1
|
Chen S, Hu X, Yang P, Yang L, Peng S, He L, Yuan L, Bao G. Status of mental and social activities of young and middle-aged patients after papillary thyroid cancer surgery. Front Oncol 2024; 14:1338216. [PMID: 38595812 PMCID: PMC11002165 DOI: 10.3389/fonc.2024.1338216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Background Papillary thyroid cancer (PTC) is prevalent among younger populations and has a favorable survival rate. However, a significant number of patients experience psychosocial stress and a reduced quality of life (QoL) after surgical treatment. Therefore, comprehensive evaluations of the patients are essential to improve their recovery. Methods The present study enrolled 512 young and middle-aged patients diagnosed with PTC who underwent surgery at our institution between September 2020 and August 2021. Each participant completed a series of questionnaires: Generalized Anxiety Disorder 7 (GAD-7), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QoL), and Readiness to Return-to-Work Scale (RRTW). Results GAD-7 data showed that almost half of the study subjects were experiencing anxiety. Regarding health-related quality of life (HRQoL), participants reported the highest levels of fatigue, insomnia, voice problems, and scarring, with patients in anxious states reporting worse symptoms. Based on RRTW, more than half of the subjects had returned to work and had better HRQoL compared to the others who were evaluating a possible return to work. Age, gender, BMI, education, diet, residence, health insurance, months since surgery, monthly income, and caregiver status were significantly correlated with return to work. Additionally, having a caregiver, higher monthly income, more time since surgery, and living in a city or village were positively associated with return to work. Conclusion Young and middle-aged patients with PTC commonly experience a range of health-related issues and disease-specific symptoms following surgery, accompanied by inferior psychological well-being, HRQoL, and work readiness. It is crucial to prioritize timely interventions targeting postoperative psychological support, HRQoL improvement, and the restoration of working ability in PTC patients.
Collapse
Affiliation(s)
- Songhao Chen
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
- Department of Obstetrics and Gynecology, The 920 Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army (PLA), Kunming, China
| | - Xi’e Hu
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Ping Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Lin Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Shujia Peng
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Li He
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Lijuan Yuan
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Guoqiang Bao
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| |
Collapse
|
2
|
Kang W, Ma M, Xu L, Tang S, Li J, Ma P, Song D, Sun Y. Customized fluorescent probe for peering into the expression of butyrylcholinesterase in thyroid cancer. Anal Chim Acta 2023; 1282:341932. [PMID: 37923409 DOI: 10.1016/j.aca.2023.341932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Thyroid cancer has been increasingly prevalent in recent years. The main diagnostic methods for thyroid are B-ultrasound scan, serum detection and puncture detection. However, these methods are invasive and complex. It is a pressing need to develop non-invasive or minimally invasive methods for thyroid cancer diagnosis. Fluorescence method as a non-invasive detection method has attracted much attention. Butyrylcholinesterase (BChE) is a common enzyme in the human body, and many diseases affect its reduction. We found that BChE is also a marker for thyroid cancer. Therefore, it is of certain clinical value to explore the expression of BChE in thyroid cancer cells through a customized fluorescent probe to provide valuable experimental data and clues for studying the expression of thyroid cancer marker to reflect thyroid status. RESULTS In this study, we customized a fluorescent probe named Kang-BChE, which is easy to synthesize with a high yield. The experimental results show that the probe Kang-BChE can detect BChE in the linear range of 0-900 U L-1 (R2 = 0.9963), and the detection limit is as low as 3.93 U L-1 (λex/em = 550/689 nm). In addition, Kang-BChE probes have low cytotoxicity, good specificity, and can completely eliminate interference from acetylcholinesterase (AChE). Kang-BChE showed excellent stability in the detection of complex biological samples in serum recovery experiments (95.64-103.12 %). This study was the first time using Kang-BChE to study the low expression of BChE in thyroid cancer cells (Tpc-1 cells). In addition, we observed that H2O2 concentration in Tpc-1 cells was positively correlated with BChE activity. SIGNIFICANCE Kang-BChE is expected to be an important tool for monitoring the change of BChE content in complex biological environments due to its excellent performance. Kang-BChE can also be used to explore the influence of molecules in more organisms on the change of BChE content due to its excellent anti-interference ability. We expect that Kang-BChE can play a significant role in the clinical diagnosis and treatment of thyroid cancer.
