What caused jump in thyroid cancer cases in Korea?
There has been a dramatic increase in the number of Koreans diagnosed with thyroid cancer in recent years. But is the growth, which has been significantly faster than the world average, a result of better health checkups or over-diagnosis?
Lee Jae-ho, a medical school professor at the Catholic University of Korea, is one of the experts who believe that healthy people are being harmed by the culture of greed at hospitals which create their own epidemics. Patients too frequently are being put under painful and costly treatment for small, slow-growing tumors that would never cause problems, he said.
”When crunching the number for every case out of 100,000 people, the thyroid cancer rate in Korea is now about 10 times larger than the world average,’’ Lee said.
”The increase in cases coincided with technological development that enabled doctors to detect tumors they could not find by feeling the throat of a patient. The problem, however, is that these tumors are mostly far from fatal. In many cases, surgery is unnecessary.’’
The thyroid gland, located near the front of the throat, serves an important role in regulating the body’s metabolism. Cancer in this area is now the most common type of cancer reported among Koreans.
According to the National Cancer Information Center, thyroid cancer cases per every 100,000 people increased from 6.9 in 2000 to 81 in 2011. The death rate from the conditions, however, remained virtually unchanged at around 0.5.
The numbers seem to support Lee’s claims that hospitals are forcing patients to undergo unnecessary treatment for profit. The five-year survival rate for thyroid cancer after diagnosis is close to 100 percent.
“Korea is the only country where hospitals promote early detection of thyroid cancer as important and patients get an ultrasound for it,” Lee said. “The U.S. Preventive Services Task Force already put “Recommendation Level D” on it in 1996. It means the diagnosis and treatment of the cancer has more harm than benefit.”
If doctors are indeed over-diagnosing thyroid cancer, it is not only the patients who suffer but taxpayers as a whole. The National Health Insurance Service spent 260 billion won ($241,973,010) on treating thyroid cancer in 2012, which was radical increase from 120 billion won in 2008.
People who undergo operations for thyroid cancer lose part of their thyroid or have it removed entirely. So, they have to take hormones to make up for the loss for the rest of their lives. But drugs cannot fully match the gland’s function.
Kim Jung-mi, a 29-year-old housewife, had surgery for thyroid cancer in 2010. And she regrets she did.
“After getting an ultrasound, I was diagnosed with thyroid cancer. It was about one centimeter in diameter. A doctor recommended surgery. Scared by the word, cancer, I just had it,” she said. “Now it feels like my body recovers from fatigue much slower than before the surgery. I wish I did more research before making the decision.”
The first symptom of thyroid cancer usually is a nodule in the neck and then an enlarged lymph node. They can develop into neck pain or vocal alterations.
Lee said the profit-oriented medical operation, which is increasingly encouraged by the government’s medical tourism slogan, is what hinders evidence-based medical services for the health of patients.
“More than 90 percent of hospitals are privately run, and even public hospitals have to make profits to survive in the market. Otherwise, they could shut down anytime like Jinju Medical Center did,” he said. “To a certain extent, it is against humanitarianism.”
After Lee and seven other doctors held a press conference on March 18 to address the risk of unnecessary and expensive tests for thyroid cancer, the Ministry of Health and Welfare said Sunday it would come up with new guidelines for its diagnosis and treatment.
Source: The Korea Times
