More harm than good
The Health Insurance Review and Assessment Service published an interesting analysis on the medical cost for thyroid cancer treatment between 2008 and 2014. The number of patients treated for the disease grew from 108,000 in 2008 to 302,000 last year.
While the number who have undergone surgery has drastically increased by 15 percent annually since 2008, it began to decline starting in 2013. Last year, 1,000 less patients had surgery, 24 percent down from the previous year. It is quite unusual for the number of surgery cases to decline while the number of patients continues to grow.
Behind the statistics is the overdiagnosis of thyroid cancer. A health service source said, “People are worried of cancer and get a thyroid ultrasound, but even when they are diagnosed they postpone surgery because of the overdiagnosis controversy.”
Thyroid cancer is the most common cancer for Koreans, with diagnoses rising 30-fold in 30 years. In November 2014, a New York Times report described the phenomenon as “a tsunami of thyroid cancer.” But the number of people who die from it is 300 a year - a number that has not changed significantly. The five-year survival rate, which virtually means a full recovery, is 99 percent. That’s why thyroid cancer is considered overdiagnosed.
Korea University medical school’s Professor Ahn Hyun-sik said, “Isn’t it an overdiagnosis when a patient lives with or without surgery?”
The government is responsible for this strange situation. On April 3, the Ministry of Health and Welfare announced a recommendation for thyroid cancer diagnoses for medical professionals.
“Routine screening on adults with no symptoms is not recommended as there is no ground to advise on or against an ultrasound screening. But if the patient wants a screening, the benefits and harms of the screening should be explained before the screening,” the ministry announced in an unclear statement.
When the ministry was called to explain further, one of its officials said, “It practically means not to get a thyroid screening if there are no symptoms.”
But the government is actively advertising the recommendation. The recommendation was published as a paper in a Korea Medical Association journal, targeting only doctors. Konkuk University professor Lee Yong-sik said the ministry published a vague recommendation without thoroughly reviewing numerous research papers on how screening has more harms than benefits. The Ministry of Welfare is neglecting its duty to enhance public health to please doctors.” When the government is so incompetent, its citizens grow frustrated.
The author is a national news writer
for the JoongAng Ilbo.
JoongAng Ilbo, April 24, Page 29
by LEE ESTHER