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 noninvasive and has a low risk of recurrence. The name change, described today in JAMA Oncology, is expected to reduce the psychological and medical consequences of a cancer diagnosis, potentially affecting thousands of people worldwide.
The incidence of thyroid cancer has been rising partly due to early detection of tumors that are indolent or non-progressing, despite the presence of certain cellular abnormalities that are traditionally considered cancerous, explained senior investigator Yuri Nikiforov, M.D., Ph.D., professor of pathology and director of Pitt’s Division of Molecular and Genomic Pathology.
“This phenomenon is known as overdiagnosis,” Dr. Nikiforov said. “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 behavior to prevent inappropriate and costly treatment.”
In particular, a tumor type known as encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) has increased in incidence by an estimated two- to three-fold over the past 20 to 30 years and makes up 10 to 20 percent 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. 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.
Dr. Stegall’s Comments: This development illustrates the power of the “C-word” – cancer – and the reactions we commonly associate with it. By renaming this type of thyroid cancer to remove the word cancer from the diagnosis, we will likely reduce the amount of patient and provider anxiety related to it. However, this renaming should not prevent us from monitoring the tumor closely to ensure that it is not growing or spreading.