What are the benefits and harms of screening for thyroid cancer in asymptomatic adults?

The U.S. Preventive Services Task Force (USPSTF) concludes that current evidence is sufficient to recommend against screening for thyroid cancer in asymptomatic adults (D statement). This recommendation does not apply to persons at increased risk of thyroid cancer (eg, those with a history of exposure to ionizing radiation, a diet low in iodine, inherited genetic syndrome, or a first-degree relative with a history of thyroid cancer). This updated recommendation is essentially unchanged from the previous recommendation in 1996. (LOE = 2a-)

Bibbins-Domingo K; US Preventive Services Task Force. Screening for thyroid cancer. US Preventive Services Task Force recommendation statement. JAMA 2017;317(18):1882-1887.  [PMID:28492905]

Practice guideline

Government

Population-based

In this updated review the USPSTF evaluated current evidence assessing the balance of benefits and harms of screening for thyroid cancer in asymptomatic adults. The Task Force found inadequate evidence on the accuracy of neck palpation or ultrasound as a screening test for thyroid cancer. Although no studies directly compared screened versus unscreened populations or immediate surgery versus surveillance or observation on patient-oriented outcomes, the best observational evidence demonstrates no change in mortality over time after the introduction of population-based screening. Studies reporting on the potential harms of screening found at least moderate evidence of harm from treatment, including surgery-induced permanent hypoparathyroidism and recurrent laryngeal nerve palsy, as well as an increase in the risk of second primary malignancy and dry mouth from radioactive iodine treatment. The American Cancer Society, The American Thyroid Association, and The Canadian Task Force do not recommend screening for thyroid cancer. The American Academy of Family Physicians recommends against screening for thyroid cancer in asymptomatic adults.