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Invited Commentary
October 2018

Association of the Word Cancer With Thyroid Cancer Treatment Decisions—A Rose by Any Other Name

Author Affiliations
  • 1Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor
JAMA Otolaryngol Head Neck Surg. 2018;144(10):896. doi:10.1001/jamaoto.2018.1813

“A rose by any other name would smell as sweet,” but would papillary thyroid cancer with another name be treated as aggressively?

In Nickel et al’s article, “Association of Preferences for Papillary Thyroid Cancer Treatment With Disease Terminology: A Discrete Choice Experiment,”1 the authors highlight important issues in thyroid cancer treatment decisions. First, the authors show that the cancer label is associated with a willingness to accept greater harm. When presenting 2054 adults with a discrete choice experiment, the label “papillary thyroid cancer” was associated with a greater willingness to accept more harms than the label “papillary thyroid lesion.” This finding is not unique to thyroid cancer—prior authors have recognized the psychological impact of a cancer label and its relationship to overtreatment.2 However, although a name change has recently occurred for a subtype of thyroid cancer, encapsulated follicular variant of papillary thyroid cancer,3 it is unlikely that classic variant of papillary thyroid cancer will receive a new name in the near future. The solution to the harmful effects of a “papillary thyroid cancer” label may lie in patient education instead of a new name.

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