"Screening for Thyroid and Pancreatic Cancer Not Recommended for Healthy Individuals... Risks Must Be Considered"

The 20th Health and Medical Forum of the Korean Academy of Medical Sciences

[Asia Economy Reporter Kim Young-won] There is an opinion that healthy individuals should not be recommended to undergo health screenings for certain cancers such as thyroid cancer and pancreatic cancer using PET-CT.

At the 20th Health and Medical Forum hosted by the Korean Academy of Medical Sciences on the 2nd, experts discussed the topic "Is excessive health screening acceptable as it is?"

The first presenter, Professor Myung Seung-kwon of the National Cancer Center (Dean of the Graduate School of International Cancer Graduate School), stated, "Thyroid ultrasound screening is not recommended for asymptomatic adults for cancer screening purposes." According to the 2019 National Cancer Registry Statistics Report, thyroid cancer was the most common cancer among both men and women, with a 5-year relative survival rate of 100.0%, which is the same level as people without the disease. Professor Myung explained, "The main reason is that excessive thyroid cancer screening led to many small-sized cancers being detected through ultrasound."

Regarding why thyroid ultrasound is not recommended for healthy adults, Professor Myung said, "There is insufficient evidence that thyroid ultrasound can reduce thyroid cancer mortality," adding, "Although ultrasound is more effective than palpation in detection, there is a possibility of overdiagnosis, and in cases where thyroid cancer surgery is performed, although rare, voice changes and hypoparathyroidism may require continuous calcium supplementation."

According to Professor Myung, overseas national guidelines also do not recommend thyroid cancer screening for adults without specific risk factors. This year, the American Cancer Society cited Korea's case, stating that thyroid cancer screening does not reduce thyroid cancer mortality and that excessive diagnosis and treatment can cause harms such as false positives, unnecessary diagnostic tests, and long-term sequelae. In Korea, the incidence of hypothyroidism after thyroid cancer surgery has increased about threefold compared to 2007, and there was no correlation between incidence and mortality rates.

There was also an opinion against recommending pancreatic cancer screening or whole-body positron emission tomography-computed tomography (PET-CT) screening for healthy adults. Professor Cha Jae-myung of the Department of Gastroenterology at Kangdong Kyung Hee University Hospital said that pancreatic cancer screening is not recommended for asymptomatic healthy adults. Professor Cha added, "As many around me have seen, psychological harm often occurs through pancreatic cancer screening. If someone undergoes screening by chance and the pancreatic cancer-related markers are high, the patient experiences extreme stress until reassured that 'it's okay.' Therefore, most foreign guidelines recommend against pancreatic cancer screening in such situations."

Regarding the recently increasing claims for PET-CT, Professor Cha also argued against its use for cancer screening. According to Professor Cha, PET-CT has advantages such as responding to various types of cancer, being able to examine the whole body at once, and being non-invasive. However, it involves a high radiation dose, is relatively expensive, and has limitations in early detection of some genitourinary tumors, low-metabolic tumors, and small cancers.

Professor Cha explained, "In a screening data analysis study involving 5,000 people, the rate of actual cancer confirmation when PET results were positive was 4.2%, which is lower than expected," adding, "It may be useful for groups with high prevalence such as elderly patients, but its usefulness may be low for asymptomatic healthy individuals."

This content was produced with the assistance of AI translation services.