Do not routinely request / perform thyroid ultrasound in subjects without signs and / or symptoms of thyroid disease and not belonging to risk groups for thyroid cancer and limit the indication and execution of fine needle aspirations on low-risk nodules.
Thyroid ultrasound is a fundamental test in the diagnosis of thyroid pathologies; its use, however, must take place in an appropriate clinical setting. Small thyroid nodules are very common in the general population and, in most cases, benign. Furthermore, in the last decades, there has been a notable increase in the diagnosis of thyroid carcinoma (often differentiated and small in size), not associated with an increase in mortality, thus highlighting a condition of overdiagnosis. The indiscriminate execution of ultrasound not only identifies a large number of thyroid nodules devoid of “pathological weight” but can cause anxiety in the patient and an increase in diagnostic procedures and surgical interventions (possible overtreatment), with consequent unjustified costs for the community, as well as possible harm to the patient. It is therefore recommended 1) to avoid ultrasound screening on populations not at risk for thyroid cancer; 2) avoid frequent ultrasound checks in subjects with chronic autoimmune thyroiditis and without nodules; 3) limit the indication and execution of fine needle aspirations on nodules which, based on the stratification of the risk of malignancy on ultrasound, belong to the low-risk classes.
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3. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan;26(1):1-133. doi: 10.1089/thy.2015.0020. PMID: 26462967; PMCID: PMC4739132.
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5. Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014 Apr;140(4):317-22.
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.