Can we check off thyroid cancer as a conquered disease? Maybe not!

Yesterday, I came across Carolyn Sayre's nytimes.com entry, The Rising Incidence of Thyroid Cancer.  As I scanned through the article, my brain was filled with conflicting conclusions. 

Carolyn writes, "incidence [of thyroid cancer] has more than doubled since the early 1970s, and for women, it is the cancer with the fastest-growing number of new cases" - treatable papillary form of tumors accounting for the most increase.

The bright side is that most of the diagnosed cases are benign, one in 20 is malignant, and fewer will ever advance to aggressive form which is curable with 97% cancer-free rate in five years (and just 1700 deaths per year.)  Typical (and effective) interventions are surgical removal and/or radiotherapy.

...so why this increased incidence?  Carolyn points: "A study published in The Journal of the American Medical Association first brought this issue to light in 2006. Researchers concluded that the reported 140 percent increase in thyroid cancer from 1973 to 2002 was simply a result of “increased diagnostic scrutiny.”  This sounds like the classic observations made a quarter century ago by the great master, Judah Folkman, that benign non-angiogenic nodules are as common as the Starbucks on every other street corner, very few ever undergo angiogenic switch (and become the dreaded thing called "cancer.")  Starting to think about treating each and everyone of these nodules found in the super-sensitive-diagnosis-dragnet will make us a nation of hypochondriacs.  Is too much information bad!

 (Fig: Nature 2004 article)

If the disease is "apparently" nearly conquered, I was intrigued to see many thyroid cancer clinical trials going on?  I counted two-hundred-and-fifty-one listed. Does it make business sense??  I am sometimes intrigued by the business decisions which apparently do not make business sense, at least on the surface :-)

Further Reading

Times Health Guide: Thyroid Cancer

Cancer without disease. by: Judah Folkman, Raghu Kalluri. Nature, Vol. 427, No. 6977. (26 February 2004), pp. 787 [PubMed][GoogleScholar]

 What is the evidence that tumors are angiogenesis dependent? by: Judah Folkman. Journal of the National Cancer Institute, Vol. 82, No. 1. (3 January 1990), pp. 4-6 [PubMed]