Kim Na Hyun, Han Jong Soo, Bae Woo Kyung, Kim Joo Young, Lee Kiheon, Lee Hyejin, Lee Kee Hyuck, Jung Se Young, Lee HanKyung, Jeong Hee-Yeong, Kim Young A, Sim Suyoun, Kang Ji-Won
Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Health Promotion Center, Seoul National University Bundang Hospital, Seongnam, Korea.
Korean J Fam Med. 2022 Jul;43(4):225-230. doi: 10.4082/kjfm.21.0168. Epub 2022 Jul 19.
Since the era of "thyroid cancer epidemic," many Korean academic societies discouraged the use of ultrasonography in healthy individuals and revised the Korean Thyroid Imaging Reporting and Data System to address the overscreening and overdiagnosis issues. This study aimed to evaluate the change in the diagnostic effectiveness of thyroid cancer screening over the last decade.
This single-center, retrospective observational study analyzed the data of 125,962 thyroid nodules obtained during cancer screening at the health promotion center of Seoul National University Bundang Hospital from 2010 to 2019. Only 327 thyroid cancer cases pathologically confirmed by fine-needle aspiration (FNA) were included in the study. The strength of the association between the number of FNA and (1) the number of thyroid cancer diagnoses, (2) the positive predictive values (PPVs), and (3) the difference in PPV from the previous year were evaluated using Pearson's correlation analysis.
The number of thyroid FNA biopsies as well as the thyroid cancer diagnoses decreased from 2010 to 2019 (166 to 48 [-71.1%] vs. 43 to 22 [-48.8%]). The PPV of FNA biopsies increased from 25.9% to 45.8% (+76.8%) and was negatively correlated with the number of FNA biopsies performed (R=-0.87, P<0.001). The difference in PPV from the previous year increased similarly but without statistical significance (R=-0.59, P=0.09).
The diagnostic efficiency of thyroid cancer screening has increased over the last decade, as evidenced by the increasing PPV of FNA biopsies.
自“甲状腺癌流行”时代以来，许多韩国学术团体不鼓励对健康个体进行超声检查，并修订了韩国甲状腺影像报告和数据系统，以解决过度筛查和过度诊断问题。本研究旨在评估过去十年甲状腺癌筛查诊断效能的变化。
这项单中心回顾性观察研究分析了2010年至2019年首尔国立大学盆唐医院健康促进中心癌症筛查期间获得的125,962个甲状腺结节的数据。本研究仅纳入了327例经细针穿刺（FNA）病理确诊的甲状腺癌病例。使用Pearson相关分析评估FNA数量与（1）甲状腺癌诊断数量、（2）阳性预测值（PPV）以及（3）与上一年PPV差异之间的关联强度。
2010年至2019年，甲状腺FNA活检数量以及甲状腺癌诊断数量均有所下降（166例至48例[-71.1%]，对比43例至22例[-48.8%]）。FNA活检的PPV从25.9%增至45.8%（+76.8%），且与所进行的FNA活检数量呈负相关（R = -0.87，P < 0.001）。与上一年PPV的差异同样增加，但无统计学意义（R = -0.59，P = 0.09）。
过去十年甲状腺癌筛查的诊断效率有所提高，FNA活检的PPV增加证明了这一点。
