Introducing New Section Editor and Clinical Focus: Care of Patients With Endocrine Conditions

In this issue, we present the study by Ohtsuru and colleagues¹ who analyzed clinical characteristics of thyroid cancers screened by ultrasonography in children and young adults during the first 5 years after the 2011 Fukushima Daiichi Nuclear Power Station accident. Along with the publication of this landmark study, I am excited to announce a new section editor in JAMA Otolaryngology–Head & Neck Surgery who will be dedicated to the care of patients with endocrine conditions. I invited Louise Davies, MD, MS, to serve as the first Endocrinology Section Editor. Dr Davies is an internationally recognized expert on thyroid cancer with a focus on appropriate treatment of adults diagnosed with small thyroid nodules and has methodologic expertise in epidemiology and mixed-methods research approaches. I am also excited to announce the appointment of Luc G. T. Morris, MD, MSc, to the editorial board. Dr Morris’ research program straddles head and neck cancer genomics and the epidemiology of overdiagnosis, and he has methodologic expertise in biostatistics and bioinformatics. Together, they will provide breadth and depth to this renewed area of clinical focus.

Endocrine conditions of the head and neck are an increasingly common part of the repertoire of the otolaryngologist. By far, thyroid nodules and cancers are the most common of these for which an otolaryngologist is asked to provide care. Until the last 20 years, the most common cancers of the head and neck were larynx, oral cavity, and pharyngeal cancer. Now, rates of thyroid cancer surpass the 3 of these combined (annual thyroid cancer incidence is 14.5 per 100 000; larynx cancer, 2.5 per 100 000; and oral and pharyngeal cancers, 11.5 per 100 000).

Clinical management and decision making for endocrine diseases of the head and neck are distinct from other aspects of our specialty. The medical aspects of both the care and decision-making processes are prominent. Head and neck endocrine disorders require new areas of knowledge, skills in using nerve monitoring and interpreting ultrasound and other imaging and laboratory tests, and new relationships with endocrinologists and radiologists. This contrasts with other neoplasms of the head and neck, which have their own unique epidemiology and body of knowledge, and where clinical decisions are often more anatomically and functionally driven than medically driven. The personnel and expertise in this setting are different as well, with care plans developed as a result of multidisciplinary discussions with radiation oncologists and medical oncologists.

In medical and surgical endocrine conditions of the head and neck, overdiagnosis and overtreatment, which have previously not been prominent parts of our specialty, now must be considered. Otolaryngologists have brought key information and understanding of the nuances of detection of thyroid cancer, safe treatment of the primary condition, and sequela of treatment. With our long history of research to understand and support the optimal function of speech, swallowing, and other quality-of-life issues in problems of the head and neck, otolaryngologists are the ideal specialists to lead the field forward, serving as thought leaders in wise approaches to treatment decision making and clinical care, and discoverers of techniques to minimize harm while maximizing function and optimizing outcomes.

Corresponding Author: Jay F. Piccirillo, MD, Editor, JAMA Otolaryngology–Head & Neck Surgery, Washington University in St Louis, 660 S Euclid Ave, McMillan Bldg, Campus Box 8115-06-805F, St Louis, MO 63110 (jamaoto@jamanetwork.org).

Published Online: November 29, 2018. doi:10.1001/jamaoto.2018.3122

Conflict of Interest Disclosures: None reported.