DOCTOR'S VIEW ARCHIVE

Screening for Thyroid Disease?

Medical Authors and Editors: Barbara K. Hecht, Ph.D. and Frederick Hecht, M.D.

Should everyone have a thyroid test? "Yes" says the American Thyroid Association (ATA). It recommends measuring thyroid function in all adults beginning at age 35 with follow-up testing every five years. "No" says a new report from the U.S. Preventive Services Task Force (USPSTF). The rationale for routine thyroid screening has been that thyroid disease is very common and is best detected early so it can be treated without delay.

Thyroid disease is, indeed, common. Nearly 15 million people in the US have thyroid disease, causing them to be hypothyroid (not enough hormone) or hyperthyroid (too much hormone).

However, the USPSTF found no convincing studies to show that asymptomatic patients do better if they begin treatment before symptoms of thyroid disease develop. Therefore, it concludes that the current evidence is insufficient to recommend for or against routine screening for thyroid disease in adults with no symptoms of thyroid disease.

Evidence-Based Medicine

What is the basis for this difference of opinion between two authoritative bodies as to whether screening thyroid tests should or should not be routine? It is called evidence-based medicine (or practice).

Evidence-based medicine is an approach to health care based on the collection, interpretation, and integration of valid, applicable evidence (patient-reported, clinician-observed, and research-derived evidence). The best available evidence is then applied to improve the quality of clinical judgments.