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March 21, 1980

Postirradiation Screening for Thyroid Nodules

Author Affiliations

University of Chicago School of Medicine Chicago

JAMA. 1980;243(11):1131-1132. doi:10.1001/jama.1980.03300370011007

To the Editor.—  The article by Royce et al (242:2675, 1979) has been widely publicized in the media. However, headlines and statements such as "Irradiation Treatment Exonerated as Cause of Thyroid Cancer" or "Irradiation Does Not Cause Thyroid Cancer" do not render justice to the work and conclusions. The authors merely failed to show significant differences in palpable thyroid abnormalities and in carcinoma in a group of persons with history of neck irradiation, as compared with a nonirradiated control group. Although the introduction of a control group represents an important feature, it is not unique,1 and the study is by no means free of flaws. These need to be pointed out.Two physicians carrying out neck examination on only 30 to 50 persons at a time does not represent, by any stretch of the imagination, a complete or even an optimal screening program.2-4While the higher percent of thyroid