Collapse
Affiliation(s)
- Wenxin Kang
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, 130012, China
| | - Mo Ma
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, 130012, China; School of Pharmacy, Jilin University, Qianjin Street 2699, Changchun, 130012, China
| | - Lanlan Xu
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, 130012, China
| | - Shuai Tang
- School of Chemistry, Jilin University, Qianjin Street 2699, Changchun, 130012, China
| | - Jingkang Li
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, 130012, China
| | - Pinyi Ma
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, 130012, China
| | - Daqian Song
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, 130012, China
| | - Ying Sun
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, 130012, China.
| |
Collapse
|
3
|
Bleyer A. Increasing Cancer in Adolescents and Young Adults: Cancer Types and Causation Implications. J Adolesc Young Adult Oncol 2023; 12:285-296. [PMID: 37074337 DOI: 10.1089/jayao.2022.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Purpose: This study aimed to identify cancer incidence trends in the United States and globally in adolescents and young adults (AYAs) 15-39 years of age, by sex, and to speculate on causes for trend changes. Methods: For the United States, SEER*Stat was used to obtain average annual percent change (AAPC) trends in cancer incidence during the period 2000-2019 among 395,163 AYAs. For global data, the source was the Institute of Health Metrics and Evaluation and its sociodemographic index (SDI) classification system. Results: In the United States, the invasive cancer incidence increased during the period 2000-2019 in both females (AAPC: 1.05, 95% CI: 0.90-1.20, p << 0.001) and males (AAPC: 0.56, 95% CI: 0.43-0.69, p << 0.001). A total of 25 and 20 types of cancers increased statistically significantly in female and male AYAs, respectively. Among potential causes for the increases, the obesity epidemic in the United States strongly correlates with the overall cancer increase in both its female (Pearson correlation coefficient R2 = 0.88, p = 0.0007) and male (R2 = 0.83, p = 0.003) AYAs, as does the most common malignancy in American AYAs, breast cancer (R2 = 0.83, p = 0.003). Worldwide, cancer incidence in the age group increased steadily during the period 2000-2019 among high-middle, middle, and low-middle SDI countries, but not in low SDI countries and with slowing of increase in high SDI countries. Conclusions: The increases and their age-dependent profiles implicate several causations that are preventable, including obesity, overdiagnosis, unnecessary diagnostic radiation, human papilloma virus infection, and cannabis avoidance. The United States is beginning to reverse the increasing incidence, and prevention efforts should be augmented accordingly.
Collapse
Affiliation(s)
- Archie Bleyer
- Pediatric & Young Adult Oncology, Oregon Health & Science University, Bend, Oregon, USA
- McGovern Medical School, University of Texas, Houston, Texas, USA
| |
Collapse
|
4
|
Na DG. [Clinical Application of the 2021 Korean Thyroid Imaging Reporting and Data System (K-TIRADS)]. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:92-109. [PMID: 36818707 PMCID: PMC9935946 DOI: 10.3348/jksr.2022.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/03/2022] [Indexed: 02/10/2023]
Abstract
In patients with thyroid nodules, ultrasonography (US) has been established as a primary diagnostic imaging method and is essential for treatment decision. The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is a pattern-based, US malignancy risk stratification system that can easily diagnose nodules during real-time ultrasound examinations. The 2021 K-TIRADS clarified the US criteria for nodule classification and revised the size thresholds for nodule biopsy, thereby reducing unnecessary biopsies for benign nodules while maintaining the appropriate sensitivity to detect malignant tumors in patients without feature of high risk thyroid cancer. Thyroid radiology practice has an important clinical role in the diagnosis and non-surgical treatment of patients with thyroid nodules, and should be performed according to standard practice guidelines for proper and effective clinical care.
