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TABLE F.6Hypothetical Relationship Between Efficacy of Early Detection and Five-Year Survival from Thyroid Cancer

a. SEER data
Five-year survivalProportion of cancers in each risk categoryOverall Survival
Risk categoriesTotalMalesFemalesMalesFemales
 localized0.9970.9940.9980.600.5960.599
 regional0.9370.9130.9470.310.2830.294
 distant0.4480.4030.4750.050.0200.024
 unstaged0.7660.7730.7610.040.0310.030
 5 year and overall survival0.9310.947
b. Consequences of screening (categories of information needed to estimate effect of screening on dectection of disease by stage)
Usual CareScreening
size categories
 (1) 0.5 -1.0 cm%
 (2) 1.0- 1.5 cm%
 (3) 1.5 cm or larger%
delay in diagnosis (average)years
rates of transitions between size categories
 (1) to (2)% per year
 (2) to (3)% per year
relation of size to spread of cancer
 (1) 0.5-1.0 cm% localized
 (2) 1.0-1.5 cm% localized
 (3) 1.5 cm or larger% localized
c. Hypothetical improvement in survival in relation to risk categories if screening increased proportion of cancers with no metasteses from 60% to 70% compared to usual care (adult females only)
Usual CareScreening
Risk categories
 localized0.60.7
 regional0.310.21
 distant0.050.05
 unstaged0.040.04
Contribution to 5 year survival0.9470.952
 Number needed to treat to prevent 1 death in 5 years184
 Number needed to screen to prevent 1 death in 5 years57,445

From: Appendix F, Screening for Thyroid Cancer: Background Paper

Cover of Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests
Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications.
Institute of Medicine (US) Committee on Thyroid Screening Related to I-131 Exposure; National Research Council (US) Committee on Exposure of the American People to I-131 from the Nevada Atomic Bomb Tests.
Washington (DC): National Academies Press (US); 1999.
Copyright © 1999, National Academy of Sciences.

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