Abstract
Simple SummaryThis review reflects on health economic considerations associated with the increasing diagnosis and treatment of differentiated thyroid cancer. Analysis of different relevant health economic topics, such as overdiagnosis, overtreatment, surgical costs, and costs of follow-up are being addressed. Several unanswered research questions such as optimising molecular markers for diagnosis, active surveillance of primary tumours, and improved risk stratification and survivorship care all influence future healthcare expenditures.The incidence of differentiated thyroid cancer (DTC) is rising, mainly because of an increased detection of asymptomatic thyroid nodularity revealed by the liberal use of thyroid ultrasound. This review aims to reflect on the health economic considerations associated with the increasing diagnosis and treatment of DTC. Overdiagnosis and the resulting overtreatment have led to more surgical procedures, increasing health care and patients’ costs, and a large pool of community-dwelling thyroid cancer follow-up patients. Additionally, the cost of thyroid surgery seems to increase year on year even when inflation is taken into account. The increased healthcare costs and spending have placed significant pressure to identify potential factors associated with these increased costs. Some truly ground-breaking work in health economics has been undertaken, but more cost-effectiveness studies and micro-cost analyses are required to evaluate expenses and guide future solutions.
Highlights
Accepted: 5 May 2021Thyroid nodules are common and increase with age, especially in iodine-deficient areas [1]
This paper aims to reflect on the health economic considerations associated with the increasing diagnosis and treatment of Differentiated thyroid cancer (DTC)
In the United Kingdom (UK), where thyroid cancer incidence is lower than most other European countries, it has increased by 68% over the last decade with 3700 new thyroid cancers diagnosed a year
Summary
Thyroid nodules are common and increase with age, especially in iodine-deficient areas [1]. Detected thyroid nodules are investigated to establish a benign or malignant diagnosis and the treatment plan for each of these outcomes is informed by national and international guidelines [3,4]. The incidence of DTC has been increasing for the last three decades, but the disease-specific mortality remains stable. Most patients have an excellent prognosis, so the increasing diagnoses have created a vast pool of thyroid cancer survivors that require follow-up. This paper aims to reflect on the health economic considerations associated with the increasing diagnosis and treatment of DTC.
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