There’s no question medical science benefits from better diagnostic tests.
But sometimes these advances make it harder to define who’s sick and who’s not.
Consider cancer of the thyroid, a hormone-producing gland located below the Adam’s apple.
Since the early 1970s, thyroid cancer cases have more than doubled in America. Currently, the disease strikes about nine people per one-hundred-thousand.
But a study published recently in the Journal of the American Medical Association concluded that thyroid cancer isn’t becoming more common.
Instead, new diagnostic tests such as ultrasound and fine needle aspiration have enabled doctors to find small tumors that were previously undetectable.
Researchers examined thyroid cancer data collected from 1973 to 2002, representing about ten percent of the U-S population.
The mortality rate held steady, suggesting the incidence of the disease didn’t change.
But diagnoses increased, because doctors found more and more small tumors.
Many of them measured two centimeters or less, so small that, arguably, they didn’t require medical intervention.
Nonetheless, three out of four patients with tumors measuring less than one centimeter had their thyroid glands removed.
The operation may be unnecessary. Patients risk surgical complications and face a lifetime of thyroid-replacement therapy.
So the researchers suggest perhaps we should classify small thyroid tumors as normal findings.
It may seem strange to call a cancer diagnosis normal. But when technology can detect tumors so small, it raises an interesting question
How can we accurately predict which tiny tumors will stay harmless, and which ones won’t?