their “medical effectiveness have yet to be proved,” the association said.

BY LEE SUNG-EUN [selee@joongang.co.kr]