2021
DOI: 10.1007/s40618-020-01475-3
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Trends in thyroid function testing, neck ultrasound, thyroid fine needle aspiration, and thyroidectomies in North-eastern Italy

Abstract: Purpose Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy. Methods A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA)… Show more

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Cited by 9 publications
(5 citation statements)
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“…PAC were more frequent in the case of cancers of the breast, thyroid, and other endocrine glands; as concerning breast cancer, our finding is consistent with the literature, as concerning thyroid cancer, the high frequency is probably related to the diagnostic pressure in Italy [27]. Differences in the cancer ranking concerning the general female population aged 15-49 were also due to the different age composition of the two groups (women with PAC are younger); melanoma was the third cancer in the general female population, while it was the fifth among women with PAC [28].…”
Section: Discussionsupporting
confidence: 91%
“…PAC were more frequent in the case of cancers of the breast, thyroid, and other endocrine glands; as concerning breast cancer, our finding is consistent with the literature, as concerning thyroid cancer, the high frequency is probably related to the diagnostic pressure in Italy [27]. Differences in the cancer ranking concerning the general female population aged 15-49 were also due to the different age composition of the two groups (women with PAC are younger); melanoma was the third cancer in the general female population, while it was the fifth among women with PAC [28].…”
Section: Discussionsupporting
confidence: 91%
“…This trend is unlikely to be a consequence of an increasing proportion of very low-risk differentiated thyroid cancer due to widespread overdiagnosis. Declines in diagnostic pressure, namely fine-needle aspiration biopsies of thyroid nodules, were reported at the population level in some Italian areas after 2014 ( 24 ). Meanwhile, the growth in thyroid cancer surgery previously registered in Italy leveled off after 2013–2014 at the national level ( 11 ); recent data show a relative increase in the recourse to lobectomy among overall thyroid surgeries in Italy, after a decade of marked decline ( 24 ).…”
Section: Discussionmentioning
confidence: 99%
“…These aspects have made it difficult to establish "causality" in the continuum of the pathogenesis between AITD and DTC; furthermore, the relationship could also be argued to be non-causal, and that what really happens is the coexistence between two independent and highly prevalent entities, with enormous ease of early identification through laboratory tests, thyroid ultrasound, and thyroid cytology [97][98][99].…”
Section: Brafv600ementioning
confidence: 99%
“…Accordingly, it must be considered that the over-screening of thyroid functional evaluation (or imaging evaluation) and for TC can be potential confounders when evaluating the possible association between AITD and DTC (a phenomenon of overestimation of the association, with overdiagnosis and, potentially, overtreatment) [97][98][99][100][101].…”
Section: Brafv600ementioning
confidence: 99%