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. 2019 Dec 10;9:18745. doi: 10.1038/s41598-019-55370-w

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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(a) After 2004, the disease specific death of patients with TC and initial distant metastasis who were diagnosed by asymptomatic screening and clinical symptoms showed a statistically significant difference (P < 0.001). (b) Asymptomatic screening showed a better prognosis than did systemic systems as well as local symptoms (P < 0.001).