Use of imaging tests after primary treatment of thyroid cancer in the United States: population based retrospective cohort study evaluating death and recurrence

Differentiated thyroid cancer has been increasing in incidence for several decades and is expected to be the fourth leading cancer diagnosis by the year 2030. Most of this rise in incidence is explained by diagnoses of small, low risk cancers. These low risk cancers are associated with an excellent long term survival; disease specific survival at 10 years for patients diagnosed with low risk thyroid cancer is between 96% to 100%. Yet, despite this increase in low risk cancers, our previous work found that the use of imaging tests after primary treatment of thyroid cancer is rising. The reason for this rise in imaging is unknown, but because risk of death from thyroid cancer is low, increased use of imaging could be due to growing concern for the risk of recurrence, which ranges from 1% to 68%. When thyroid cancer recurrence occurs, treatment options include repeat neck surgery, radioactive iodine for iodine avid recurrence, and radiation for unresectable disease. However, these treatments are not without risks, and the relation between imaging, treatment for recurrence, and survival remains unknown. Read more.