Identifying thyroid, parathyroid and adrenal tumors

The expert physicians at the Hospital for Endocrine Surgery work closely with other HCA Healthcare hospitals throughout Florida to help identify endocrine tumors that are identified on an x-ray or blood test on patients being seen at one of their emergency rooms (or outpatient clinics). This national HCA Healthcare initiative is called the Care Assure program and it involves dedicated nurses at each participating HCA Healthcare hospital to examine CT scans and blood results of ER patients to help make sure any evidence of an endocrine tumor gets the followup tests it deserves.

Background: Why endocrine screening is needed

Many endocrine tumors are not diagnosed and patients can suffer the effects of poorly regulated hormones from these glands for years, having a tremendous effect on how patients feel and their overall health. About 70% of parathyroid tumors are not diagnosed and the patients feel bad for years not knowing why. More than 90% of adrenal tumors that are making too much adrenal hormones are unrecognized causing many symptoms that can last for years and even cause early death. Similarly, about 20% of thyroid cancers and masses are not recognized in a timely fashion resulting in thyroid hormone issues and delayed cancer diagnosis.

Fortunately, many endocrine tumors are able to be seen on CT scans of the neck (for thyroid) or CT scans of the abdomen (for adrenal). Parathyroid tumors are often discovered by detecting high levels of calcium in the patient's blood. Unfortunately, at every hospital in the world, when these potential problems are noted on a CT scan or blood test, the patient doesn't get the followup tests they need to determine if a tumor exists that needs to be addressed or removed. This happens at all hospitals because the patient typically came into the emergency room for a specific problem which is being taken care of–and the "accidentally found" endocrine issue is noted on the side. But since the endocrine/hormone issue was not the problem the patient came to the hospital with, it is standard for this issue to be addressed at a later time with the patient's regular doctor. This is the step that is often missing–and the significance of the detected endocrine problem does not get the attention it deserves. This problem that affects every hospital world-wide is what HCA Healthcare's Care Assure program is designed to help address.

HCA Healthcare's Endocrine Tumor Screening Program

The expert physicians at the Hospital for Endocrine Surgery helped develop criteria to understand what thyroid and adrenal tumors, and what level of blood calcium should have additional followup. This was done using current clinical guidelines published by the major endocrine societies and within established evidence-based norms found within the peer-reviewed medical literature. A bibliography of select articles is provided at the bottom of the page for each of these glands. By July 1, 2021 endocrine tumor screening will include 48 HCA Healthcare hospitals in Florida.

Thyroid Tumor Screening

Thyroid tumors are often seen on CT scans of the neck or even CT scans of the head or the chest–scans that were obtained for a completely different reason (like a severe headache). When a thyroid mass is seen on a scan, the Care Assure nurses go into action to help assure it isn't overlooked.

See Our Detailed Page on Thyroid Tumor Screening

Parathyroid Tumor and High Calcium Screening

Since parathyroid glands control the amount of calcium in the blood, a high blood calcium level is a sign that a tumor has grown on one of the parathyroid glands. High blood calcium is never normal, and almost always due to a parathyroid tumor. These tumors are almost always benign but they need to be removed.

See Our Detailed Page on Calcium and Parathyroid Screening

Adrenal Tumor Screening

Adrenal tumors occur in 3.5% of adults. These small, round adrenal tumors are often seen when patients go to the emergency room of their local hospital and get a cat-scan of their abdomen. Adrenal tumors are benign more than 95% of the time, but they can make adrenal hormone. So every patient with an adrenal tumor seen on a scan should have their adrenal hormones checked.

See Our Detailed Page on Adrenal Tumor Screening