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Progression of papillary thyroid cancer is lower in older adults

Question clinique

Is patient age associated with the progression of low-risk papillary thyroid cancer?

L’Essentiel

Although the identification of thyroid cancer has skyrocketed over the past 10 years, the likelihood of people dying due to the disease has remained remarkably steady. The verdict? Overdiagnosis. This study found low rates of size progression (0 - 10%). Patients aged 40 years to 50 years were half as likely as younger patients to have tumor diameter growth of at least 3 mm over the 2 to 10 years of follow-up. 1a

Référence

Koshkina A, Fazelzad R, Sugitani I, et al. Association of patient age with progression of low-risk papillary thyroid carcinoma under active surveillance. A systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2020;146(6):552-560.

Plan de l'etude: Meta-analysis (other)

Financement: Other

Cadre: Various (meta-analysis)

Sommaire

This meta-analysis began with a search of 8 databases to identify clinical trails, cohort studies, or cross-sectional studies that followed patients with low-risk papillary thyroid carcinoma. The authors identified 5 studies enrolling a total of 2468 patients, mostly women, that analyzed the rate of growth of thyroid microcarcinomas or tumors up to 2 cm in diameter without treatment. Across the studies, 10% or fewer people had tumor growth of at least 3 mm over the 2 years to 10 years of follow-up. Patients aged 40 years to 50 years were half as likely as younger patients to have tumor progression of at least 3 mm (adjusted risk ratio 0.51). There was no significant heterogeneity among the studies.

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


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Commentaires

Anonymous

No

No

septembre 30, 2020
Nickolas Myles

Overdiagnosis

Overaggressive thyroid imaging and biopsies of small thyroid (<1 cm) nodules fuel overdiagnosis and should be discouraged by compleling evidence . Even if pathology interpreation of papillary carcinoma is correct, vast majority of them are sublicnical and never life threatening.

septembre 30, 2020
Anonymous

good information

Good reminder

octobre 1, 2020
Alan Kenneth Macklem

reassessment times

I suspect my ENT consultant would increase the time intervals on older patients.

octobre 1, 2020
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