High Prevalence Of Thyroid Cancer Research Articles

Integration of big data analytics in the investigation of the relationship between acromegaly and cancer

ObjectiveTo evaluate the association between acromegaly and cancer and different types of cancer by using natural language processing systems and big data analytics. Material and methodsWe conducted an observational, retrospective study utilizing data from the electronic health records (EHRs) of Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. Information from the EHRs was extracted using artificial intelligence techniques and analyzed using Savana Manager 4.0 software. ResultsOut of a total of 708,047 registered patients (54.7% females), 544 patients (0.08%; 330 women, 60.7%; mean age at diagnosis 53.0±15.8 yr) were diagnosed with acromegaly. The incidence of cancer was higher in patients with acromegaly vs those without this condition (7.7% vs 3.9%, p<0.001; OR, 2.047, 95%CI, 1.493–2.804). Male acromegalic patients had a higher prevalence of cancer vs females (57.1% vs 42.9%, p=0.012). A significantly higher prevalence of colorectal cancer (2.9% vs 1.4%, p=0.006), bladder cancer (1.1% vs 0.3%, p=0.005), and lymphoma (1.1% vs 0.3%, p=0.009) was observed in patients with acromegaly vs those without the condition. Acromegalic men had significantly higher prevalence rates of colorectal cancer (4.7% vs 1.3%, p=0.001), bladder cancer (2.8% vs 0.4%, p<0.001), breast cancer (0.9% vs 0.2%, p=0.042), gastric cancer (0.9% vs 0.1%, p=0.011), lymphoma (1.4% vs 0.3%, p=0.037), and liver cancer (0.9% vs 0.1%, p=0.012) vs non-acromegalic men. On the other hand, acromegalic women showed a higher prevalence of thyroid cancer (1.2% vs 0.4%, p=0.043) vs non-acromegalic women. ConclusionOur study, based on artificial intelligence techniques and analysis of real-world data and information, revealed a significant association between acromegaly and cancer in our hospital population, mainly acromegalic men, with a higher frequency of colorectal cancer, bladder cancer and lymphoma in particular.

Increased thyroid malignancy in patients with primary hyperparathyroidism.

BackgroundMultiple studies have reported the increased incidence of thyroid cancer in patients with primary hyperparathyroidism (PHPT). However, the underlying risk factors of concomitant thyroid cancer in patients with PHPT remain unknown. The primary aim of this study was to examine the records of patients with PHPT to identify characteristics that correlated with the presence of coexisting thyroid nodules, and which may have an implication for the prediction of thyroid cancer.MethodsMedical records of consecutive patients with PHPT (n = 318) were reviewed from January 2010 to September 2020 in two tertiary medical centers in China. Patient clinicopathological and biological data were collected and analyzed.ResultsOf a total of 318 patients with PHPT, 105 (33.0%) patients had thyroid nodules and 26 (8.2%) patients were concomitant with thyroid cancer. A total of 38 thyroid nodules taken from 26 patients were pathologically assessed to be well-differentiated papillary thyroid carcinoma (PTC), with 81% being papillary thyroid microcarcinoma (PTMC). In 79% (30/38) of these cancers, thyroid nodules were considered suspicious following preoperative ultrasound. Multinomial logistic regression analysis revealed that female gender was associated with increased risk of thyroid nodules (OR = 2.13, 95% CI: 1.13–3.99, P = 0.019), while lower log-transformed parathyroid hormone levels were an independent predictor of thyroid cancer in patients with PHPT (OR = 0.50, 95% CI: 0.26–0.93, P = 0.028).ConclusionIn conclusion, we observed a relatively high prevalence of thyroid cancer in our cohort of Chinese patients with PHPT. Evaluation of thyroid nodules by preoperative ultrasound may be advisable in patients with PHPT, particularly for females and patients with modestly elevated serum parathyroid hormone levels.

Serum biomarkers for thyroid cancer.

