Are Physicians Confident in Ultrasonography’s Ability to Detect Thyroid Cancer Recurrence?
Posted: Tuesday, February 9, 2021
Neck ultrasonography is routinely used to monitor patients with differentiated thyroid cancer because of recurrence concerns, yet there seems to be a striking difference in surveillance for recurrence among physicians. Megan R. Haymart, MD, of the University of Michigan, Ann Arbor, and colleagues found that physicians’ confidence in their ability to use neck ultrasonography to detect recurrence is a primary obstacle to standardizing surveillance practices. Their results indicate that general surgeons and the number of patients with thyroid cancer treated annually seem to be linked to higher confidence in ultrasonography in detecting recurrence. Their findings were published in JAMA Otolaryngology–Head & Neck Surgery.
This population-based, cross-sectional study evaluated responses from physicians who treated patients with differentiated thyroid cancer. The analytic cohort consisted of 320 physicians who were sometimes, often, or almost always involved in continuous monitoring of such patients for recurrence after primary treatment.
The survey items included medical specialty, years in practice; practice setting; number of patients with cancer treated each year; and Surveillance, Epidemiology, and End Results Program (SEER) site. Questions regarding follow-up practices included the length and types of modalities used for surveillance. Physicians were asked to evaluate their confidence level in identifying lymph nodes that were suspicious for recurrence using bedside ultrasonography.
In total, 27% of physicians (n = 84) reported performing bedside ultrasonography; however, just 20% (n = 57) reported having high confidence in their ability to identify lymph nodes suggestive of recurrence. Physicians who treated more than 50 patients with thyroid cancer per year showed the highest confidence in their ability to use bedside ultrasonography; yet, even among this group, just 33% (n = 23) reported having high confidence in their ability to use this technology to identify lymph nodes indicating recurrence. Overall, 33% of physicians had low confidence in their own and in a radiologist’s ability to identify lymph nodes suggestive of recurrence using ultrasonography.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.