Extent of Surgery for Differentiated Thyroid Cancer: Recommended Guideline

Abstract

Cancer is a major public health problem in many parts of the world. Thyroid cancer is one of the least deadly cancers. The 5-year survival rate for all thyroid cancer is about 97%. Thyroid cancer is different from many other adult cancers in that it is commonly diagnosed in young people. Nearly 2 of 3 cases are found in people between the age of 20 and 55. The age–and gender-adjusted incidence of thyroid cancer has increased faster than that of any other malignancy in recent years. The American cancer Society in recent estimate for thyroid cancer in the United States (2010) showed that about 44,670 new cases of thyroid cancer will occur (33,930 in women and 10,740 in men). Thyroid cancer will cause about 1,690 deaths (960 women and 730 men). Over the past three decades, the incidence of thyroid cancer (TC) has significantly increased worldwide, rising from a rate of 3.6 /100,000 in 1973 to 8.7/100,000 in 2002, without any change in the mortality rate. The increase is almost exclusively due to a rise in papillary cancer rates, this being attributed to both environmental radiation and increased diagnostic scrutiny. In areas which have not been afflicted by nuclear fallout, the annual incidence of TC ranges from 2.0 to 3.8/100,000 in women and from 1.2 to 2.6/100,000 in men. Significant differences in TC incidence have been reported among various regions, with Hawaii, the Philippines and Iceland presenting the greatest incidence worldwide. This phenomenon possibly suggests that common environmental influences in these regions may be responsible for the strikingly high rates. The aim of this communication is to highlight the guideline for surgical treatment of well differentiated thyroid cancer.

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