The high prevalence of thyroid cancer requires a reliable serum biomarker for diagnosis and prognostic monitoring. Serum thyroglobulin has been established as the primary postoperative and postablative monitoring biomarker for this malignancy. However, the presence of thyroglobulin antibody imposes a significant interference on its overall management, which cannot be diminished by currently available assays. Trends on the level of the thyroglobulin antibody during follow-up is considered as a surrogate biomarker, but controversy exists. A variety of alternative biomarkers are being proposed and investigated, nevertheless, clinical trials and prospective validations are needed before they can be regarded as clinically viable serum parameters for thyroid cancer.

MON-507 A Descriptive Study of Clinical and Surgical Characteristics of Patients with Thyroid Cancer: A 10-Year Retrospective Study from UAE

Introduction: Thyroid cancer is the sixth most common type of cancer in the UAE. It has been observed that the incidence of thyroid cancer has been steadily increasing worldwide. However, limited studies about thyroid cancer has been reported from the Arab gulf region.Objective: The objective of this study was to describe the clinical and surgical characteristics of patients with thyroid cancer in the UAE population.Methods: Retrospective analysis was performed on all adult patients attending thyroid cancer clinic at Sheikh Khalifa Medical City (SKMC) in Abu Dhabi, UAE over ten years from 2008 to 2018. All patients with a confirmed histological diagnosis of thyroid cancer who had surgical intervention with long-term follow up data on cancer outcome have been included. Categorical variable analysis and descriptive analysis were used to identify factors associated with increased risk of developing thyroid cancer.Results: Total number of 203 patients with confirmed diagnosis of thyroid cancer were included. Most of the patients were female (72.9 %, n=148). Mean age at the time of diagnosis was 40±13 years. Papillary thyroid carcinoma was the most common thyroid cancer observed (95.6%, n=194) followed by follicular thyroid carcinoma (2%), medullary thyroid carcinoma (1.5%) and mixed medullary-papillary (0.9%). Classical variant and follicular variant of papillary thyroid carcinoma were the two most commonly observed histological subtypes of thyroid cancer with prevalence of 54.7 % and 21.7 % respectively. 91.1% (n=185) of patients had total thyroidectomy and 8.9%(n=18) had hemithyroidectomy. Female gender has been observed to be associated with higher prevalence of thyroid cancer (OR 2.78, 95% CI 1.18–4.50, p=0.001). Smoking status did not show any significant association with developing thyroid cancer. Recurrent thyroid cancer was observed in 9.4%(n=19). Most of recurrence happened as local metastasis 89.5%(n=17). The mean time of recurrence was 24 months (range, 7–64 months).Conclusions: Our data demonstrate that in the UAE population, papillary thyroid cancer is the most common type of thyroid cancer. Female gender is observed to be associated with higher risk of thyroid cancer. Recurrence rate of thyroid cancer noted to be 9.4%. Further studies are required to investigate factors associated with recurrence and cancer free survival rates.

The AsSociation Between Type 2 Diabetes Mellitus, Hypothyroidism, and Thyroid Cancer.

SUMMARYThis study aimed to investigate the association between type 2 diabetes mellitus (T2DM), antidiabetic therapy, hypothyroidism, and thyroid cancer. We analyzed data from 320 patients who underwent thyroid surgery for suspicion of cancer. The diagnosis of thyroid cancer was confirmed by histopathological analysis in 95 patients. No significant difference was found in the diagnosis of T2DM and hypothyroidism concerning the presence of thyroid cancer (p=0.13; p=0.85), nor in the gender of patients with T2DM and hypothyroidism with respect to the type of thyroid cancer (p=0.19; p=0.25). Patients with T2DM (Odds ratio [OR] 1.89; 95% CI, 0.856-4.163) and patients with hypothyroidism (OR, 1.05; 95% CI, 0.530-2.164) had higher prevalence of thyroid cancer, as did those who had both diagnoses combined (p=0.37; OR, 2.39; 95% CI, 0.333-17.278), compared with the patients who did not have those diagnoses. Men with T2DM (OR, 6.19; 95% CI, 1.180-32.513) had higher prevalence of thyroid cancer than women. Patients who were on oral antidiabetics (OR, 1.91; 95% CI, 0.804-4.512) had higher prevalence of thyroid cancer than those receiving insulin. According to the results of this study, we can conclude that there is an association between T2DM, hypothyroidism, oral antidiabetics, and thyroid cancer.

