Authors' recommendations: A converging array of findings points to a strong association between the more intensive use of specific diagnostic and surgical strategies in the Walloon Region and the higher incidence of thyroid cancers such as papillary microcarcinomas (T1a) in that Region. The probability of chance detection (by imaging or anatomical pathological exam) and consequently the probability of overdiagnosis and overtreatment of these small tumours is higher than their detection based on clinical symptoms. However, several methodological limitations the use of retrospective data and the inference of thyroid disease on the basis of therapeutic procedures (in the absence of true diagnoses), preclude us from drawing definitive conclusions about a causal link between the more or less intensive use of the diagnostic and therapeutic procedures and the incidence of thyroid cancer. Furthermore, the study did not allow us to evaluate the pertinence of choices made by clinicians when making diagnoses or proposing treatments. However, it did reveal significant variability in the management of the thyroid disease. This study suggests in particular that compliance with international guidelines recommending a more frequent use of FNAC in preoperative assessments could be improved. The training and experience of pathologists in practising and interpreting cytological exams also required a special attention. Compliance with good practice recommendations for the management of thyrotoxicosis and thyroid nodules could be reinforced, which would also help to reduce variability in the diagnostic and therapeutic strategies used in Belgium. Finally, a more detailed prospective analysis should be performed in order to test the hypothesis of a link between the increased incidence of small cancers on the one hand and diagnostic activities using highly sensitive methods and surgical treatment on the other hand.

Project Status: Completed

Year Published: 2012

URL for published report: http://kce.fgov.be/sites/default/files/page_documents/KCE_177C_thyroid_cancer_in_Belgium.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Belgium

Organisation Name: Belgian Health Care Knowledge Centre

Contact Address: Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium tel: +32 2 287 33 88 fax: +32 2 287 33 85

Contact Name: info@kce.fgov.be

Contact Email: info@kce.fgov.be

Copyright: Belgian Health Care Knowledge Centre (KCE)