Barriers to thyroid cancer screening with ultrasound in patients with familial adenomatous polyposis

2019 ◽  
Vol 129 (10) ◽  
pp. 2436-2441 ◽  
Author(s):  
Celeste Nagy ◽  
Zachary Kelly ◽  
Steven Keilin ◽  
Field Willingham ◽  
Amy Chen
Keyword(s):  
Thyroid Cancer ◽  
Cancer Screening ◽  
Familial Adenomatous Polyposis ◽  
Adenomatous Polyposis ◽  
Thyroid Cancer Screening

scholarly journals An Ethical Issue After the Nuclear Accident in Fukushima: Young People’S Perspectives of Thyroid Cancer Screening and its Harms

2021 ◽  
Author(s):  
Sanae Midorikawa ◽  
Akira Ohtsuru
Keyword(s):  
Thyroid Cancer ◽  
Cancer Screening ◽  
Young People ◽  
Ethical Issue ◽  
Screening Program ◽  
Nuclear Accident ◽  
School Based ◽  
Cancer Screening Program ◽  
Opt Out ◽  
Thyroid Cancer Screening

Abstract Background Overdiagnosis of thyroid cancer has become a major global medical issue. Ultrasound-based thyroid cancer screening has promoted overdiagnosis, and recently international recommendations indicate that such screening should not be conducted, even after a nuclear accident. The Fukushima thyroid cancer screening program was initiated in 2011 as a health policy after the nuclear accident, although the risk for radiation-induced thyroid cancer was unlikely given the low radiation levels. However, the thyroid cancer screening program has continued at 2-year intervals with a relatively high participation rate and is now in its fifth round. Therefore, it is crucial to clarify whether those targeted for screening understand the disadvantages of screening and identify factors that influenced their decision to participate. Methods We conducted an anonymous mail-based questionnaire that included young people from Fukushima (subjects) and a neighboring prefecture that was not targeted for screening (non-subjects). We asked them about the significance of the thyroid cancer screening in Fukushima, the reasons for taking or not taking a screening, their perception of the harms of screening, and their opinions on thyroid examination at school. Then we compared the results of the questionnaire between subjects and non-subjects and examinees (who accepted screening) and non-examinees (who declined screening). Results Only 16.5% of respondents were aware of the harms associated with thyroid cancer screening, with most perceiving that the benefits outweighed the harms. Comparison of subjects’ and non-subjects’ responses showed there were no significant differences between subjects and non-subjects. In addition, among subjects, there were no differences of responses between examinees and non-examinees. The most common reason for participation in screening was that the screening was conducted in schools and perceived as obligatory. Conclusions These results highlighted a serious ethical issue in that school-based screening leads to making young people think that it is mandatory screening in an opt-out and default setting manner, with a lack of knowledge about the disadvantages of screening. Based on the autonomy of the subjects and the ethical principle of the post-disaster, surveys after a nuclear disaster should be conducted in an opt-in style without an opt-out style such as school-based screening.

scholarly journals Age- and Gender-Specific Risk of Thyroid Cancer in Patients With Familial Adenomatous Polyposis

2016 ◽  
Vol 101 (12) ◽  
pp. 4611-4617 ◽  
Author(s):  
Shinya Uchino ◽  
Hideki Ishikawa ◽  
Akira Miyauchi ◽  
Mitsuyoshi Hirokawa ◽  
Shiro Noguchi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Familial Adenomatous Polyposis ◽  
Thyroid Nodules ◽  
Adenomatous Polyposis ◽  
Protein Truncation Test ◽  
Exact Test ◽  
Female Patients ◽  
And Gender ◽  
Transducer Probe ◽  
Gender Specific

Context: The cribriform-morula variant of papillary thyroid carcinoma (CMV-PTC) is a rare variant of PTC and is associated with familial adenomatous polyposis (FAP). However, the incidence and the nature of CMV-PTC among FAP patients have not been well characterized. Objective: The aim of this study was to determine the incidence and characteristics of thyroid cancer screened by neck ultrasonography for FAP patients. Design, Patients, and Intervention: A total of 129 FAP patients were included in this study. Neck ultrasonography was performed using a 12.0-MHz transducer probe. Germline APC gene mutation was examined for by the protein truncation test or DNA sequencing methods. Results: Twenty-one patients (16.3%) had solid nodules, and 24 patients (18.6%) had benign cystic nodules. In total, PTC was found in 11 patients (16% of the women and 0% of the men), 8 of which were CMV-PTC and the rest were classical PTC. In 17 female patients with thyroid nodules, CMV-PTC occurred in 8 of 9 patients who were 35 years age or younger but in none of the 8 patients who were older than 35 (P = .0004 by Fisher’s exact test). The APC germline mutations in 8 patients with CMV-PTC were present at the 5′ side of the profuse type of FAP region (codons 1249–1330). Conclusions: The prevalence of CMV-PTC in FAP patients was higher than previously reported and this type of tumor was found preferentially in younger (under age 35) female patients with FAP in this cohort.

Thyroid Cancer in Patients with Familial Adenomatous Polyposis

1998 ◽  
Vol 22 (7) ◽  
pp. 738-743 ◽  
Author(s):  
Nancy D. Perrier ◽  
Jon A. van Heerden ◽  
John R. Goellner ◽  
E. Dillwyn Williams ◽  
Hossein Gharib ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Familial Adenomatous Polyposis ◽  
Adenomatous Polyposis
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