Dose dependence of pediatric thyroid cancer prevalence in the 6 years after the Fukushima nuclear power plant accident

Background: After the Fukushima nuclear accident in March 2011, Fukushima Prefecture initiated thyroid ultrasound screening as part of the Fukushima Health Management Survey (FHMS). Regional differences in external radiation dose were often reported not associated with thyroid cancer prevalence in the firstround screening E-I (2011-2013). The association between childhood thyroid cancer and radiation exposure in the 6 years after the accident is studied by analyzing the results of the first and second-round examinations E-I+II (2011-2015). Methods: Dose dependence of thyroid cancer proportion in E-I and E-II for all residents aged ≤18 years at the accident was analyzed for FHMS external dose and UNSCEAR effective dose by regression analysis using Microsoft Excel. Two divisions of Fukushima prefecture, O-model in the order of decreasing external dose and S-model according to the initial screening schedule, were adopted. Results: In O-model, thyroid cancer proportion per 100,000 in E-II and in E-I+II were found to increase linearly to FHMS external dose in 0.2–1.4 mSv range and UNSCEAR effective dose in 1.6–5 mSv range. Thyroid cancer proportion in E-II and E-I+II was observed to increase linearly to effective dose in Smodel. Conclusion: The observed linear prevalence–dose relation after 6 years from the accident and incidencedose relation during 4-6 years after exposure suggest a possible association between pediatric thyroid cancer and radiation exposure. Regional differences were not obvious in E-I presumably because of the short interval from exposure to screening in high-dose areas. High prevalence of thyroid cancer cannot be attributed only to mass screening effect that does not depend on radiation dose and elapsed time from exposure.

Prevalence of papillary thyroid cancer in subacute thyroiditis patients may be higher than it is presumed: retrospective analysis of 137 patients.

BackgroundThe association of subacute thyroiditis (SAT) and papillary thyroid carcinoma is a rare finding. In this study, we aimed to investigate the prevalence of differentiated thyroid cancer in a cohort of patients followed with the diagnosis of SAT.Patients and methodsWe retrospectively screened medical records of Endocrinology and Metabolism outpatient clinic in the past 20 years for patients with SAT. Patients with nodules and suspicious ultrasonography findings who underwent fine needle aspiration biopsy (FNAB) and operated due to malignancy risk were identified.ResultsWe identified 137 (100 females, 37 males) patients with reliable records to confirm the diagnosis of SAT. The mean age of female patients was 41.1 ± 9.1 (range, 20–64) and of male patients was 43.0 ± 9.3 (range, 20–65). One or more FNAB was performed in 23 of the patients (16.8%) at the beginning and/or during the follow-up period when needed. Seven patients with suspicious FNAB findings were operated, and histopathological examination of the nodules confirmed the diagnosis of papillary thyroid carcinoma in 6 patients (4.4%).ConclusionsOur observations suggesting a relatively higher prevalence of thyroid cancer in a small series of SAT patients warrant further studies to identify the real frequency of differentiated thyroid cancer and its association with inflammatory pathogenesis of SAT. This finding is compatible with the trend of increased thyroid cancer incidence all over the world. A repeat ultrasonography after resolution of clinical and inflammatory findings, and FNAB should be recommended to all patients with suspicious nodules.

