This is a troubling trend in thyroid cancer screening and treatment today, according to Dr Nguyen Trieu Vu, former Head of Oncology at Thu Duc City General Hospital (HCM City).

Thyroid cancer tops endocrine-related cancers, with rising patient numbers. The HCM City Oncology Hospital reported that thyroid cancer cases made up 15 percent of all cancers in 2023, rising to 23 percent in 2024.

Mass screening frenzy

N.M.A, 31, from Ha Dong, Hanoi, newly married, underwent a regular health check several days ago. During the exam, a doctor found a thyroid nodule under 1cm via ultrasound, suspecting malignancy, and recommended a biopsy guided by ultrasound.

She visited 2-3 more facilities for checks. However, doctors gave different prescriptions. Some pushed for immediate surgery, others said there was no need to undergo prompt surgery and suggested monitoring.

Panicked, she flew from Hanoi to HCM City to consult Dr Vu.

Ultrasounds showed a benign 5-7mm thyroid nodule; even if malignant, it wasn’t alarming. Vu advised against surgery, recommending follow-ups instead.

In the past week, three others sought Vu’s advice after routine checkups flagged possible thyroid cancer. All had small benign nodules, yet some doctors’ cancer claims left them terrified.

Vu notes that thyroid cancer screening is now widespread—every health screening package includes a neck ultrasound, with biopsies ordered for any lump. But this “zeal” can spark complications worse than the cancer’s progression.

“Many rush to surgery, but not all cancers need aggressive action. People should only check their neck for lumps, swollen nodes, or swallowing pain,” Vu said.

40-60 percent have thyroid nodules

Per Dr. Vu, thyroid nodules are common, affecting an estimated 40-60 percent of people, with 5-10 percent being malignant. Yet, thyroid cancer grows slowly, and not every case requires intervention.

Major cancer centers in the US, Japan, and South Korea now monitor low-risk thyroid cancers without surgery.

In South Korea, ultrasounds revealed many small thyroid nodules. Studies there found that while detections soared, death rates stayed flat. Experts began questioning the urgency of tackling thyroid cancer.

In Japan, of 2,100 low-risk thyroid cancer patients, 50 percent are assigned periodic monitoring, while the rest undergo immediate surgery. Among the monitored group, 80 percent later need surgery, with outcomes as good as those who undergo operation early.

“Papillary thyroid cancer’s death rate is lower than surgery complication rate,” Vu said.

Surgery carries risks—complications from anesthesia, hoarseness, hand numbness, or lifelong thyroid replacement drugs (about 2 percent of cases). Plus, radioactive iodine treatment raises risks of secondary cancers and salivary or dental issues.

Thus, for tiny tumors of a few millimeters, not invading the thyroid or beyond, skilled doctors advise patients to opt for regular monitoring.

Vo Thu