Thyroid cancer screening

This page tells you about thyroid cancer screening. You can find information about

A quick guide to what's on this page
What we mean by screening
If you have a high risk of thyroid cancer
If you are found to have a faulty gene

Thyroid cancer screening

Before screening for any type of cancer can be carried out, doctors must have an accurate test to use. The test must be reliable in picking up cancers that are there. And it must not give false positive results in people who do not have cancer. Screening is usually only used for illnesses that affect large numbers of people, or people known to be at a particularly high risk.

Thyroid cancer is rare. But medullary thyroid cancer can run in families. If you have a very close relative diagnosed with medullary thyroid cancer or a relative who has a change in a gene known as the RET proto oncogene, your GP can refer you for tests for the abnormal gene. If you are referred for screening, a genetics counsellor will ask about your family medical history. If the abnormal gene is likely to run in your family, you may then have a blood test. If you do have the abnormal gene, you can have regular thyroid scans and blood tests. This will make sure that if you do develop thyroid cancer it will be found and treated as early as possible. Or you may have your thyroid gland removed to prevent a cancer developing.

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Screening means looking for early signs of a particular disease in healthy people who don't have any symptoms. Screening cannot prevent cancer, it can only find it as early as possible. Before we can carry out screening for any type of cancer, doctors must have an accurate test to use. The test must be reliable in picking up cancers that are there. And it must not give results that make it look as though someone has cancer when they do not (false positive results). Screening is usually only used for illnesses that affect large numbers of people. Or for groups of people who are known to be at a particularly high risk of that illness.

Thyroid cancer is rare. But some people are at higher risk of developing medullary thyroid cancer if they have a relative with thyroid cancer. They may have inherited an abnormal gene called the RET proto oncogene. If you have a very close relative who has been diagnosed with medullary thyroid cancer you can be screened to see if you have the abnormal gene. This gene is sometimes linked to a condition called MEN2. People with MEN2 have a higher risk of some types of cancer of hormone producing glands, including thyroid cancer. Your GP can refer you to a family cancer clinic or genetic screening clinic for advice.

If you are referred for screening, a genetics counsellor will ask you about your family medical history. The information about your family history will be used to decide whether the abnormal gene is likely to run in your family. If the gene may run in your family the clinic staff will offer you a blood test to look for the faulty gene.

The implications of having the blood test will be explained to you beforehand. These include

How you will feel if the test is positive
What can be done if the test is positive
Whether a positive test will affect your ability to get life insurance or a mortgage

Not everyone who is offered a blood test for a faulty gene wants to have it done. It is worth taking the time to think carefully about this decision.

What is done will depend on the type of inherited abnormal gene you have. But if you have an abnormal gene you may be offered one or more of the following options.

Regular thyroid scans to make sure that if a cancer does develop, it is diagnosed and treated as early as possible
Regular blood tests for the hormone calcitonin
Surgery to have your thyroid removed to prevent a cancer developing

Medullary thyroid cancers tend to make and release extra calcitonin. The extra hormone circulates in the blood. So it can be picked up by a blood test. Calcitonin blood tests can be used to screen family members where there is a known risk of medullary thyroid cancer.

Removing the thyroid (a thyroidectomy) is usually done if you have a MEN 2B gene abnormality. If this gene runs in your family, it is usual to try to pick it up in the children of the family. This is because medullary thyroid cancer usually develops at a young age in MEN 2B carriers.