Papillary thyroid microcarcinoma in adults may initiate from childhood

A total of 298 577 children aged<18 years old in Fukuaka in Japan were screened for thyroid cancer after less than 3 years after nuclear accident. 110 children were diagnosed as thyroid cancer by fine needle aspiration cytology (FNAC) and 87 cases received thyroid operation. The prevalence of thyroid cancer was 36.8/100 000 in population of<18 year old and 120/100 000 at age of 16-18 years old. The 5th international expert symposium in Fukushima on radiation and health concluded that the high prevalence of thyroid cancer was not related with nuclear accident but to the screening. According to the findings, Willimas propsed a hypothesis: thyroid cancer in adults might originate from childhood. They had three stages for initiation and development of thyroid cancer: initial mutation stage, constraint growth stage, and non-constraint growth stage. The growth of thyroid cancer were stopped in the constraint stage, which was thyroid microcarcinoma. (Chin J Endocrinol Metab, 2017, 33: 719-722) Key words: Fukuoka; Nuclear accident; Thyroid cancer; Overdiagnosis

EXPRESSION OF MENIN IN THE HUMAN THYROID GLAND.

The expression of menin in the thyroid gland has long been debated. Animal models with targeted inactivation of menin in the thyroid gland have shown that its inactivation might play a role in the progression to a more aggressive type of cancer. Human studies are conflicting, some have identified mutations in the MEN1 gene in a sub-type of oncocytic thyroid carcinomas, while others have not identified a higher prevalence of thyroid cancer in MEN1 patients. To analyze the immunohistochemical expression of menin in different types of thyroid carcinomas. 48 thyroid tumours (12 papillary thyroid carcinomas (PTC), 6 anaplastic thyroid carcinomas (ATC), 12 poorly differentiated thyroid carcinomas (PDTC), 5 medullary thyroid carcinomas (MTC), 5 oncocytic follicular carcinomas (OC), 3 oncocytic adenomas (OA) and 5 goiters (G)) were tested for nuclear expression of menin using an anti-menin antibody. The expression was considered positive, negative or decreased. The expression of menin was positive, identical to normal tissue, in 39 cases (81.25%). The expression was decreased (n=8) or absent (n=1) in 9 tumours (18.75% - 2 PTC, 5 PDTC, 2 OC) accounting for 42% (5/12) of the PDTC and 40% (2/5) of the OC. Our results show that the expression of menin is generally preserved in human thyroid carcinomas, but it can be decreased or absent in certain types of thyroid cancer. Further molecular studies are needed to evaluate to potential of menin protein in tumorigenesis.

Prevalence of neoplasms in acromegaly in the Moscow Region

Rationale: Prevalence of neoplasms in patients with acromegaly and the effects of various risk factors on their development have been insufficiently studied. Aim : To assess the prevalence of thyroid, gastric and colon neoplasms in patients with newly diagnosed acromegaly, depending on their age, gender, duration and activity of the underlying disease. Materials and methods: We retrospectively analyzed data extracted from out- and in-patient medical files of 108 patients with acromegaly (25 male, 93 female). Their median age was 50.5 [range 39.3 to 59] years, median duration of acromegaly 5 [range 2 to 10] years (starting from the first appearance of the first physique abnormalities). Thyroid ultrasound was performed in 96 patients, gastroscopy in 92, and colonoscopy in 89. Results: Benign thyroid nodules were found in 50% (48/96) of patients, malignant thyroid nodules in 6.2% (6/96). Insulinlike growth factor 1 (IGF-1) levels (calculated as a percentage above upper limit of the normal range) in patients with thyroid cancer was 2.3-fold higher than in patients without nodular thyroid disease and 2-fold higher than in patients with benign thyroid nodules (р < 0.012 and p < 0.03, respectively). Malignant neoplasms were more often seen in the elderly (above 60 years of age), compared to younger adults (45 to 60 years) (30.8% and 4.3% of patients, respectively, p = 0.01). Male patients had higher prevalence of thyroid cancer than female (11.1% and 5.1%, respectively). Benign gastrointestinal neoplasms were observed in 51.7% of patients (18% had gastric polyps and 37% colon polyps). Age and duration of acromegaly in patients with gastric neoplasms were higher, than in those without them (р = 0.015 and p = 0.036, respectively). Colon neoplasms consisted of hyperplastic polyps (33.7%) and colon cancer (3% of patients). Patients with colon neoplasms were 11 years older than those without it (p = 0.015). Conclusion : Gastrointestinal tract and thyroid gland should be diagnostically assessed in all patients at diagnosis of acromegaly, because of the higher risk of the neoplasms in these patients. The association of higher IGF-1 levels with thyroid cancer indicates that this factor may contribute to carcinogenesis and requires further studies.

