[ RadSafe ] Fwd: Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis

[KARAM, PHILIP]

My mother worked for many years as a genetic counselor and said that, during her career, she saw the miscarriage rate "skyrocket." In this case it was due to early pregnancy testing that could tell a woman she was pregnant within a few weeks of conception - instead of the one-two months it had previously taken. The problem was not that the miscarriage rate actually increased - it's that doctors (and patients) were now aware of far more conceptions than in the past. Something that would earlier have been thought to be simply a late (or missed) period was now known to be a miscarriage. Had doctors (and public health officials) interpreted this information as rising miscarriage rates we could well have had all sorts of folks running around trying to figure out what to blame.

Andy

P. Andrew Karam, PhD, CHP
NYPD Counterterrorism Division
(718) 615-7055 (desk)
(646) 879-5268 (mobile)

-----Original Message-----
From: radsafe-bounces at health.phys.iit.edu [mailto:radsafe-bounces at health.phys.iit.edu] On Behalf Of Chris Alston
Sent: Monday, August 22, 2016 7:43 PM
To: The International Radiation Protection (Health Physics) Mailing List
Subject: [ RadSafe ] Fwd: Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis

Folks

The same can be said about both prostate and breast Ca.  Because of the great increase in early diagnoses, we are now in the position of having to decide what needs tx, and/or *when*, and in what form, and what needs only monitoring.  While obviously a very challenging problem (not least because most people's first, and continuing, take on a dx of Ca is: "Get that thing out of me!"), it's a huge step from the days, not so very long ago, when a dx of prostate Ca meant a death sentence for many men, and, for breast Ca, too often the same, or anyway severely mutilative surgeries + chemo + radiotherapy for women.

I suspect that, because of the way our healthcare system works (that is "functions" or "operates") in the USA, we will not be the leader in figuring out what to do about it.  Seems like the U.K. is a more likely candidate.  On the other hand, for instance, some of the crucial trials of the surgical alternatives to radical mastectomy were in the US.  Took a helluva lot of guts on the part of both pt and physician.

Cheers
ca
---------- Forwarded message ----------
From: Brooks, Michael <Michael.Brooks at poole.nhs.uk>
Date: Mon, Aug 22, 2016 at 9:34 AM
Subject: [ RadSafe ] Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis
To: "radsafe at health.phys.iit.edu" <radsafe at health.phys.iit.edu> http://www.nejm.org/doi/full/10.1056/NEJMp1604412?query=TOC
I can't access the article, but thought it looked interesting for those that can (given the 'new' cancers found post Fukushima).
Regards,
Mick
Michael Brooks, PhD
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