Collapse
Affiliation(s)
- Dong Gyu Na
- Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
- Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Korea
| |
Collapse
|
5
|
Heinzel A, Müller D, van Santen HM, Clement SC, Schneider AB, Verburg FA. The effect of surveillance for differentiated thyroid carcinoma in childhood cancer survivors on survival rates: a decision-tree-based analysis. Endocr Connect 2022; 11:e220092. [PMID: 36240044 PMCID: PMC9716375 DOI: 10.1530/ec-22-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/14/2022] [Indexed: 11/08/2022]
Abstract
Background Childhood cancer survivors (CCS) who received radiation therapy exposing the thyroid gland are at increased risk of developing differentiated thyroid cancer (DTC). Therefore, the International Guideline Harmonization Group (IGHG) on late effects of childhood cancer therefore recommends surveillance. It is unclear whether surveillance reduces mortality. Aim The aim of this study was to compare four strategies for DTC surveillance in CCS with the aim of reducing mortality: Strategy-1, no surveillance; Strategy-2, ultrasound alone; Strategy-3, ultrasound followed by fine-needle biopsy (FNB); Strategy-4, palpation followed by ultrasound and FNB. Materials and methods A decision tree was formulated with 10-year thyroid cancer-specific survival as the endpoint, based on data extracted from literature. Results It was calculated that 12.6% of CCS will develop DTC. Using Strategy-1, all CCS with DTC would erroneously not be operated upon, but no CCS would have unnecessary surgery. With Strategy-2, all CCS with and 55.6% of CCS without DTC would be operated. Using Strategy-3, 11.1% of CCS with DTC would be correctly operated upon, 11.2% without DTC would be operated upon and 1.5% with DTC would not be operated upon. With Strategy-4, these percentages would be 6.8, 3.9 and 5.8%, respectively. Median 10-year survival rates would be equal across strategies (0.997). Conclusion Different surveillance strategies for DTC in CCS all result in the same high DTC survival. Therefore, the indication for surveillance may lie in a reduction of surgery-related morbidity rather than DTC-related mortality. In accordance with the IGHG guidelines, the precise strategy should be decided upon in a process of shared decision-making.
Collapse
Affiliation(s)
- Alexander Heinzel
- RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen, Germany
| | - Dirk Müller
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
| | - Hanneke M van Santen
- Wilhelmina Children’s Hospital, University Medical Center Utrecht, Department of Pediatric Endocrinology, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Sarah C Clement
- Wilhelmina Children’s Hospital, University Medical Center Utrecht, Department of Pediatric Endocrinology, Utrecht, The Netherlands
- Emma Children’s Hospital, Amsterdam UMC, Department of Pediatrics, Amsterdam, The Netherlands
| | - Arthur B Schneider
- University of Illinois at Chicago, Department of Medicine, Chicago, IL, USA
| | - Frederik A Verburg
- Erasmus MC Rotterdam, Department of Radiology & Nuclear Medicine, Rotterdam, The Netherlands
- University Hospital Würzburg, Department of Nuclear Medicine, Würzburg, Germany
| |
Collapse
|
6
|
Kim PH, Yoon HM, Baek JH, Chung SR, Choi YJ, Lee JH, Lee JS, Jung AY, Cho YA, Bak B, Na DG. Diagnostic performance of the 2021 Korean thyroid imaging reporting and data system in pediatric thyroid nodules. Eur Radiol 2022; 33:172-180. [PMID: 35976400 DOI: 10.1007/s00330-022-09037-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the diagnostic performance of 2021 K-TIRADS biopsy criteria for detecting malignant thyroid nodules in a pediatric population, making comparisons with 2016 K-TIRADS. METHODS This retrospective study included pediatric patients with histopathologically confirmed diagnoses. The diagnostic performance of 2021 K-TIRADS was compared with that of 2016 K-TIRADS. Simulation studies were performed by changing biopsy cut-off sizes for K-TIRADS 5 to 1.0 cm (K-TIRADS5-1.0cm) and 0.5 cm (K-TIRADS5-0.5cm), and for K-TIRADS 4 to 1.0 cm (K-TIRADS4-1.0cm) and 1.0-1.5 cm (K-TIRADS4-1.0~1.5cm). Subgroup analysis was performed in small (< 1.5 cm) and large nodules (≥ 1.5 cm). RESULTS Two hundred seventy-seven thyroid nodules (54.9% malignant) from 221 pediatric patients were analyzed. All simulated 2021 