Risk Factor For Thyroid Cancer Research Articles

Prevalence and risk factors for thyroid cancer in patients with multinodular goitre

BackgroundRates of thyroid cancer in patients with multinodular goitre (MNG) vary widely, from 3 per cent in older studies to 35 per cent in more recent studies. The purpose of the present study was to evaluate the prevalence of thyroid cancer in patients operated on for MNG, and to determine risk factors for incidental thyroid malignancy.MethodsA prospectively developed database of all patients who underwent thyroidectomy for a benign MNG at the high-volume endocrine surgery unit of a tertiary referral university hospital was interrogated.ResultsA total of 3233 patients were analysed, separated into three groups according to their functional thyroid status (hypothyroid, hyperthyroid or euthyroid). There were 2788 women (86.2 per cent); the mean patient age was 56.4 years and mean preoperative disease duration was 106.2 months. Incidental thyroid cancer was identified in 1026 patients (31.7 per cent), of which 917 (89.4 per cent) were papillary cancers. Multivariable regression analysis identified functional thyroid status, younger age, male sex, smaller adenoma size, smaller thyroid glands, Hashimoto’s thyroiditis and chronic non-specific thyroiditis as independent risk factors for thyroid cancer.ConclusionMNG was associated with a considerable rate of incidental thyroid cancer, which has been underestimated. A variety of factors should be taken into account when considering the malignant potential of a presumed benign MNG.

Challenges in investigating risk factors for thyroid cancer

Thyroid cancer has become the fifth most commonly diagnosed cancer in adult women worldwide, and the second most common in women older than 50 years. 1 Bray F Ferlay J Soerjomataram I Siegel RL Torre LA Jemal A Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68: 394-424 Crossref PubMed Scopus (41701) Google Scholar The rapid increase in incidence compared with mortality trends—which generally have remained stable at low levels (around two orders of magnitude lower than incidence) or have even declined 2 Li M Brito JP Vaccarella S Long-term declines of thyroid cancer mortality: an international age–period–cohort analysis. Thyroid. 2020; 30: 838-846 Crossref PubMed Scopus (23) Google Scholar —strongly suggests that the thyroid cancer epidemic has been largely driven by overdiagnosis (the diagnosis of cancers that would not have caused symptoms in a person's lifetime). 3 Vaccarella S Franceschi S Bray F Wild CP Plummer M Dal Maso L Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. NEJM. 2016; 375: 614-617 Crossref PubMed Scopus (543) Google Scholar The increasingly intense scrutiny of the thyroid gland has led to the discovery of a large reservoir of subclinical thyroid cancers. 4 Furuya-Kanamori L Bell KJL Clark J Glasziou P Doi SAR Prevalence of differentiated thyroid cancer in autopsy studies over six decades: a meta-analysis. J Clin Oncol. 2016; 34: 3672-3679 Crossref PubMed Scopus (106) Google Scholar Overdiagnosis might account for as much as 70–90% of all thyroid cancer diagnosed in adult women in some countries including South Korea, the USA, and Italy, and around 40–60% in the Nordic countries—in which there has been a smaller increase in thyroid cancer incidence compared with other countries. 3 Vaccarella S Franceschi S Bray F Wild CP Plummer M Dal Maso L Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. NEJM. 2016; 375: 614-617 Crossref PubMed Scopus (543) Google Scholar , 5 Li M Dal Maso L Vaccarella S Global trends in thyroid cancer incidence and the impact of overdiagnosis. Lancet Diabetes Endocrinol. 2020; 8: 468-470 Summary Full Text Full Text PDF PubMed Scopus (64) Google Scholar The peak in thyroid cancer incidence is found in age groups that have the highest surveillance pressure, with young adult women mostly affected because of their better access to health care for reproductive and gynaecological reasons and consequently increased chance of having their thyroid inspected. Overdiagnosis might also account for a substantial part of the increase in thyroid cancer diagnoses in adolescents, particularly girls, worldwide. 6 Vaccarella S Lortet-Tieulent J Colombet Davies L et al. Thyroid cancer in children and adolescents: global patterns and trends of incidence and mortality. Lancet Diabetes Endocrinol. 2020; (in press). PubMed Google Scholar Maternal health, in-utero, and perinatal exposures and risk of thyroid cancer in offspring: a Nordic population-based nested case-control studyIn-utero exposures, particularly those related to maternal thyroid disorders, might have a long-term influence on thyroid cancer risk in offspring. Full-Text PDF

