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Making Choices: Screening for Thyroid Disease

  • Posted: 08/01/2003

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Worksheet

Step 1: What is your estimated dose of I-131 from the Nevada tests?

To get your estimated dose of I-131 in rad, find the row on the left that includes your year of birth. Then find the column that best describes the kind and amount of milk you drank between 1951 and 1963.

What Is Your Estimated I-131 Dose?

Year of birthDoses in rad by amount and type of milk
No milkProcessed milkFarm cowFarm goat
0 cups/day1-3 cups/day4+ cups/dayAny amountAny amount
Before 1933Less than 124630
1933-1937Less than 136945
1938-1942Less than 15101575
1943-1947Less than 171421105
1948-1957Less than 1102030150
1958-1963Less than 112315
After 1963Less than 1Less than 1Less than 1Less than 1Less than 1

Your estimated dose of I-131 in rad: ________

(For more precise estimates of dose, including effect of where you lived, see the individual dose calculator at ntsi131.nci.nih.gov.)

Step 2: What is your likely risk of thyroid cancer?

Circle the number that best shows your chance of eventually developing thyroid cancer. The first graphic is for men. The second is for women. Statistics are for people who are 50 years old and cancer-free.

Men

Women

Step 3: How important is each of the pros and cons of screening to you?

Pros

  • 800 to 960 people out of 1,000 are correctly reassured that they don't have cancer
  • 1 to 6 people out of 1,000 will have cancers found and treated early

Cons

  • 40 to 200 people out of 1,000 will have false alarms causing anxiety, tests, and surgery when they don't have cancer
  • Early detection may not increase the chance of cure

Your priorities

Looking at the pros and cons given here, shade the diamonds below to show how important the following are to you (5 diamonds means very important; 0 diamonds means not important at all):

<> <> <> <> <>Knowing whether or not you have cancer
<> <> <> <> <>Avoiding anxiety caused either by false alarms or by knowledge that cancer is present; avoiding unneeded tests that may result from false alarms

If you shaded more diamonds in the first row, you are leaning toward being screened (continue to step 4). If you shaded more diamonds in the second row, you are leaning toward not being screened (go to step 5).

Step 4: Which of the two screening methods is best for you?

Ultrasound

  • More cancers found and treated early (4-6 people out of 1,000)
  • More false alarms (150-200 people out of 1,000)

Neck examination

  • Fewer cancers found and treated early (1-3 people out of 1,000)
  • Fewer false alarms (40-80 people out of 1,000)

Your priorities

Looking at the information about ultrasound and neck exam given here, shade the number of diamonds below to show how important the following are to you (5 diamonds means very important; 0 diamonds means not important at all):

<> <> <> <> <>Early detection
<> <> <> <> <>Avoiding false alarms

If you shaded more diamonds in the first row, you are leaning toward ultrasound. If you shaded more diamonds in the second row, you are leaning toward neck examination.

Step 5: What questions do you have before deciding?

Step 6: Discuss your decision-making with your doctor.