{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:29:14Z","timestamp":1791404954734,"version":"4.3.3"},"reference-count":9,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,11,24]],"date-time":"2010-11-24T00:00:00Z","timestamp":1290556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives\/Hypothesis:<\/jats:title><jats:p>To identify the trigger events that lead to the detection of otherwise asymptomatic thyroid cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design:<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Chart abstraction of patients who underwent thyroidectomy. Iterative development of a classification algorithm to categorize trigger events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>A total of 279 thyroidectomies were performed, which resulted in 95 new diagnoses of thyroid cancer. Just less than half of identified cancers (44 cancers, 46%) were in the 127 thyroidectomies performed after identification of a thyroid abnormality by either screening or chance. A screening trigger event occurs when a physician performs a routine thyroid examination when there is no specific neck complaint. A chance trigger event can occur either by serendipity (a radiologic test done for a different reason) or by diagnostic cascade (identification of a thyroid abnormality on any test that does not plausibly explain the patient's presenting complaint). Physician screening examination was the trigger event for 49 thyroidectomies (18%). Serendipity was the trigger event for 41 thyroidectomies (15%). Diagnostic cascade was the trigger event for 33 thyroidectomies (12%). Only 75 thyroidectomies (27%) were performed because of symptoms directly referable to a neck mass, such as a patient complaint of feeling something in the neck. Forty percent received a cancer diagnosis (30 of 75 cases).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Screening and chance identification were the trigger events for just less than half of both the cancers diagnosed and the thyroidectomies performed. These extra cancer diagnoses and surgeries are a significant burden for patients. These data will help direct future efforts to curb treatment of clinically unimportant thyroid nodules. 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