Quantification of the increase in thyroid cancer prevalence in Fukushima after the nuclear disaster in 2011--a potential overdiagnosis?

A thyroid ultrasound examination programme has been conducted in Fukushima Prefecture, Japan, after the nuclear disaster in 2011. Although remarkably high prevalence of thyroid cancer was observed, no relevant quantitative evaluation was conducted. We calculated the observed/expected (O/E) ratio of thyroid cancer prevalence for the residents aged ≤20 years. Observed prevalence was the number of thyroid cancer cases detected by the programme through the end of April 2015. Expected prevalence was calculated as cumulative incidence by a life-table method using the national estimates of thyroid cancer incidence rate in 2001–10 (prior to the disaster) and the population of Fukushima Prefecture. The underlying assumption was that there was neither nuclear accident nor screening intervention. The observed and estimated prevalence of thyroid cancer among residents aged ≤20 years was 160.1 and 5.2, respectively, giving an O/E ratio of 30.8 [95% confidence interval (CI): 26.2, 35.9]. When the recent increasing trend in thyroid cancer was considered, the overall O/E ratio was 22.2 (95% CI: 18.9, 25.9). The cumulative number of thyroid cancer deaths in Fukushima Prefecture, estimated with the same method (annual average in 2009–13), was 0.6 under age 40. Combined with the existing knowledge about radiation effect on thyroid cancer, our descriptive analysis suggests the possibility of overdiagnosis. Evaluation including individual-level analysis is required to further clarify the contribution of underlying factors.

Obesity is a risk factor for thyroid cancer in a large, ultrasonographically screened population

Obesity is a well-known risk factor for many cancers, including those of the esophagus, colon, kidney, breast, and skin. However, there are few reports on the relationship between obesity and thyroid cancer. We conducted this study to determine whether obesity is a risk factor for thyroid cancer by systematically screening a selected population by ultrasonography. We obtained data from 15,068 subjects that underwent a routine health checkup from 2007 to 2008 at the Health Screening and Promotion Center of Asan Medical Center. Thyroid ultrasonography was included in the checkup, and suspicious nodules were examined by ultrasonography-guided aspiration. Those with a history of thyroid disease or family history of thyroid cancer were excluded from this study. In total, 15,068 subjects, 8491 men and 6577 women, were screened by thyroid ultrasonography. Fine-needle aspiration cytology was performed in 1427 of these patients based on the predefined criteria and thyroid cancer was diagnosed in 267 patients. The prevalence of thyroid cancer in women was associated with a high BMI (per 5 kg/m(2) increase) (odds ratios (OR)=1.63, 95% CI 1.24-2.10, P<0.001), after adjustment for age, smoking status, and TSH levels. There was no positive correlation between the prevalence of thyroid cancer in men and a high BMI (OR=1.16, 95% CI 0.85-1.57, P=0.336). There was no association between age, fasting serum insulin, or basal TSH levels and thyroid cancer in either gender. Obesity was associated with a higher prevalence of thyroid cancer in women when evaluated in a routine health checkup setting. This association between risk factor and disease was unrelated to serum insulin and TSH levels. Additional studies are needed to understand the mechanism(s) behind the association of obesity with thyroid cancer risk.

Thyroid cancer: burden of illness and management of disease.

The incidence of thyroid cancer, the most common endocrine malignancy, has increased dramatically in the last fifty years. This article will review the standard approach to thyroid cancer treatment as well as novel therapies under investigation. We will also address potential cost considerations in the management of thyroid cancer. A comprehensive literature search was performed. Review article. The high prevalence of thyroid cancer and the availability of novel therapies for patients with metastatic disease have potential economic implications that have not been well-studied. Because many patients likely have very low morbidity from their cancers, better tools to identify the lowest risk patients are needed in order to prevent overtreatment. Improved risk stratification should include recognizing patients who are unlikely to benefit from radioactive iodine therapy after initial surgery and identifying those with indolent and asymptomatic metastatic disease that are unlikely to benefit from novel therapies. In patients with advanced incurable disease, randomized-controlled studies to assess the efficacy of novel agents are needed to determine if the costs associated with new agents are warranted. Health care costs associated with the increased diagnosis of thyroid cancer remain unknown but are worthy of further research.

