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Thyroid cancer is increasing but the death rate remains stable? Scientists reveal the mysterious truth behind it!
Over the past three decades, the incidence of thyroid cancer has increased significantly, but the mortality rate has remained stable, a phenomenon that has attracted widespread attention and research. With the popularization of imaging examination technology, many early-stage diseases can be diagnosed, many of which are low-risk papillary thyroid microcarcinomas, and these cancers usually do not cause death.
Researchers warn that overdiagnosis and overtreatment of thyroid cancer are a growing problem and may pose unnecessary risks to patients.
Statistically, papillary thyroid microcarcinomas (1 cm or less in diameter) have been a major factor in the increase in thyroid cancer incidence over the past three decades, but this has not resulted in a corresponding increase in deaths. This situation has led many experts to propose the concept of "observational management", which does not require immediate surgery but rather follows the progression of the disease at regular intervals.
Japanese doctor Akira Miyauchi first proposed the idea of active surveillance in 1993. He believed that "most papillary microcarcinomas remain small and harmless, and it is not too late to perform surgery only after marginal progression is detected during observation management." This view led to his clinical research at the then Kagawa Medical University trial and is currently a new treatment strategy for low-risk papillary thyroid microcarcinomas.
When a patient's condition remains stable under active monitoring, the need for surgery naturally decreases, which in turn reduces overall health care costs.
Miyauchi's study showed that after 10 years of active surveillance, only 7% to 8% of patients experienced tumor growth, while almost zero patients had distant metastasis. The results of this study show that many micro-cancers do not immediately threaten the patient's life. Patients often face complications such as vocal cord paralysis or hypoparathyroidism after surgery. Therefore, choosing active surveillance not only reduces the risk of surgery, but also Improved patients' quality of life.
Around the world, medical institutions in the United States, South Korea, Italy, Colombia and other places have also driven similar active monitoring pilots, further confirming the intrauterine research. Although observational management makes patients face the psychological burden of cancer, most patients say that this anxiety will gradually lessen over time, and 83% of patients even believe that choosing active surveillance is the best option.
Therefore, experts increasingly recognize active surveillance as a management strategy for the treatment of low-risk thyroid microcarcinomas and recommend it in relevant medical guidelines.
However, active surveillance is not suitable for all patients, and certain situations, such as lymph node metastasis or tumors that invade the laryngeal nerves, may require immediate surgery. This necessitates a rigorous screening process for this management strategy in clinical practice to ensure that patients receive the most appropriate treatment regimen.
As the understanding of thyroid cancer continues to deepen, the huge clinical data also makes us more confident that appropriate screening and monitoring can bring better treatment results to patients. So, how will the future medical field balance the contradiction between over-diagnosis and appropriate treatment to benefit more patients?
