美国国家公共电台 NPR Don't Screen For Thyroid Cancer, Task Force Says（在线收听）

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Screening healthy people to look for thyroid cancer does more harm than good. That's the word from doctors on a federal health advisory committee. NPR's Richard Harris has the story.

RICHARD HARRIS, BYLINE: More and more people are being diagnosed with thyroid cancer in the United States, but the death rate remains very low, and it isn't going up. The simple explanation - more and more harmless cancers are being detected.

SETH LANDEFELD: I think the common conception is that every cancer is going to grow until it's stopped or removed or kills you. That is not the case with these cancers.

HARRIS: Dr. Seth Landefeld is on the U.S. Preventive Services Task Force which has come out strongly against screening for these cancers in the current issue of JAMA. The treatment isn't benign. It usually involves surgical removal of the thyroid gland and a lifetime of drugs to replace the hormone the gland produces.

LANDEFELD: And in a couple of percent of patients, it leads to injury to the laryngeal nerves that can lead to voice and swallowing difficulties.

HARRIS: And all these surgeries don't lead to longer or healthier lives. Dr. H. Gilbert Welch at the Dartmouth Institute for Health Policy and Clinical Practice says the task force made a good call.

H GILBERT WELCH: The evidence in thyroid cancer is if you look early, you just find a whole new category of patients that has the disease but is never going to suffer from it at all, but they will suffer from the treatment.

HARRIS: He says South Korea is the poster child for overdiagnosis. Some years ago, doctors there started a mass screening campaign to look for thyroid cancer.

WELCH: And 15 years later, thyroid cancer became the most common cancer in Korea, more common than breast, more common than colon, more common than lung.

HARRIS: Tens of thousands of Koreans were getting surgery.

WELCH: But nothing changed in the death rate. The death rate was totally flat.

HARRIS: Landefeld, who's at the University of Alabama at Birmingham, says his task force's call to avoid testing for thyroid cancer only applies to people without any symptoms.

LANDEFELD: As soon as somebody has symptoms, you know, such as a swelling in the neck or change in their voice or change in their swallowing or pain in the neck, you're in a different ballpark. You'll really want to sort those symptoms out.

HARRIS: Thyroid cancer caught at that point is still curable most of the time. Richard Harris, NPR News.