K-TIRADS showed higher accuracy than 2016 K-TIRADS. Compared with 2021 K-TIRADS5-1.0cm, 2021 K-TIRADS5-0.5cm showed lower specificity (51.6% vs. 47.9%; p = 0.004) but higher sensitivity (77.2% vs. 90.3%; p < 0.001) and accuracy (62.7% vs. 68.9%; p < 0.001). Compared with 2021 K-TIRADS4-1.0cm, 2021 K-TIRADS4-1.0~1.5cm showed higher specificity (44.9% vs. 47.9%; p = 0.018) without significant difference in other diagnostic measures. Compared with 2016 K-TIRADS, 2021 K-TIRADS (biopsy cut-offs, 0.5 cm for K-TIRADS 5; 1.0-1.5 cm for K-TIRADS 4) showed higher sensitivity (34.0% vs. 67.3%; p < 0.001) while maintaining specificity (89.4% vs. 88.2%; p = 0.790) in small nodules, and higher specificity (5.9% vs. 25.4%; p < 0.001) while maintaining sensitivity (100% vs. 98.7%; p = 0.132) in large nodules. CONCLUSIONS In pediatric patients, 2021 K-TIRADS showed superior diagnostic accuracy to 2016 K-TIRADS, especially with a biopsy cut-off of 0.5 cm for K-TIRADS 5 and 1.0-1.5 cm for K-TIRADS 4. KEY POINTS • All simulated 2021 K-TIRADS showed higher accuracy than 2016 K-TIRADS. • 2021 K-TIRADS with cut-off size for K-TIRADS 5 of 0.5 cm showed lower specificity but higher sensitivity and accuracy than that of 1.0 cm. • Compared with 2016 K-TIRADS, 2021 K-TIRADS (biopsy cut-offs, 0.5 cm for K-TIRADS 5; 1.0-1.5 cm for K-TIRADS 4) showed higher sensitivity while maintaining specificity in small nodules, and higher specificity while maintaining sensitivity in large nodules.
Collapse
Affiliation(s)
- Pyeong Hwa Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Hee Mang Yoon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Sae Rom Chung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jin Seong Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Ah Young Jung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Young Ah Cho
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Boram Bak
- University of Ulsan Foundation for Industry Cooperation, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Dong Gyu Na
- Department of Radiology, GangNeung Asan Hospital, 38 Bangdong-gil, Sacheon-myeon, Gangneung-si, Gangwon-do, 25440, Republic of Korea.,Department of Radiology, Human Medical Imaging and Intervention Center, 621 Gangnam-daero, Seocho-gu, Seoul, 06524, Republic of Korea
| |
Collapse
|
7
|
Kim PH, Yoon HM, Baek JH, Chung SR, Choi YJ, Lee JH, Lee JS, Jung AY, Cho YA, Bak B, Na DG. Diagnostic Performance of Five Adult-based US Risk Stratification Systems in Pediatric Thyroid Nodules. Radiology 2022; 305:190-198. [PMID: 35787203 DOI: 10.1148/radiol.212762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The validation of adult-based US risk stratification systems (RSSs) in the discrimination of malignant thyroid nodules in a pediatric population remains lacking. Purpose To estimate and compare the diagnostic performance of pediatric US RSSs based on five adult-based RSSs in the discrimination of malignant thyroid nodules in a pediatric sample. Materials and methods Pediatric patients (age ≤18 years) with histopathologically confirmed US-detected thyroid nodules at a tertiary referral hospital between January 2000 and April 2020 were analyzed retrospectively. The diagnostic performance of US-based fine-needle aspiration biopsy (FNAB) criteria in thyroid cancer detection was estimated. The following sensitivity analyses were performed: (a) scenario 1: nodules smaller than 1 cm, with the highest category additionally biopsied; (b) scenario 2, application of American College of Radiology Thyroid Imaging Reporting and Data System nodule size cutoffs to other RSSs; (c) scenario 3, scenarios 1 and 2 together. Generalized estimating equations (GEEs) were used for estimation. Results A total of 277 thyroid nodules in 221 pediatric patients (median age, 16 years [interquartile range {IQR}, 13-17]; 172 female; 152 of 277 patients [55%] malignant) were analyzed. The GEE-estimated sensitivity and specificity ranged from 70% to 78% (104 to 119 of 152 patients, based on each reader's interpretation) and from 42% to 78% (49 of 124 patients to 103 of 125 patients). In scenario 1, the missed malignancy rate was reduced from 32%-38% (41 of 134 patients to 34 of 83 patients) to 15%-21% (eight of 59 patients to 28 of 127 patients). In scenario 2, the unnecessary biopsy rate was reduced from 35%-39% (60 of 176 patients to 68 of 175 patients) to 20%-34% (18 of 109 patients to 62 of 179 patients). The highest accuracy was noted in scenario 3 (range, 71%-81%; 199 of 277 patients to 216 of 262 patients). Conclusion The diagnostic performances of the fine-needle aspiration biopsy criteria of five adult-based risk stratification systems were acceptable in the pediatric population and were improved by applying the American College of Radiology Thyroid Imaging Reporting and Data System size cutoff for nodules 1 cm or larger and allowing biopsy of the highest category nodules smaller than 1 cm. © RSNA, 2022 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Pyeong Hwa Kim
