Study Calls For Curbing of Excessive Imaging after Thyroid Cancer Treatment Interview with:

Megan Haymart, M.D. Assistant Professor Institute for HealthCare Policy and Innovation University of Michigan

Dr. Megan Haymart

Megan Haymart, M.D.
Assistant Professor
Institute for HealthCare Policy and Innovation
University of Michigan What is the background for this study? What are the main findings?

Response: Over the past three decades the incidence of thyroid cancer has risen. The majority of this rise in incidence is secondary to an increase in low-risk disease. In the setting of this rise in low-risk thyroid cancer, our team noted that over time there was a dramatic rise in imaging after initial treatment for thyroid cancer. We subsequently wanted to understand the implications of this increase in imaging. Does more imaging equal improved outcomes? In this study published in BMJ, we found that this marked rise in imaging after primary treatment of differentiated thyroid cancer was associated with increased treatment for recurrence but with the exception of radioiodine scans in presumed iodine-avid disease, no clear improvement in disease specific survival. What should readers take away from your report?

Response: The findings from this study emphasize the importance of curbing unnecessary imaging and tailoring imaging after treatment to patient risk. There is a place for imaging patients after initial treatment for thyroid cancer but the specific type of imaging (e.g., ultrasound, radioiodine scan, and PET) and the frequency of this imaging needs to be tailored to the patient. There is a group of patients in whom intensive imaging may be appropriate, but for many patients more imaging does not equal improved care or better outcomes. What recommendations do you have for future research as a result of this study?

Response: This study is the foundation for future work assessing the benefits and risks of imaging in patients treated for cancer. This study highlights an important issue but cost effectiveness studies, randomized control trials of different surveillance plans, and studies assessing the role of the patient and physician in decision making are still needed. Is there anything else you would like to add?

Response: Imaging is not without risks. In patients treated for cancer, imaging can be associated with stress for the patient, additional costs, and risk of patient harm from subsequent treatments. It is important to find the appropriate balance between benefits and risks of imaging. Although this study emphasizes the importance of finding the right balance in thyroid cancer patients, optimal surveillance after cancer treatment is a relevant issue for patients with other cancers, too. Thank you for your contribution to the community.


Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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