Exposure to radiotherapy for first primary cancer as a risk factor for second primary thyroid cancer: A case-control study

BackgroundSecond primary neoplasms are associated with high mortality and morbidity rates in cancer survivors successfully treated for the first malignancy. Studies suggested an association between the type of first neoplasm and risk of subsequent thyroid cancer, with part of this risk attributable to exposure to radiotherapy during treatment of the first primary tumor. This study aimed to determine whether radiotherapy is a risk factor for thyroid cancer in patients previously treated for another neoplasm. MethodsThis retrospective case-control study included patients diagnosed with their first cancer between 2007 and 2017. Patients who subsequently developed thyroid cancer as a second primary neoplasm were defined as “cases”, and patients who did not develop a second cancer were defined as “controls”. Exposure to radiotherapy was the primary risk factor of interest; other risk factors were the site to which radiotherapy was delivered and the first neoplasm type. ResultsExposure to radiotherapy was associated with an increased risk of thyroid cancer (odds ratio [OR]=2.410, 95% confidence interval [CI]: 1.219–4.764), in particular, in women (OR=3.121, 95% CI: 1.232–7.907) and in patients receiving radiotherapy to the thorax (OR=6.298, 95% CI: 2.581–15.370). The median survival time from first cancer recovery to thyroid cancer occurrence was 63.80 months; there was no difference in survival between patients who did and did not receive radiotherapy (P=0.899). ConclusionRadiation to the thorax can increase the risk of thyroid cancer as a second neoplasm among patients with cancer successfully treated for their first cancer.

Thyroid cancer after hysterectomy and oophorectomy: a nationwide cohort study.

Little is known about the role of estrogen in thyroid cancer development. We aimed to evaluate the association between hysterectomy or bilateral salpingo-oophorectomy (BSO) and the risk of subsequent thyroid cancer. A nationwide cohort study. Data from the Korea National Health Insurance Service between 2002 and 2017 were used. A total of 78 961 and 592 330 women were included in the surgery group and no surgery group, respectively. The surgery group was categorized into two groups according to the extent of surgery: hysterectomy with ovarian conservation (hysterectomy-only) and BSO with or without hysterectomy (BSO). During 8 086 396.4 person-years of follow-up, 12 959 women developed thyroid cancer. Women in the hysterectomy-only (adjusted hazard ratio = 1.7, P < 0.001) and BSO (adjusted hazard ratio = 1.4, P < 0.001) groups had increased risk of thyroid cancer compared to those in the no surgery group. In premenopausal women, hysterectomy-only (adjusted hazard ratio = 1.7, P < 0.001) or BSO (adjusted hazard ratio = 1.4, P < 0.001) increased the risk of subsequent thyroid cancer, irrespective of hormone therapy, whereas, there was no significant association between hysterectomy-only (P = 0.204) or BSO (P = 0.857) and thyroid cancer development in postmenopausal women who had undergone hormone therapy. Our findings do not support the hypotheses that sudden or early gradual decline in estrogen levels is a protective factor in the development of thyroid cancer, or that exogenous estrogen is a risk factor for thyroid cancer.

Is the consumption of sweets a risk factor for thyroid cancer?

Abstract Background Several studies have investigated the role of diet as a risk and/or protective factor on the development of the thyroid cancer but the results are unclear. The aim of this study was to investigate the role of eating habits on the risk of thyroid cancer. Methods We carried out a hospital-based case-control study. The eating habits of the participants were investigated through a validated Lifestyles Questionnaire. The frequency of consumption of the different types of food was reported on a 4-level scale (never, 1 time per week, 2-3 times a week, 6 times a week). Logistic regression models were used to estimate the ORs and their 95% confidence intervals adjusted for age, gender and BMI. Statistical data analysis was conducted using the IBM SPSS Statistics 21.0 program. Results One hundred and six cases (91.2% CA papillary type) and 217 controls were recruited. A positive association was observed for BMI (OR: 1.085; IC95% = 1.022-1.152), consumption of complex carbohydrates (OR: 2,324; IC95%: 1,364-3,960) and a low consumption of legumes, cereals, potatoes, fruit and vegetables (OR: 2.285, 95% CI: 1.330-3.926). The consumption of sweets decreased with age (Rho: -0.445, N = 318, p = 0.000), but at the same age the cases had a higher consumption than controls. In particular, the consumption of sweets was higher in the age group between 39 and 52 years old. Conclusions Our study adds new and relevant information to support the hypothesis that a sugar rich diet may increase the risk of developing thyroid cancer. Funding This research was funded by Intradepartmental Research Plan 2016/2018 of Department of Medical, Surgical and Advanced Technologies, University of Catania, grant number: 5C722012104. Key messages Future studies need to clarify the mechanisms that associate the diet with the risk of thyroid cancer. More research is also needed to explain the differences in thyroid cancer among women and men.

