Screening: Thyroid Disease

Screening for Thyroid Disease

Release Date: January 2004

The USPSTF concludes the evidence is insufficient to recommend for or against routine screening for thyroid disease in adults.

Rating: I Recommendation.

Rationale: The USPSTF found fair evidence that the thyroid stimulating hormone (TSH) test can detect subclinical thyroid disease in people without symptoms of thyroid dysfunction, but poor evidence that treatment improves clinically important outcomes in adults with screen-detected thyroid disease. Although the yield of screening is greater in certain high-risk groups (e.g., postpartum women, people with Down syndrome, and the elderly), the USPSTF found poor evidence that screening these groups leads to clinically important benefits. There is the potential for harm caused by false positive screening tests; however, the magnitude of harm is not known. There is good evidence that over-treatment with levothyroxine occurs in a substantial proportion of patients, but the long-term harmful effects of over-treatment are not known. As a result, the USPSTF could not determine the balance of benefits and harms of screening asymptomatic adults for thyroid disease.

Screening for Thyroid Disease, January 2004
Recommendation Statement (PDF File, 80 KB)
Summary of the Evidence (PDF File, 147 KB)
Systematic Evidence Review (File Download, 230 KB)