Screening for thyroid cancer in survivors of childhood and young adult cancer treated with neck radiation Journal Article
| Authors: | Tonorezos, E. S.; Barnea, D.; Moskowitz, C. S.; Chou, J. F.; Sklar, C. A.; Elkin, E. B.; Wong, R. J.; Li, D.; Tuttle, R. M.; Korenstein, D.; Wolden, S. L.; Oeffinger, K. C. |
| Article Title: | Screening for thyroid cancer in survivors of childhood and young adult cancer treated with neck radiation |
| Abstract: | Background: The optimal method of screening for thyroid cancer in survivors of childhood and young adult cancer exposed to neck radiation remains controversial. Outcome data for a physical exam-based screening approach are lacking. Methods: We conducted a retrospective review of adult survivors of childhood and young adult cancer with a history of neck radiation followed in the Adult Long-Term Follow-Up Clinic at Memorial Sloan Kettering between November 2005 and August 2014. Eligible patients underwent a physical exam of the thyroid and were followed for at least 1 year afterwards. Ineligible patients were those with prior diagnosis of benign or malignant thyroid nodules. Results: During a median follow-up of 3.1 years (range 0–9.4 years), 106 ultrasounds and 2277 physical exams were performed among 585 patients. Forty survivors had an abnormal thyroid physical exam median of 21 years from radiotherapy; 50% of those with an abnormal exam were survivors of Hodgkin lymphoma, 60% had radiation at ages 10–19, and 53% were female. Ultimately, 24 underwent fine needle aspiration (FNA). Surgery revealed papillary carcinoma in seven survivors; six are currently free of disease and one with active disease is undergoing watchful waiting. Among those with one or more annual visits, representing 1732 person-years of follow-up, no cases of thyroid cancer were diagnosed within a year of normal physical exam. Conclusions: These findings support the application of annual physical exam without routine ultrasound for thyroid cancer screening among survivors with a history of neck radiation. Implications for cancer survivors: Survivors with a history of neck radiation may not require routine thyroid ultrasound for thyroid cancer screening. Condensed abstract: Among adult survivors of childhood and young adult cancer with a history of radiation therapy to the neck, annual physical exam is an acceptable thyroid cancer screening strategy. © 2016, Springer Science+Business Media New York. |
| Keywords: | ultrasound; screening; survivorship; radiation therapy; thyroid cancer |
| Journal Title: | Journal of Cancer Survivorship |
| Volume: | 11 |
| Issue: | 3 |
| ISSN: | 1932-2259 |
| Publisher: | Springer |
| Date Published: | 2017-06-01 |
| Start Page: | 302 |
| End Page: | 308 |
| Language: | English |
| DOI: | 10.1007/s11764-016-0588-6 |
| PROVIDER: | scopus |
| PUBMED: | 28028762 |
| PMCID: | PMC5527324 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 June 2017 -- Source: Scopus |
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