Ultrasonographic Screening for Thyroid Cancer in Siblings of Patients with Apparently Sporadic Papillary Carcinoma

Clinical Management of Thyroid Cancer

“…Inherent in the question of cost is the issue of whether such a screening test has a benefit on life expectancy. Its routine use in clinical practice, however, has resulted in a dramatic rise in the number of identified nodules [11]; the vast majority of which are benign. Although calcitonin testing is highly sensitive, it is not specific; high levels may be seen in a variety of benign conditions such as renal failure, autoimmune thyroid disease, alcohol use, and those with an elevated gastrin level.…”

“…The PAX8-peroxisome proliferator-activated receptor-g (PPAR-g) fusion oncogene, found in 30-35% of FTCs and in a subset (2-13%) of FA [11], contains the PAX8, a transcription factor essential for thyroid differentiation, fused to most of the PPAR-g. The mechanism of action of PAX8-PPAR-g is related to deregulation of the normal functions of PAX8 and PPAR-g as well as the unique transcriptional activities of the fusion oncoprotein.…”

“…Radiotherapy for head and neck cancers, thorax cancers, lymphomas, breast cancers and whole-body irradiation may expose the thyroid to radiation due to its anatomical position [4]. Treatment-related secondary cancers are becoming a disturbing problem as survival from the majority of childhood cancers is relatively high and is continuing to improve [11]. An update from the Childhood Cancer Survivor Study confirmed the previously established dose-response relationships and estimated odds ratios for the development of thyroid cancer after high-dose therapy in childhood (odds ratio: 9.8; 95% CI: 3.2-34.8), as well as the fall-off risk at doses exceeding 20-25 Gy, thought to be attributable to cell killing [12].…”

“…An update from the Childhood Cancer Survivor Study confirmed the previously established dose-response relationships and estimated odds ratios for the development of thyroid cancer after high-dose therapy in childhood (odds ratio: 9.8; 95% CI: 3.2-34.8), as well as the fall-off risk at doses exceeding 20-25 Gy, thought to be attributable to cell killing [12]. www.futuremedicine.com the typical organ dose from a CT scan is 0.01-0.02 Gy [11]. There is increasing concern regarding radiation exposure to the thyroid gland from pediatric CT scans, especially if an iodinated contrast is used.…”

“…www.futuremedicine.com the typical organ dose from a CT scan is 0.01-0.02 Gy [11]. It appears that many physicians are ill-informed about the risks of diagnostic examinations using radiation, so there is a clear need to educate the medical profession and the general public about the risks regarding CT imaging [11]. It appears that many physicians are ill-informed about the risks of diagnostic examinations using radiation, so there is a clear need to educate the medical profession and the general public about the risks regarding CT imaging [11].…”