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Study Underscores Importance of Physical Exams As Diagnostic Tool for Thyroid Cancer


By a News Reporter-Staff News Editor at Diabetes Week -- A new study presented at the American Association of Clinical Endocrinologists (AACE) 22nd Annual Scientific and Clinical Congress in Phoenix, AZ, suggests that the mode of discovery of thyroid nodules may have an impact on the probability of the module being malignant (see also Thyroid Nodule).

Endocrinologist Robert Levine, M.D., director of the Thyroid Center of New Hampshire, reviewed the medical records of 200 consecutive cases referred for thyroid nodule and found that of the nodules identified upon physical examination, biopsied and subsequently surgically confirmed as cancer, 58 percent were detected during physical exams. An additional 25% of malignant nodules were originally detected by the patients themselves.

Conversely, the rate of malignancy found in patients whose thyroid abnormality was detected incidentally during imaging studies for other diagnostic reasons was only 1.5 percent.

"Some feel that the increase in thyroid cancers is due to the greater availability of thyroid ultrasound, as well as incidental findings of thyroid nodules on other diagnostic studies such as chest CT scans," Levine says. "However, we found a very low frequency of thyroid cancer in those patients in whom nodules were detected incidentally at other imaging studies and in those whom there was not a clear indication for the initial ultrasound study."

Thyroid cancer is the fastest growing cancer in the U.S., The American Cancer Society estimates that about 60,000 new cases of thyroid cancer will be diagnosed this year. The number of thyroid biopsies performed in the country has also dramatically increased to 450,000 biopsies per year, according to Dr. Levine, although the vast majority of nodules are benign. Thyroid nodules are extremely common and are present in an estimated four percent of the U.S. population.

In addition to underscoring the importance of individuals routinely performing self-neck checks, Dr. Levine suggests the study reinforces the need to improve the process by which detected nodules are selected for further evaluation.

"In working to create a sustainable health system, decreasing the number of patients being evaluated for thyroid nodules is an important goal," he said. "We propose that improvements in guidelines for nodule biopsy selection and for which nodules detected incidentally require evaluation, as well as education of primary care physicians regarding the appropriate use of thyroid ultrasound will help provide appropriate, quality, cost-effective care." To read additional press releases about the AACE 22nd Annual Scientific and Clinical Congress in Phoenix, please visit or use the Twitter hashtag #AACE2013. For a brief bio and photo of Dr. Levine, please click here. About the American Association of Clinical Endocrinologists (AACE) The American Association of Clinical Endocrinologists (AACE) represents more than 6,500 endocrinologists in the United States and abroad. AACE is the largest association of clinical endocrinologists in the world. The majority of AACE members are certified in Endocrinology, Diabetes and Metabolism and concentrate on the treatment of patients with endocrine and metabolic disorders including diabetes, thyroid disorders, osteoporosis, growth hormone deficiency, cholesterol disorders, hypertension and obesity. Visit our site at

Keywords for this news article include: Cancer, Oncology, Thyroid Nodule, Thyroid Diseases, Thyroid Neoplasms, Endocrine Gland Neoplasms, American Association of Clinical Endocrinologists (AACE).

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