The majority of patients with differentiated thyroid cancer have excellent outcomes with reasonable treatment, with a 10-year survival rate of more than 90%, and some patients can be cured. Therefore, early detection and diagnosis is especially important for those at higher risk of developing the disease. This depends on screening.
Who needs to be screened?
You need to take it seriously and get regular medical checkups if you have any of the following conditions.
- Had radiation exposure to the head and neck as a child (such as radiation therapy).
- Exposure to radioactive fallout (e.g., exposure to radioactive fallout from a nuclear weapon explosion).
- A first-degree relative (e.g., parent, sibling) who has thyroid cancer.
- Iodine intake is too low or too high. The normal urinary iodine level is 100-200 micrograms/liter, which can be used as a reference to adjust the dietary structure and control iodine intake reasonably.
- With certain genetic disorders associated with thyroid cancer, such as familial medullary thyroid carcinoma (FMTC) or multiple endocrine neoplasia syndrome (MEN) types 2A and 2B, and genetic syndromes associated with thyroid cancer, such as familial medullary thyroid carcinoma (FMTC), and The genetic syndromes associated with thyroid cancer, such as familial adenomatous polyposis (FAP).
Please note that having a first-degree relative with a benign thyroid nodule does not increase your risk of developing thyroid cancer.
To screen for thyroid cancer, what tests do I have to do?
The first choice for screening for thyroid cancer is an ultrasound of the neck.
Ultrasound is safe, noninvasive, and provides real-time results, accurate results, clear images, easy examination, and lower cost.
The thyroid gland is superficially located, and ultrasound is not only useful for early detection of thyroid cancer, but also for review and follow-up.
You should be aware that ultrasound is somewhat “subjective” and that the personal experience of the examiner and the instrument can affect the results. An experienced ultrasonographer can diagnose thyroid cancer with more than 80% confidence.
Due to the widespread use of high-resolution ultrasound and fine needle aspiration, the detection rate of thyroid cancer has increased dramatically. Some of these “microscopic cancers” are not very malignant, so you don’t have to worry too much and can choose to follow up or have them removed, depending on your situation and your doctor’s opinion.
CT and MRI can clearly show the extent of thyroid lesions, especially those that extend within the chest, and their relationship to adjacent blood vessels, but are not currently used as routine screening tests.
How often should I be checked?
Currently, ultrasound of the neck is recommended every 6 months to a year in high-risk individuals.
If you are screened for a low-risk “microscopic cancer” of the thyroid that is confirmed by puncture to be of a less malignant type, is no larger than 5 mm in size, is centrally located, has no invasion of the thyroid tegument or lymph node metastases, and has no family history of high-risk thyroid cancer, you can consider 3 to 6 years if you are not willing to undergo surgery and are adequately prepared. If you are not willing to undergo surgery and are psychologically prepared, you may consider a review once every 3-6 months. If the lesion is progressing, then excision is recommended.
Co-written by Dr. Shuwen Yang, Cancer Hospital of Fudan University