Is thyroid cancer over-diagnosed in Switzerland?

The number of diagnoses of thyroid cancer is increasing in Switzerland. The increasing number may be most likely explained as a result of thyroid nodules detected randomly or during preventive examinations. It often happens that small “carcinoma” are detected which, due to their relatively harmless type of tissue, would not be harmful in the affected individual’s lifetime. Many of these individuals may be over-treated. This conclusion is drawn by researchers from the Inselspital Bern, the Institute of Social and Preventive Medicine (IUMSP) of the University of Lausanne, and the Bern Institute of General Practice and Family Medicine (BIHAM), University of Bern.

Significantly more diagnoses

Looking back, the researchers, using data from cancer registries (www.nicer.org), made comparisons on how often “Thyroid cancer” had been diagnosed in Switzerland between 1998 and 2012, and how many thyroid resection had been performed. The authors compared these results to the annual deaths due to thyroid cancer. While the number of individuals dying of thyroid cancer was slightly decreasing, the number of diagnoses of this disease was shooting up. Among women, the number of individuals affected per 100,000 individuals annually increased, from 5.9 to 11.7. In the case of men, the number of individuals affected annually increased from 2.7 to 3.9 per 100,000 individuals.

Unnecessary surgeries?

The main reason for the increase in diagnoses was due to a relatively benign type of tissue and early stages of thyroid cancer, which are partly harmless, partly slowly growing and often do no harm in the patient’s lifetime. Despite this, the number of thyroid resections has increased threefold to fourfold. This leads the authors to the conclusion that thyroid cancer is over-diagnosed and may be surgically removed too often in Switzerland. Therefore, it is necessary to analyse which individuals would benefit from an early diagnosis and treatment and which would not.

Media enquiries:

Dr. med. Sabrina Jegelehner, Department of General Internal Medicine, Inselspital,
+41 31 632 21 11, sabrina.jegerlehner@insel.ch (in German)

PD Dr. Arnaud Chiolero, Institute of Social and Preventive Medicine (IUMSP) of the University of Lausanne and Bern Institute of General Practice and Family Medicine (BIHAM), +41 79 205 68 53, arnaud.chiolero@biham.unibe.ch (in French)

Prof. Dr. med. Drahomir Aujesky, Head and Chief Physician, Department of General Internal Medicine, Inselspital, +41 31 632 88 83, DrahomirAntonin.Aujesky@insel.ch (in German and French)

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