Endocrine manifestations of hepatitis C virus infection

Chronic infection with hepatitis C virus (HCV) can result in both hepatic and extrahepatic disease and endocrine dysfunction represents an important class of HCV-related extrahepatic disease. The most frequently occurring--and clinically important--of these endocrine disorders are thyroid disease and type 2 diabetes mellitus. In this Review, we evaluate the evidence in support of a link between HCV infection and endocrine-system dysfunction, and discuss potential pathophysiological mechanisms. A meta-analysis of the literature has revealed significant associations between chronic HCV infection, thyroid autoimmunity and hypothyroidism. Furthermore, a high prevalence of thyroid cancer has been reported in HCV-positive patients. Several clinicoepidemiological studies have demonstrated that chronic HCV infection could lead to the development of type 2 diabetes mellitus, possibly as a result of HCV-induced metabolic disturbances. Some researchers have postulated that a type 1 T-helper -cell mediated immune response underpins the association of chronic HCV infection with endocrine disease. Indeed, the available data suggest that a common immunological, type 1 T-helper cell pattern of cytokine expression and activation (via interferon-gamma) could provide the pathophysiological basis for this association. Nonetheless, additional studies will be necessary to elucidate fully all the mechanisms involved in HCV-related endocrine dysfunction.

Thyroid Disease Prevalence in Carabineers Deployed in a War Theater

The problem of morbidity in deployed military personnel represents a much-debated topic. Because there have been two cases of thyroid cancer in the Tuscania regiment, the aim of the present study was to investigate the prevalence of all types of thyroid disease in a cohort of carabineers. A total of 673 carabineers, including 501 deployed carbineers (DCs) (29-48 years of age) and 172 nondeployed carabineers (NDCs) (29-51 years of age), of the Tuscania regiment were involved in the study. Thyroid volume, percentages of single nodules and multinodular goiter, percentage of autoimmune thyroid disease, and percentages and histological types of thyroid cancer were all measured. No statistical difference between DCs and NDCs was found for any of the data. Furthermore, when we divided DCs into subgroups according to time spent on deployment and time elapsed since the first deployment, we found no differences. However, a high prevalence of thyroid cancer was found in our cohort (2.0% in DCs and 2.5% in NDCs; not significant), and the prevalence of thyroid cancer in nodules in the cohort of carabineers was higher (10.0%) than the prevalence of thyroid cancer in nodules in the civilian population (5.6%, p < 0.001). No differences regarding the prevalence of thyroid diseases were observed when we compared DCs and NDCs, which suggests that no significant difference in exposure to toxic or carcinogenic substances that could have affected the thyroid occurred during deployments. The high prevalence of thyroid cancer in carabineers may merely reflect an increase of this cancer in the general population, or it may suggest the presence of some carcinogenic event in this specific cohort.

Behavior of small thyroid cancers found by screening radiation-exposed individuals.

