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최근의 “갑상선암 과잉진단 및 과잉진료” 논란에 대한 소고(小考)

A Refutation against Unfounded Reports on Thyroid Cancer

정재훈
대한갑상선학회 (Korean Thyroid Association)|2014.05|International Journal of Thyroidology|제7권 제1호|pp. 1-6

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참고문헌

키워드

Guideline선별 검사Incidence발생률Screening초음파Ultrasonography갑상선암Thyroid cancer진료지침Papillary thyroid carcinoma유두암
주제분류의학일반

초록

The incidence of thyroid cancer has been increasing in Korea as well as in many countries. This is mainly due to the early detection of papillary thyroid microcarcinoma less than 1 cm in diameter with a high-resolution ultrasonography. Because of the unique Korean medical environment, its incidence is abruptly increasing in Korea. Many experts have emphasized that the early detection cannot completely explain the observed increase in thyroid cancer. Therefore, other possible explanations should be explored. Unnecessary diagnosis and excessive treatment should be avoided. If unreasonable regulations are applied, they could do more harm than good. In terms of screening efficacy, the National Evidence-based Healthcare Collaborating Agency in conjunction with Korean Thyroid Association concluded in 2013 that evidence was insufficient to recommend for or against ultrasonography screening for thyroid cancer. If a patient incidentally finds a tumor on the thyroid, a physician should manage the patient according to the guidelines. The guidelines should be developed based on evidence-based medical decisions for patients, not on economic efficacy.

Abstract

The incidence of thyroid cancer has been increasing in Korea as well as in many countries. This is mainly due to the early detection of papillary thyroid microcarcinoma less than 1 cm in diameter with a high-resolution ultrasonography. Because of the unique Korean medical environment, its incidence is abruptly increasing in Korea. Many experts have emphasized that the early detection cannot completely explain the observed increase in thyroid cancer. Therefore, other possible explanations should be explored. Unnecessary diagnosis and excessive treatment should be avoided. If unreasonable regulations are applied, they could do more harm than good. In terms of screening efficacy, the National Evidence-based Healthcare Collaborating Agency in conjunction with Korean Thyroid Association concluded in 2013 that evidence was insufficient to recommend for or against ultrasonography screening for thyroid cancer. If a patient incidentally finds a tumor on the thyroid, a physician should manage the patient according to the guidelines. The guidelines should be developed based on evidence-based medical decisions for patients, not on economic efficacy.

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