How to Be Considerate to Patients with Thyroid Nodules: Lessons from the Pediatric Thyroid Cancer Screening Program in Fukushima After the Nuclear Plant Accident
Overdiagnosis of thyroid cancer is considered to be a global problem [1–3]. Thus, the indication criteria for thyroid fine needle aspiration (FNA) cytology are also currently being debated [4, 5]. Standard indications for FNA cytology of thyroid nodules detected by ultrasound are described in some guidelines [5, 6] as well as in other chapters of this textbook. Notably, application of FNA cytology to incidentally detected thyroid nodules in asymptomatic patients should be very carefully considered because overdiagnosis of thyroid cancer can easily occur in mass screening, which tends to directly lead to overtreatment . In this chapter, we focus on ultrasound screening of young asymptomatic patients and indications for FNA cytology of thyroid nodules, from the two perspectives of psychosocial impact and ethical issues, based on lessons learned from the experience of the Fukushima Health Management Survey (FHMS) conducted after the nuclear accident in Fukushima, Japan.
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