Thyroid cancers detected by screening irradiated individuals are often small and of uncertain clinical significance. We retrospectively analyzed the effect of screening in a cohort of 4296 individuals exposed to radiation as children in the 1940s and 1950s and followed by us from 1974 until the present. We compared the thyroid cancers diagnosed before 1974 (122 cases, routine care) with the cancers found in subjects screened by us after 1974 (172 cases, screened), using cancer recurrence as the end point. Screening included a thyroid scan or, more recently, thyroid ultrasound. As expected, many of the cancers found by screening were very small (52% were <10 mm), but the range of tumor sizes overlapped those found by routine care. The recurrence rate was significantly lower in the cases found by screening, but when the comparison was limited to cancers 10 mm or larger, no difference in the recurrence rates was seen. This would suggest that the lower recurrence rate observed for small thyroid cancers detected at screening was due to earlier diagnosis rather than more effective treatment. By univariate analysis, four factors were associated with an increased risk of recurrence of small (<10 mm) thyroid cancers: short latency (i.e. a shorter time interval between the radiation exposure and the first thyroid surgery), lymph node metastases present at diagnosis, multifocal cancers, and higher radiation dose. In a multivariate analysis combining the four risk factors, only short latency was significant. As thyroid cancers that escape detection by routine means should be diagnosed at screening, and both large and small thyroid cancers have the potential to recur, screening may be of value, but only if groups with a sufficiently high prevalence of thyroid cancer can be identified to offset the adverse effects of unnecessary treatment due to false positive results.

The high prevalence of thyroid cancer in patients with hepatitis type c virus infection

The high prevalence of thyroid cancer in patients with hepatitis type c virus infection

Thyroid cancer associated with adenomatous goiter: an analysis of the incidence and clinical factors.

We evaluated the incidence of thyroid cancer in patients with adenomatous goiter and investigated the clinical factors distinguishing patients with occult thyroid cancer, defined as a tumor size smaller than or equal to 10 mm, from those with clinical thyroid cancer, defined as a tumor size larger than 10 mm. Of 835 patients with histologically confirmed adenomatous goiter, 256 (30.7%) also had thyroid cancer, being occult in 137 patients and clinical in 119 patients. There was no correlation between the maximum size of the thyroid cancer tumor and the age of the patient, and the percentage of patients with thyroid cancer in each group was not influenced by age. There were no significant differences in age, sex, the serum concentrations of free triiodothyronine, free thyroxine, thyrotropin, and thyroglobulin, or the urinary iodine creatinine ratio. The frequency of calcified lesions being detected by ultrasonography (US) and/or neck X-ray in the patients with clinical thyroid cancer was significantly greater than that in those with occult cancer at 83% vs 57%, respectively (P < 0.0001). This study disclosed a high prevalence of thyroid cancer associated with adenomatous goiter, and the results suggest that a considerable number of associated carcinomas remain occult. The detection of calcification in the thyroid gland is one of the surgical indications for patients with adenomatous goiter.

Population surveys on the prevalence of thyroid cancer in a non-endemic region, Nagano, Japan.

AbstractFor the purpose of evaluating the epidemiological situation of thyroid cancer in non‐endemic regions, the prevalence of thyroid cancer was studied in the general population in 15 areas of Nagano Prefecture, Japan.In the survey, 59,106 subjects (representing 80.9% of the population) were examined for goiter. The total number of thyroid diseases detected was 2,098; i.e., 3.5% (1.4% for males and 5.4% for females) of the subjects examined. Non‐endemic diseases were prevalent. Of the cases detected, 633 were diagnosed as nodular goiter, with 472 cases requiring surgical treatment. Of these, operations were performed in 390 cases, while two cases of thyroid cancer were considered too advanced for surgery.In the clinical and histological studies, 76 cases (16 males and 60 females) were diagnosed as having thyroid cancer. Most of the cancer cases detected in the survey consisted of papillary adenocarcinoma. The prevalence rate of thyroid cancer was 1.3 (0.6 for males and 1.9 for females) per 1,000 examined. The prevalence for females varied with area, though this variation was not significant in the case of males. The prevalence by age varied for both sexes, being greater in the thirties and above than in the under‐thirties.It may be stated that the prevalence of thyroid cancer in the general population is as high as one per 1,000 subjects examined in non‐endemic regions, and that this is not merely a non‐representative case, but that a similarly high prevalence of thyroid cancer can be found in other non‐endemic regions.Statistical comparison of the prevalence of thyroid cancer with its mortality or morbidity rate indicates a considerable difference between the two. The incidence of the latter was only approximately one hundredth of the former. Because of this low mortality, thyroid cancer is apt to be neglected, both clinically and epidemiologically, in comparison to other sites of cancer associated with a higher mortality rate.