Overdiagnosis of Papillary Thyroid Cancer

What proportion of papillary thyroid cancer (PTC) cases were overdiagnosed between 1991 and 2019, and what might be the implications of reducing thyroid ultrasonography use for PTC incidence and overall mortality in the US?In this study, a simulation model that accounted for changes in incidence during the study period estimated that between 72% and 94% of PTC cases were overdiagnosed in the US between 1991 and 2019. Reducing thyroid ultrasonography for nonpalpable nodules would decrease PTC incidence, with a negligible change in overall mortality.The finding that thyroid cancer overdiagnosis remained substantial despite accounting for a true increase in incidence suggests that reducing ultrasonography referrals for nonpalpable nodules could help mitigate overdiagnosis.

Corresponding Author: David O. Francis, MD, MS, Department of Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-0001 (dofrancis@wisc.edu).

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