Changes in the Diagnostic Efficiency of Thyroid Fine-Needle Aspiration Biopsy during the Era of Increased Thyroid Cancer Screening in Korea
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA. Materials and Methods This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables. Results The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=-0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=-0.853, p=0.007). Conclusion The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules.
Abstract
Purpose The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA. Materials and Methods This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables. Results The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=-0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=-0.853, p=0.007). Conclusion The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules.
참고문헌 (32)
- Global Burden of Disease Cancer Collaboration, "The Global Burden of Cancer 2013", JAMA Oncol, 1, pp.505~527 (2015)
- Udelsman R, "The epidemic of thyroid cancer in the United States : the role of endocrinologists and ultrasounds", Thyroid, 24, pp.472~479 (2014)
- Hoang JK, "An exponential growth in incidence of thyroid cancer : trends and impact of CT imaging", AJNR Am J Neuroradiol, 35, pp.778~783 (2014)
- Vaccarella S, "The impact of diagnostic changes on the rise in thyroid cancer incidence : a population-based study in selected high-resource countries", Thyroid, 25, pp.1127~1136 (2015)
- 오창모, "Age-Period-Cohort Analysis of Thyroid Cancer Incidence in Korea", Cancer Research and Treatment, 47(3), pp.362~369 (2015), 대한암학회[DOI]
- Park S, "Association between screening and the thyroid cancer "epidemic" in South Korea: evidence from a nationwide study", BMJ, 355, pp.i5745~ (2016)
- Haugen BR, "2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer : the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer", Thyroid, 26, pp.1~133 (2016)
- Ahn HS, "Korea's thyroid-cancer"epidemic" : screening and overdiagnosis", N Engl J Med, 371, pp.1765~1767 (2014)
- Zevallos JP, "Increased thyroid cancer incidence corresponds to increased use of thyroid ultrasound and fine-needle aspiration : a study of the Veterans Affairs health care system", Cancer, 121, pp.741~746 (2015)
- Zimetbaum PJ, "Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations : a cost-effectiveness analysis", Ann Intern Med, 128, pp.890~895 (1998)
- Steinberg LA, "Syncope in children : diagnostic tests have a high cost and low yield", J Pediatr, 146, pp.355~358 (2005)
- Valencia CA, "Clinical impact and cost-effectiveness of whole exome sequencing as a diagnostic tool : a pediatric center's experience", Front Pediatr, 3, pp.67~ (2015)
- Bini EJ, "Diagnostic yield and cost-effectiveness of endoscopy in chronic human immunodeficiency virus-related diarrhea", Gastrointest Endosc, 48, pp.354~361 (1998)
- Larson EB, "Diagnostic evaluation of headache : impact of computerized tomography and costeffectiveness", JAMA, 243, pp.359~362 (1980)
- 송선옥, "Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System", Diabetes and Metabolism Journal, 38(5), pp.395~403 (2014), 대한당뇨병학회[DOI]
- Hai-Rim Shin, "Nationwide Cancer Incidence in Korea, 1999~2001; First Result Using the National Cancer Incidence Database", Cancer Research and Treatment, 37(6), pp.325~331 (2005), 대한암학회
- Nilsson IL, "Thyroid incidentaloma detected by fluorodeoxyglucose positron emission tomography", computed tomography : practical management algorithm, 2011, pp.35, 2691~2697
- Steele SR, "The significance of incidental thyroid abnormalities identified during carotid duplex ultrasonography", Arch Surg, 140, pp.981~985 (2005)
- 유정인, "Evaluation of Diagnostic Performance of Screening Thyroid Ultrasonography and Imaging Findings of Screening-Detected Thyroid Cancer", Cancer Research and Treatment, 50(1), pp.11~18 (2018), 대한암학회
- Cho YJ, "Thyroid fine-needle aspiration biopsy positively correlates with increased diagnosis of thyroid cancer in South Korean patients", BMC Cancer, 17, pp.114~ (2017)
- Heller M, "Cost-effectiveness analysis of repeat fine-needle aspiration for thyroid biopsies read as atypia of undetermined significance", Surgery, 152, pp.423~430 (2012)
- Yip L, "Cost impact of molecular testing for indeterminate thyroid nodule fine-needle aspiration biopsies", J Clin Endocrinol Metab, 97, pp.1905~1912 (2012)
- Lin JS, "Screening for thyroid cancer : updated evidence report and systematic review for the US Preventive Services Task Force", JAMA, 317, pp.1888~1903 (2017)
- Choi YM, "Changes in standardized mortality rates from thyroid cancer in Korea between 1985 and 2015 : Analysis of Korean national data", Cancer, 123, pp.4808~4814 (2017)
- 박수경, "소아 무균성 뇌막염의 역학적 연구를 위한 건강보험자료원의 유용성 평가", 예방의학회지, 36(4), pp.7~358 (2003), 대한예방의학회
- Cheong HK, "Six year national trend of childhood aseptic meningitis incidence in Korea, 1996-2001", Korean J Epidemiol, 30, pp.252~262 (2008)
- Report of the evaluation for validity of discharged diagnoses in Korean Health Insurance database, "Park BJ", Seoul National University, 19~52 (2003)
- 이서영, "Estimating the Prevalence of Treated Epilepsy Using Administrative Health Data and Its Validity: ESSENCE Study", Journal of Clinical Neurology, 12(4), pp.434~440 (2016), 대한신경과학회[DOI]
- 김희진, "Validity of the Diagnosis of Acute Myocardial Infarction in Korean National Medical Health Insurance Claims Data: The Korean Heart Study (1)", Korean Circulation Journal, 42(1), pp.10~15 (2012), 대한심장학회
- Houlton JJ, "Thyroid fine-needle aspiration: does case volume affect diagnostic yield and interpretation?", Arch Otolaryngol Head Neck Surg, 137, pp.1136~1139 (2011)
- Beland MD, "Resident experience increases diagnostic rate of thyroid fineneedle aspiration biopsies", Acad Radiol, 21, pp.1490~1494 (2014)
- 이영흔, "Ultrasound-Guided Fine Needle Aspiration of Thyroid Nodules: A Consensus Statement by the Korean Society of Thyroid Radiology", Korean Journal of Radiology, 16(2), pp.391~401 (2015), 대한영상의학회[DOI]
