The role of preventive examination on the basis of the Healthy Moscow pavilion in the early diagnosis of thyroid nodules

Introduction. The urgency of the problem of early diagnosis of nodular formations of the thyroid gland (thyroid gland) is due to their very wide spread. With ultrasound examination of the thyroid gland, the primary detectability of nodular formations according to different authors can vary from 11 to 40 %. At the same time, among all thyroid diseases, thyroid cancer in the Russian Federation is 31,4 %.  

Research methods. In order to widely cover the population of the city of Moscow with measures aimed at early detection (screening) of complications after a new coronavirus infection COVID-19, as well as chronic non-communicable diseases and risk factors for their development, in accordance with the order of the Department of Health of the City of Moscow dated April 22, 2022 No. 399 "On conducting preventive examinations of the adult population in In 2022, 46 Healthy Moscow pavilions were organized in park zones, squares, recreation areas of the city of Moscow.  One of the Pavilions is deployed on the territory of the VDNH Park, in 2022, a preventive examination is carried out from May 11, daily from 8.00 to 20.00, without days off and lunch breaks.  

Discussion. The key direction of the preventive examination in the pavilion is the early detection of thyroid nodules, carried out by means of a special questionnaire (identification of the risk of development), physical examination, including palpation of the thyroid gland, regional lymph nodes, and ultrasound examination of the thyroid gland when abnormalities are detected.  The article presents information on the number and structure of those who underwent preventive examination in the pavilion in the period from 11.05.2022 to 31.07.2022, including the number and structure of patients with deviations in the results of the examination of the thyroid gland.  

Conclusions. The structure of the identified thyroid nodules is analyzed in accordance with modern classification concepts, the role of preventive examination in the pavilion "Healthy Moscow" in the early diagnosis of thyroid nodules is demonstrated, the need for improving diagnostic screening is suggested.

1. Order of the Moscow Government. Department of Health of the City of Moscow dated April 22, 2022 No. 399 “On conducting preventive examinations of the adult population in park areas, squares, recreation areas of the city of Moscow in 2022”, [Electronic resource]. (In Russ.)

2. Suzdaltsev I.V., Kurbanov S.I., Pykhtin Yu.Yu. Diagnosis and surgical treatment of thyroid nodules. Medical Bulletin of the North Caucasus, 2018, № 4, pp.13–15. (In Russ.)

3. Ambrosimov A.Yu., Abdulkhabirova F.M. The Bethesda system for reporting thyroid cytopathology (2017 revision). perspective of diagnosis of thyroid tumors and update of management of patients. Russian News of Clinical Cytology, 2017, № 21(3–4), рр. 23–31. (In Russ.)

4. Bederina Е.L., Orlinskaya N.Yu., Konovalov V.A., Zubeev P.S. Diag­nostic Value sonoelastography in Differential Diagnosis of Thyroid Nod­ules. Sovremennye tehnologii v medicine, 2014, № 6(1), рр. 43–46 (In Russ.)

5. Beltsevich D.G., Vanushko V.E., Melnichenko G.A., Rumyantsev P.O., Fadeev V.V. Clinical recommendations of the Russian Association of Endocrinologists for the diagnosis and treatment of (many) nodular goiter in adults (2015). Endocrine surgery, 2016, Volume 10, № 1, pp. 5–12. (In Russ.)

6. Beltsevich D.G., Mudunov A.M., Vanushko V.E., etc. Clinical rec­ommendations: Differentiated thyroid cancer. Modern Oncology, 2020, № 22(4), рр. 30–44. http://doi.org/10.26442/18151434.2020.4.200507 (in Russ.)

7. Beltsevich D.G., Vanushko V.E., Rumyantsev P.O. et al. 2017 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment. Endocrine surgery, 2017, № 11(1), рр. 6–27. (In Russ.) https://doi.org/10.14341/serg201716-27 (in Russ.)

8. Kaprin A.D. Starinsky V.V., Shakhzadova A.O. Malignant neoplasms in Russia in 2019 (morbidity and mortality). Moscow: P. A. Herzen Moscow State Medical Research Institute – Branch of the Federal State Budgetary Institution “NMIC of Radiology” of the Ministry of Health of Russia, 2020, 252 р. (In Russ.)