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Hee Mang Yoon
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Jung Hwan Baek
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Sae Rom Chung
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Young Jun Choi
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Jeong Hyun Lee
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Jin Seong Lee
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Ah Young Jung
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Young Ah Cho
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Boram Bak
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| | - Dong Gyu Na
- From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.)
| |
Collapse
|
8
|
Mass Spectrometry and Mass Spectrometry Imaging-based Thyroid Cancer Analysis. JOURNAL OF ANALYSIS AND TESTING 2022. [DOI: 10.1007/s41664-022-00218-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
9
|
Midorikawa S, Ohtsuru A. Young people's perspectives of thyroid cancer screening and its harms after the nuclear accident in Fukushima Prefecture: a questionnaire survey indicating opt-out screening strategy of the thyroid examination as an ethical issue. BMC Cancer 2022; 22:235. [PMID: 35241012 PMCID: PMC8896110 DOI: 10.1186/s12885-022-09341-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Overdiagnosis of thyroid cancer has become a major global medical issue. Ultrasound-based thyroid cancer screening has promoted overdiagnosis, and recently international recommendations state that it should not be conducted, even after a nuclear accident. The Fukushima thyroid cancer screening program was initiated in 2011 as a health policy after the nuclear accident. The risk of radiation-induced thyroid cancer was unlikely given the low radiation levels, but the thyroid cancer screening program has continued at 2-year intervals with a relatively high participation rate and is now in its fifth round. It is therefore crucial to clarify whether those targeted for screening understand the disadvantages of screening, and to identify factors that influenced their decision to participate. METHODS We conducted an anonymous mail-based questionnaire among young people from Fukushima Prefecture (subjects) and a neighboring prefecture that was not targeted for screening (non-subjects). We asked them about the significance of the thyroid cancer screening in Fukushima Prefecture, their reasons for accepting or refusing screening, their perception of the harms of screening, and their opinions on thyroid examination at school. We compared the results of the questionnaire between subjects and non-subjects and between examinees (who were screened) and non-examinees (who declined screening). RESULTS Only 16.5% of respondents were aware of the harms associated with thyroid cancer screening, with most perceiving that the benefits outweighed the harms. Comparison of subjects' and non-subjects' responses showed there were no significant differences between the two groups. Among subjects, there were also no differences in responses between examinees and non-examinees. The most common reason for participation in screening was that the screening was conducted in schools and perceived as obligatory. CONCLUSIONS These results highlighted a serious ethical issue in that school-based screening leads to making young people think that it is mandatory screening in an opt-out and default setting manner, with a lack of knowledge about the disadvantages of screening. Based on the autonomy of the subjects and the ethical principle of the post-disaster, surveys after a nuclear disaster should be conducted in an opt-in style without an opt-out style such as school-based screening.
