👉The Canadian Task Force on Preventive Health Care has issued a strong recommendation against routine thyroid screening in nonpregnant adults without symptoms in the primary care setting, saying there is insufficient evidence of clinical benefit from the treatment of thyroid dysfunction in such individuals.
👉The guideline was published online November 17, 2019 in the Canadian Medical Association Journal (CMAJ) and was funded by the Public Health Agency of Canada.
👉”If you are a clinician who orders thyroid-stimulating hormone (TSH) tests as part of preventive health visits, we would like you to reconsider this practice.
👉The evidence isn’t there to suggest a health benefit for this type of screening as a routine part of care,” says Richard Birtwhistle, MD, chair of the Task Force Thyroid Dysfunction working group, in a press statement from CMAJ.
👉”Given the lack of clinical effectiveness and the burden on patients, including financial costs, screening patients without symptoms consumes resources that could be better used elsewhere,” added Birtwhistle, professor emeritus of family medicine and public health sciences at Queen’s University, in Kingston, Ontario, Canada.
👉This advice differs from the recommendations of other groups, as consensus on the issue is lacking.
👉”The recommendation represents a change in thinking about screening for thyroid dysfunction and contradicts other medical society recommendations that favor screening, particularly among older people,” write Juan Brito, MD, and Omar El Kawkgi, MD, of the Department of Endocrinology, Mayo Clinic, in Rochester, Minnesota.
👉Specifically, the position of the American Thyroid Association (ATA), published as joint guidelines with the American Association of Clinical Endocrinologists (AACE), is that screening for hypothyroidism in patients older than age 60 should be considered.
👉However, the US Preventive Services Task Force issued an updated guideline in 2015 recommending against screening for thyroid dysfunction based on insufficient evidence, they point out, and that position has also been endorsed by the American Academy of Family Physicians, editorialist El Kawkgi told Medscape Medical News.
Rodrigo Arrangoiz MS, MD, FACS, FSSO 