Prognostic Impact of Histologic Grade for Papillary Thyroid Carcinoma.

While numerous factors affect prognosis in papillary thyroid carcinoma (PTC), the comparative impact of histologic grade has not been well described. Moreover, indications for external beam radiation therapy (EBRT) remain imprecise. We evaluate clinicopathologic characteristics and outcomes for PTC stratified by grade. We profiled histologic grade for PTC (well differentiated, moderately differentiated, poorly differentiated) via hospital (National Cancer Database) and population-based (Surveillance, Epidemiology, and End Results) registries. Cox regression was used to adjust for clinicopathologic covariates. Statistical interactions between subtypes and the effect of EBRT on survival were assessed. Collectively, worsening clinicopathologic factors (age, tumor size, extrathyroidal extension, nodal spread, M1 disease) and outcomes (disease-free survival, overall survival) correlated with less differentiated state, across all histologic grades (p < 0.001). Multivariable analysis showed escalating hazard with loss of differentiation relative to well-differentiated PTC (moderately differentiated hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.04-1.41, p = 0.02; poorly differentiated HR 2.62, 95% CI 2.23-3.08, p < 0.001). Correspondingly, greater survival benefit was associated with EBRT for poorly differentiated cases (HR 0.36, 95% CI 0.18-0.72, p = 0.004). This finding was upheld after landmark analysis to address potential immortal time bias (HR 0.37, 95% CI 0.17-0.80, p = 0.01). Worsening histologic grade in PTC is independently associated with parallel escalation in mortality risk, on a scale approximating or surpassing established thyroid cancer risk factors. On preliminary analysis, EBRT was associated with improved survival in the most aggressive or least differentiated subvariants. Further investigation is warranted to examine the efficacy of EBRT for select poorly differentiated thyroid carcinomas.

Hashimoto's thyroiditis as a risk factor for thyroid cancer.

To summarize the recent developments in considering Hashimoto's thyroiditis as a risk factor for thyroid cancer. Modern approaches to understanding the co-occurrence of Hashimoto's thyroiditis and thyroid cancer have consistently found increased prevalence of both conditions, separately as well as of their coexistence. The inflammatory process in Hashimoto's thyroiditis is understood as a potential risk factor for thyroid cancer development. This has also provided a better understanding of the limitations in the current diagnostic and follow-up armamentarium for both conditions, resulting in international guidelines from the clinical and scientific societies. Other recent developments call for a paradigm shift in guidelines on thyroid carcinomas when lymphocytic infiltration is present, which potentially should always be considered the case at least in areas of sufficient iodine intake. The literature of Hashimoto's thyroiditis as a risk factor for thyroid cancer is reviewed over the last year to highlight new developments in the understanding of their association and future clinical implications.

Thyroid cancer: retrospective study of patients with surgical treatment (a single-center experience)

Introduction. Nodular goiter is one of the most common endocrine disorder, and thyroid cancer takes a leading place among malignancy of the endocrine system. The aim of our study is to evaluate the prevalence and risk factors of thyroid cancer. Materials and methods: this is a retrospective case-control study that included 140 patients operated with suspected thyroid cancer according to a cytological study of fine needle aspirates in single center in 2018. All patients underwent preoperative cytological examination with interpretation of the results according to the Bethesda system, thyroid ultrasound examination, thyroid status assessment. The results of the cytological examination, as well as clinical and laboratory data were compared with the data of histological analysis. Results: According to the preoperative cytological study, 76 nodules were reported as Bethesda IV, 4 – Bethesda III, 32 – Bethesda VI, 28 – Bethesda V. According to the results of a histological examination, thyroid cancer was confirmed in 70% of patients: in 89,3% of Bethesda V and 100% in the Bethesda VI group, 52,6% of Bethesda IV, 25% of the Bethesda III. The risk of nodule malignancy was associated with such ultrasound signs as hypoechoicity, calcifications and irregular contours. Conclusions: the improvement of the methods of preoperative diagnosis of thyroid cancer should help to choose the optimal surgical strategy, reduce the number of diagnostic and repeated thyroidectomy.

Obesity as a risk factor for thyroid cancer.

