Thyroid growths are first ever to be ‘downgraded’ to prevent patients having unnecessary treatment
Scientists have re-classified a certain type of cancer as less serious, in what they claim is a world first.
They say a particular form of the disease that affects the thyroid will now be downgraded to more accurately reflect the level of the condition.
The international panel of pathologists and clinicians say the reclassification of this type of thyroid cancer demonstrates the fact it is non-invasive and has a low risk of recurrence.
It is hoped it will reduce the possible psychological effects of being diagnosed with cancer as well as reducing the cost caused by unnecessary treatments.
The type in question is a tumour type known as encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC).
It has seen an almost three-fold increase over the past 20 to 30 years and accounts for between 10 and 20 per cent of all thyroid cancers diagnosed in Europe and North America, the panel noted.
Although studies have shown EFVPTC is not dangerous, it is typically treated as aggressively as other types of thyroid cancer.
‘This phenomenon is known as overdiagnosis,’ explained senior investigator Yuri Nikiforov, professor of pathology.
‘To my knowledge, this is the first time in the modern era a type of cancer is being reclassified as a non-cancer.
‘I hope that it will set an example for other expert groups to address nomenclature of various cancer types that have indolent behaviour to prevent inappropriate and costly treatment.’
At the recommendation of the National Cancer Institute, the panel sought to revise the terminology and to see if the word ‘cancer’ could be dropped from its name.
Led by researchers at the University of Pittsburgh School of Medicine, an international panel of pathologists and clinicians has reclassified a type of thyroid cancer to reflect that it is non-invasive and has a low risk of recurrence.
The name change is expected to reduce the psychological and medical consequences of a cancer diagnosis, potentially affecting thousands of people worldwide.
Two dozen experienced pathologists from seven countries and four continents independently reviewed 268 tumour samples diagnosed as EFVPTC from 13 institutions.
The experts established diagnostic criteria, including cellular features, tumour invasion and other factors.
In a group of more than 100 non-invasive EFVPTCs, there were no recurrences or signs of the disease when followed up an average 13 years later, the panel found.
These experts decided to rename EFVPTC as ‘noninvasive follicular thyroid neoplasm with papillary-like nuclear features’ or NIFTP.
It means doctors are pointed towards the key features of the disease, without using the word cancer.
The should stop patients from being given unnecessary treatments such as the internal radiotherapy, radioiodine, or other aggressive approaches.
‘We determined that if NIFTP is carefully diagnosed, the tumour’s recurrence rate is extremely low, likely less than 1 percent within the first 15 years,’ Dr. Nikiforov said.
‘The cost of treating thyroid cancer in 2013 was estimated to exceed $1.6 billion in the U.S.
‘Not only does the reclassification eliminate the psychological impact of the diagnosis of ‘cancer,’ it reduces the likelihood of complications of total thyroid removal, and the overall cost of health care.’
Ronald Ghossein, director of head and neck pathology at the Memorial Sloan-Ketttering Cancer Cancer in New York and one of the researchers behind the study, told The Independent that the reclassification is expected to affect 45,000 thyroid cancer patients worldwide.
He said it could also influence how patients are treated for other cancers including prostate, lung and breast cancer.
He said: ‘The tumour should not be labelled cancer only on its appearance but on its clinical behaviour.
‘This lesson could be applied to all diseases malignant or not.
‘If reclassification of indolent lesions is performed in some of these common cancers, it will affect health care at so many levels from the psychological burden of cancer to therapy, screening and of course it will impact costs significantly.’
Written by Anna Hodgekiss and Kate Pickles for The Daily Mail, May 4, 2016.
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