Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made.  (Formerly, these situations were captured under a "C Recommendation".)  This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade.  For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.

Screening for Thyroid Disorders and Thyroid Cancer in Asymptomatic Adults

Prepared by Marie-Dominique Beaulieu, MD, MSc, FCFP, Associate Professor of Family Medicine, University of Montreal, Quebec, drawing from materials prepared for the U.S. Preventive Services Task Force


 
MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

Thyroid disorders (hypothyroidism and hyperthyroidism)
Clinical examination of postmenopausal women and measurement of serum thyroid-stimulating hormone (TSH) level by immunoradiometric assay. Effectiveness of screening and early treatment has not been evaluated in the general population. Community surveys <4-6> (III) Poor evidence for either inclusion or exclusion of TSH screening (C); due to the high prevalence of thyroid disorders in peri-menopausal women, physicians should maintain a high index of clinical suspicion.
Early treatment of hypothyroidism may be beneficial for some women. Randomized controlled trials <11,12> (I)

Thyroid cancer
Neck palpation in asymptomatic adults. Effectiveness of screening never evaluated. Poor test characteristics in asymptomatic adults. Case-series <9,13> (III) Poor evidence for either inclusion or exclusion of screening for thyroid cancer. (C)