In this review, we evaluate recent findings related to the association between obesity and thyroid cancer. During the last several decades, the prevalence of obesity and thyroid cancer have been increasing in parallel on a global scale. Current evidence suggests that the growing incidence of differentiated thyroid cancer (DTC) is pathogenically linked to the spread of obesity, but the biological mechanisms that may explain this connection have been only partially described. Furthermore, unlike other tumors, data on the impacts of obesity on the aggressiveness of DTC and response to treatment of DTC remain conflicting. Emergent knowledge regarding the links between obesity and thyroid cancer suggests a relevant role for obesity as a risk factor for DTC, with no apparent impact on its aggressiveness.

Cancer screening activity results in overdiagnosis and overtreatment of papillary thyroid cancer: A 10-year experience at a single institution.

BackgroundIt is estimated that one of the potential cause of the increasing prevalence of thyroid cancer (TC) is the easier and widespread access to diagnostic tools. If an individual evaluates the thyroid gland due to a mentioned mechanism without considering TC risk factors or symptoms, we can describe this phenomenon as cancer screening activity (CSA).Aim of the studyWe 1) estimated what types of TC were diagnosed due to CSA, 2) analyzed what clinicopathological features were characteristic of TCs diagnosed by CSA, 3) determined if these features were characteristic of indolent cases, and finally we 4) assessed whether CSA could have resulted in the increasing incidence of potentially indolent papillary thyroid cancer (PTC).Materials and methodsA retrospective review of 4,701 medical records of patients admitted and surgically treated at one surgical center between 2008 and 2017 was performed. Among the enrolled patients, 569 (12.1%) had thyroid malignancy, and 514 (10.9%) were diagnosed with PTC. We divided these patients into two groups: 1) patients in whom TC diagnostics were performed without considering any TC risk factors or symptoms (CSA-yes) and 2) those in whom TC was diagnosed due to TC risk factors or symptoms (CSA-no). We then compared the clinicopathological features of these two groups.ResultsThe most common type of TC diagnosed in the CSA-group was PTC (p = 0.024). CSA-yes patients showed a significantly lower degree of Tumor-Node-Metastasis (TNM) staging and demonstrated a significantly lower rate of multifocality, but not of bilaterality (p<0.0001 and p = 0.198, respectively). In the CSA-yes group, the number of TC foci was significantly lower than that in the CSA-no group (p<0.0001). All clinicopathological features characteristic of aggressive cases of TC were absent in CSA-yes patients (p<0.0001), while all features observed in CSA-yes patients were characteristic of indolent cases (p<0.0001).ConclusionsThe use of CSA results in the diagnosis of indolent cases of PTC and may be one of the potential causes of overdiagnosis and overtreatment of this malignancy.

The Role of Vitamin D, Platelet-Derived Growth Factor and Insulin-Like Growth Factor 1 in the Progression of Thyroid Diseases

Background:Thyroid cancer (TC) is a common malignant tumor, however the role of total vitamin D: 25(OH)D, Platelet Derived Growth Factor (PDGF) and Insulin Like Growth Factor 1 (IGF-1) in the development of TC is still unclear. Aim:To assess the roles of 25(OH)D, PDGF and IGF-1 in the progression of thyroid diseases. METHODS: The serum levels of 25(OH)D, PDGF and IGF-1 were assessed in 70 patients with papillary thyroid cancer (PTC), 60 patients with benign thyroid nodules (BN) compared to 60 normal controls (NC) using ELISA technique. Results:There was a significant decrease in the serum level of 25(OH)D in TC patients compared to NC (P<0.001) and BN patients (P=0.006). There was a significant increase in the serum levels of PDGF and IGF-1 in TC patients (P<0.001), and BN patients (P<0.001) compared to NC, while there were no significant differences between TC and BN (P=0.087, and 0.258; respectively). PDGF correlated significantly with IGF-1 (r=0.412, P<0.001), TSH (r=0.146, P=0.045), and inversely correlated with 25(OH)D (r= -0.156, P=0.013) and FT4 (r=-0.178, P=0.014). There was a significant inverse correlation between the serum levels of IGF-1 and FT4 (r=-0.172, P=0.017). Sensitivity and specificity for assessment of TC patients were (65.7% and 58.3%, P= 0.001) for 25(OH)D, (65.7% and 58.3%, P=0.021) for IGF-1, and (68.6% and 61.7%, P=0.006) for PDGF. Multivariate analysis demonstrated that serum 25(OH)D (OR=0.578, 95%CI= 0.426-0.783), IGF-1 (OR=1.019, 95%CI= 1.010-1.029) and PDGF (OR=1.007, 95%CI= 1.004-1.009) were considered independent risk factors for thyroid cancer (P<0.001, for all). Conclusion:25(OH) D, IGF-1 and PDGF are significantly different in TC and BN cases compared to control. They have an important role in the progression of TC. However, these data should be validated on a larger sample size.

