Mortality unaffected by rise in use of imaging tests

New research shows that most patients undergoing imaging tests after primary treatment of thyroid cancer have an increased likelihood of being treated for recurrence, but no improvement in disease-specific survival. In a population-based, retrospective cohort study, 28,220 patients in the SEER-Medicare database diagnosed with differentiated thyroid cancer between 1998 and 2013 were followed-up for a median of 69 months. During the period 1998–2013, incident cancer, imaging and treatment for recurrence all increased significantly (rate ratio (RR) 1.05, 1.13 and 1.01, respectively); mortality was not significantly changed (RR 0.98). Neck ultrasonography increased the likelihood of additional surgery (OR 2.30) and ¹³¹I treatment (OR 1.45); radioiodine scanning increased the likelihood of additional surgery (OR 3.39), ¹³¹I treatment (OR 17.83) and radiotherapy (OR 1.89); and PET increased the likelihood of additional surgery (OR 2.31), ¹³¹I treatment (OR 2.13) and radiotherapy (OR 4.98). Disease-specific survival was unaffected by use of neck ultrasonography and PET; however, radioiodine scanning was associated with improved disease-specific survival (HR 0.7).