9. Rumyantsev P.O., Ilyin A.A., Rumyantseva U.V., Saenko V.A. Thyroid cancer. Modern approaches to diagnosis and treatment. M. : GEOTAR-Me­dia, 2009, 448 р. (In Russ.)

10. Sencha A.N. Ultrasound examination of the thyroid gland. Step by step. From simple to complex. M. : MEDpress-inform, 2019, 202 р. (In Russ.)

11. Solomadin YU.S., Sych YU.P., Fadeyev V.V. Metody otsenki zlok­achestvennogo potentsiala uzlov shchitovidnoy zhelezy. RMZH, 2022, № 1, рр. 31–35 (In Russ.)

12. Fisenko E.P., Sych Yu.P., Zabolotskaya N.V. et al. TIRADS classifi­cation in assessing the degree of malignancy of thyroid nodules. M. : OOO “Firma STROM”, 2020, 56 р. (In Russ.)

13. Chernyshev V.A., Khamidullin R.G., Rudyk A.N., Busygin M.A., Zinchenko S.V., Afanasyeva Z.A., Kosova A.L., Glukhova N.A., Usmanova G.A. Evolution of diagnosis and treatment of patients with thyroid cancer. Volga Oncological Bulletin, 2017, № 2(29), рр. 37–43. (In Russ.)

14. Clinical guidelines. Differentiated thyroid cancer, 2020. (In Russ.)

15. Clinical guidelines. Nodular goiter in adults, 2016. (In Russ.)

16. Ali Z.S., Cibas E.S. The Bethesda System for Reporting Thyroid Cy­topathology. LLC, 2010.

17. Aschebrook-Kilfoy B., Schechter R.B., Shih Y.C., Kaplan E.L., Chiu B.C., Angelos P., Grogan R.H. The clinical and economic burden of a sus­tained increase in thyroid cancer incidence. Cancer Epidemiol Biomarkers Prev., 2013, № 22 (7), рр. 1252–1259.

18. Brito J.P., Al Nofal A., Montori V., Hay I.D., Morris J.C. The impact of subclinical disease and mechanism of detection on the rise in thyroid cancer incidence: a population-based study in Olmsted County, Minnesota during 1935 through 2012. Thyroid., 2015, № 25 (9), рр. 999–1007.

19. Bryan R. Haugen, Erik K. Alexander Keith C. Bible, Gerard M. Doherty, Susan J. Mandel, Yuri E. Nikiforov et al. American Thyroid Associ­ation Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer The American Thyroid Association Guide­lines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer Thyroid., 2016, № 26(1), рр. 1–147.

20. Davies L., Welch H.G. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg., 2014, № 140 (4), рр. 317–322.

21. Dobruch-Sobczak K., Adamczewski Z., Szczepanek-Parulska E., Migda B., Woliński K., Krauze A., Prostko P., Ruchała M., Lewiński A., Jakubowski W., Dedecjus M. Histopathological Verification of the Diagnos­tic Performance of the EU-TIRADS Classification of Thyroid Nodules— Results of a Multicenter Study Performed in a Previously IodineDeficient Region. Journal of Clinical Medicine, 2019, № 8(11), рр. 1781. https://doi.org/10.3390/jcm8111781

22. Gharib H., Papini E., Garber J.R. et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Asso­ciazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules – 2016 Update. Endocr Pract., 2016, № 22(Supplement 1), рр. 1–60.

23. Haugen B. The 2015 American Thyroid Association Evidence-Based Guidelines for Management of Patients with Thyroid Nodules and Differ­entiated Thyroid Cancer: Key Recommendations. Practical Management of Thyroid Cancer, 2018, № 1, рр.20. https://doi.org/10.1007/978-3-319-91725-2_3

24. Siegel R., Ma J., Zou Z., Jemal A. Cancer statistics, 2014. CA Cancer J Clin., 2014, № 64 (1), рр. 9–29.

25. Yoon J.H., Lee H.S., Kim E.K. et al. Malignancy risk stratification of thyroid nodules: comparison between the thyroid imaging reporting and data system and the 2014 American Thyroid Association man. Radiology, 2016, Mar; № 278(3), рр. 917–924.

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