Collapse
Affiliation(s)
- Sanae Midorikawa
- Faculty of Human Life Science, Miyagi Gakuin Women's University, 9-1-1 Sakuragaoka, Aobaku, Sendai, 981-8557, Japan.
| | - Akira Ohtsuru
- Department of First Internal Medicine, Nagasaki University, Nagasaki, Japan
| |
Collapse
|
10
|
Suzuki G. Communicating with residents about 10 years of scientific progress in understanding thyroid cancer risk in children after the Fukushima Dai-ichi Nuclear Power Station accident. JOURNAL OF RADIATION RESEARCH 2021; 62:i7-i14. [PMID: 33978170 PMCID: PMC8114208 DOI: 10.1093/jrr/rraa097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/15/2020] [Indexed: 06/12/2023]
Abstract
After the Fukushima Dai-ichi Nuclear Power Station (FDNPS) accident in 2011, radiation-related risk of childhood thyroid cancer remains a matter of concern among residents living in areas affected by radioactive plumes. As a countermeasure to that, the Fukushima Prefectural Government-in conjunction with Fukushima Medical University-began the Fukushima Thyroid Examination (FTE) campaign in 2011. As 116 definite or suspected thyroid cancer cases were found after the first round of FTE and the total number of cases was >240 as of June 2020, residents' concerns have deepened. Some researchers claim that these cases are radiation-induced, while others claim a screening effect (because FTE uses high-resolution ultrasound equipment) and express concern about over-diagnosis. Researchers therefore must address two conflicting issues: one is to elucidate radiation effects on thyroid cancer, which requires continuation of FTE; the other is to solve ethical problems associated with FTE. As to over-diagnosis, surgeons claim that early diagnosis benefits children by reducing the side-effects of treatment and prolonging disease-free survival, while cancer epidemiologists claim that early diagnosis will result in overtreatment without reducing the death rate. 'To receive FTE or not' and 'to stop FTE or not' are ongoing dilemmas for children (and their parents) and other stakeholders, respectively. To facilitate building a consensus among stakeholders, I overview recent findings about dose reconstruction, the dose-response relationship of thyroid cancer, over-diagnosis, and the natural history of thyroid cancer, all of which contribute to judging the risk-benefit balance of thyroid screening.