Obesity and Waist Circumference are Possible Risk Factors for Thyroid Cancer: Correlation with Different Ultrasonography Criteria.

BackgroundObesity has an important role in the pathogenesis of cancer; however, there are no clear mechanisms explaining the association between obesity and risk of thyroid cancer (TC).MethodsIt is a cross-sectional study including 184 patients with benign thyroid nodules (BN) and 19 patients with TC. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist/hip (W/H) ratio were assessed and correlated to relevant clinico-pathological features of the patients, different ultra-sonographic (U/S) criteria and risk of malignancy.ResultsThere was a significant increase in BMI, WC and W/H ratio in TC patients compared to BN group (P=0.001, 0.011 and 0.003). Increased BMI, WC and HC were associated significantly with solid nodules (P<0.05). WC increased in hypoechoic (103.1±15.4cm) and heterogeneous (103.8±16.7cm) nodules, compared to isoechoic (97.3±15.5cm) and hyperechoic (96.1±10cm) nodules (P=0.046). It also increased with lymph nodes enlargement (P=0.04). There was a significant association between WC and TIRADS classification (P=0.032), as it increased with TR4b (118.5 ± 12.9 cm) and TR5 (117.3 ± 13.9 cm) compared to TR2 (114.1 ± 15.7 cm, P=0.025 and 0.008, respectively). WC is an independent predictor for TC [OR: 1.092, CI: 1.020–1.170, P=0.012]. It achieved sensitivity, specificity and AUC (71.4%, 68.7% and 0.750; respectively), at a cutoff value of 108.5 cm (P=0.003), and when combined with BMI at a cutoff value of 32.59 (77.8% and 68.4%, respectively, AUC: 0.780, P<0.001).ConclusionCentral adiposity is strongly associated with the risk of TC. WC is more superior to BMI when correlated with TIRADS classification and also is an independent predictor for TC.

Thyroid cancer risk factors and Pakistani University students' awareness towards its preventive practice.

Thyroid Cancer is one of the rarest cancers but its prevalence has been increasing worldwide for the last couple of decades. The data collection tool was designed to assess knowledge, awareness, perception, and attitude towards preventive practices of thyroid cancer in Pakistani university students. The data were collected over a duration of six months and a total number of 3722 students participated. The knowledge of risk factors of thyroid cancer was an important parameter of this study. The students who knew all the early signs of thyroid cancer were 28.7%. In this study, the independent variables such as age, gender, demographic location, and financial status were found to be highly significant with knowledge, attitude towards warning signs of cancer, and the perception of students about developing thyroid cancer. The participants were found to have poor knowledge about early signs of thyroid cancer. The study participants perception, behavior, and attitude towards preventive practices of thyroid cancer were found inadequate and appropriate measures on a National level should be taken to enhance the knowledge about preventive practices of thyroid cancer. Increasing knowledge and awareness shall help decrease the overall morbidity and mortality linked with thyroid carcinomas and thyroid diseases.

Thyroid cancer in the world: An epidemiological review

BackgroundThyroid cancer is the most common malignancy of the endocrine glands at any age and sex. The present study was designed to comprehensively identify the epidemiological status of thyroid cancer using the results of similar studies.MethodsThe present study was an epidemiological review study. Studies on the epidemiology of thyroid cancer between March 2020 and April 2020 were searched by two researchers at four Latin scientific databases (Google Scholar, PubMed / Medline, Scopus, ISI Web of Science). Persian and Latin articles about the epidemiology of thyroid cancer were included in the study.ResultsThe incidence of thyroid cancer is increasing worldwide; however, this type of cancer has a good survival rate. The most important risk factors for thyroid cancer include Ionizing radiation, diet, female gender, age, genetic background and race and ethnicity.ConclusionThe incidence of thyroid cancer in the world is increasing. Therefore, preventive and protective measures to reduce the risk factors of this cancer are recommended to reduce the incidence of the disease.

Risk Factors for Thyroid Cancer: What Do We Know So Far?