Collapse
Affiliation(s)
- Gen Suzuki
- Corresponding author. International University of Health and Welfare Clinic, 2600-6, Kitakanemaru, Ohtawara city, Tochigi Prefecture, Japan 324-8501.Tel: +81-287-24-1001; Fax: +81-287-24-1003;
| |
Collapse
|
11
|
Ohtsuru A, Midorikawa S. Lessons learned from conducting disease monitoring in low-dose exposure conditions as a counter-measure after a nuclear disaster. JOURNAL OF RADIATION RESEARCH 2021; 62:i64-i70. [PMID: 33978183 PMCID: PMC8114222 DOI: 10.1093/jrr/rraa105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/01/2020] [Indexed: 06/12/2023]
Abstract
The complex disaster of the Great East Japan Earthquake and the Fukushima nuclear accident caused concern about their various health impacts. Many types of intervention are desired as a countermeasure, depending on the phase of the disaster cycle. The importance of developing and applying codes of conduct has recently been emphasized for post-disaster investigations. Thyroid examination as a type of cancer screening survey was launched from October 2011 after the Fukushima nuclear accident as part of the Fukushima Health Management Survey. In this article, we reviewed the results of three rounds of thyroid examination from 2011 to 2018, and summarized the points to consider in the health survey conducted after the Fukushima nuclear accident. Large-scale mass screening by ultrasound thyroid examination resulted in many cancer diagnoses, >200 cases from a large reservoir of thyroid cancer that goes mainly unnoticed without screening. To prevent the harms of such over-diagnosis, we should be aware of the disadvantage of mass-screening based on the expected natural history of thyroid cancer. A change in strategy from mass-screening to individual monitoring is urgently needed according to international recommendations that are opposed to thyroid ultrasound cancer screening even after a nuclear disaster. To guarantee autonomy and informed choice on post-disaster disease monitoring for residents in a disaster-zone, it is important to set protocol participation and on a voluntary code of conduct basis.
Collapse
Affiliation(s)
- Akira Ohtsuru
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, 960-1295, Japan
- Atomic Disease Institute, Nagasaki University, Nagasaki, 852-8523, Japan
- Ohtsuru Medical Clinic, Nagasaki, 850-0055, Japan
| | - Sanae Midorikawa
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, 960-1295, Japan
- Miyagi Gakuin Woman’s University, Sendai 981-8557, Japan
| |
Collapse
|
12
|
Park J, Park H, Kim TH, Kim SW, Jang HW, Chung JH. Trends in Childhood Thyroid Cancer incidence in Korea and Its Potential Risk Factors. Front Endocrinol (Lausanne) 2021; 12:681148. [PMID: 34054738 PMCID: PMC8160442 DOI: 10.3389/fendo.2021.681148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/26/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although the incidence of thyroid cancer had been increasing until a few years ago, a decrease has been observed in the last years, probably due to the reduction of the screening tests in Korea. Childhood thyroid cancer has been increasing in the past with the same trend as in adults, but there have been few reports on recent trends. We analyzed the trends of thyroid cancer in Korean children and related factors. METHODS From national statistics and cancer register database, the data of age-specific incidence rate in Korean childhood thyroid cancer from 1999 to 2017 was obtained, and levels of seaweed intake, the number of computed tomography (CT) and neck ultrasonography (US), obesity prevalence rate, and smoking and alcohol consumption rates in children were analyzed. RESULTS The age-specific incidence of thyroid cancer in Korean children has increased in both genders between 1999 and 2017 (2.0 in 1999 vs. 7.2 in 2017, per population of 100,000), especially in the age group of 14-18 years (1.5 in 1999 vs. 5.5 in 2017, per population of 100,000). During the same period, levels of seaweed intake, number of CT scans and neck US, and prevalence of obesity in children increased significantly, while childhood smoking and alcohol consumption rates decreased. CONCLUSION Unlike the adult thyroid cancer in Korea, childhood thyroid cancer continues to increase, and the cause might be accompanied by actual increases due to the environmental factors such as excessive iodine intake, exposure to medical radiation, and increased obesity prevalence as well as the screening effect.
Collapse
Affiliation(s)
- Jun Park
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Division of Endocrinology, Department of Medicine, Sahmyook Medical Center, Seoul, South Korea
| | - Hyunju Park
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Won Jang
- Department of Medical Education, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Jae Hoon Chung,
| |
Collapse
|
13
|
Takano T. In Reply. Arch Pathol Lab Med 2020; 144:797-798. [DOI: 10.5858/arpa.2019-0683-le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Toru Takano
- Thyroid Center, Rinku General Medical Center, Osaka, Japan; Departments of Metabolic Medicine and Laboratory Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|