SUMMARYThyroid cancer (TC) is the most common endocrine cancer today. The rising incidence of the differentiated papillary type cannot be entirely explained by early and meticulous diagnosis, since a proportion of large tumors has also been reported. In this review, we present the results of numerous investigations focused on possible factors causing increased TC incidence, such as chromosomal and genetic alterations, iodine intake, TSH level, autoimmune thyroid disease, gender, estrogen, obesity, lifestyle changes, and environmental pollutants. Up to now, only childhood exposure to ionizing radiation has been fully recognized as a risk factor. There is also a possibility that yet undiscovered carcinogens, especially during intrauterine life or early childhood, might be responsible for increased TC incidence as well as epigenetic changes. Therefore, more studies are necessary in order to further investigate the potential risk factors for TC and their mechanisms of action.

Risk of second primary papillary thyroid cancer among adult cancer survivors in the United States, 2000-2015

BackgroundWhile radiotherapy is a major risk factor for thyroid cancer after childhood cancer, factors contributing to increased thyroid cancer risk after adulthood cancer remain unclear. MethodsWe evaluated second primary papillary thyroid cancer (PTC) risk among 3,175,216 ≥ 1-year adult survivors of non-thyroid malignancies from US population-based cancer registries (2000–2015), using standardized incidence ratios (SIRs). Because heightened surveillance may increase detection of indolent thyroid tumors and earlier detection of advanced tumors, we examined SIRs by PTC stage and time since first cancer (latency). ResultsSIRs for second primary PTC (N = 4333) were statistically-significantly 1.2–3.5-fold elevated overall and after 23/27 first cancer types evaluated, with generally similar risks for localized and regional/distant PTC. SIRs for regional/distant PTC (N = 1501) were highest after pancreatic (SIR = 3.7; 95% confidence interval [CI] = 1.9–6.5) and soft tissue (SIR = 4.2; 95%CI = 2.8–6.2) cancers, followed by melanoma, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), diffuse large B-cell lymphoma, and larynx, kidney, and brain/central nervous system (SIRs = 2.0–2.9) cancers. SIRs typically decreased with increasing latency but remained statistically-significantly elevated for regional/distant-PTC ≥5 years after diagnosis of cancers of the rectum, pancreas, lung/bronchus, soft tissue, female breast, uterine corpus, prostate, and kidney, and after melanoma, Hodgkin lymphoma, CLL/SLL, and follicular lymphoma. Neither total nor regional/distant PTC were clearly associated with initial course of radiotherapy or chemotherapy. ConclusionsPTC risk was elevated after a range of first primary adult cancers but was not clearly related to treatment. Although surveillance may contribute to elevated short-term risks of PTC, longer-term elevations in regional/distant PTC may be attributable to shared risk factors.

Molecular markers as risk factors for thyroid cancer

Thyroid cancer is the most common malignant tumor of the endocrine system. An increase in the incidence of thyroid cancer has been noted over the past decade, mainly due to papillary cancer. The influence of environmental factors, increased availability of medical care, including sensitive diagnostic tests, such as ultrasound and fine - needle aspiration (FNA), can affect the fact of the growth of this incidence. Palpation of thyroid gland has very low diagnostic value for detecting thyroid cancer, while thyroid ultrasound and FNA can detect malignant tumors in 20% of cases. Today, the FNA is the fastest, most accurate, economically accessible, and quite safe method for cytological diagnosis of the thyroid nodules. And molecular genetic testing of FNA samples could serve as an additional reliable diagnostic tool in the case of atypia of undetermined significance.

Dental X-Rays and the Risk of Thyroid Cancer and Meningioma: A Systematic Review and Meta-Analysis of Current Epidemiological Evidence.

Background: Exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for thyroid cancer and brain and central nervous system tumors. Considering the high lifetime prevalence and frequency of exposure to dental X-rays, the most common source of diagnostic radiation exposure in the general population, even a small associated increase in cancer risk would be of considerable public health importance. With the objective to inform clinical practice and guidelines, we synthesized the current epidemiological evidence on the association between dental X-rays and the risk of thyroid cancer, meningioma, and other cancers of the head and neck region. Methods: The Medline, Embase, and Web of Science databases were searched to identify eligible studies. Summary odds ratio/relative risk estimates and confidence intervals were extracted, and pooled risk ratios (RRs) for each cancer were calculated using random effects meta-analysis. Results: The literature search identified 5537 publications; of these, 26 studies including 10,868 cancer patients were included in the synthesis. The random effects meta-analyses, based on seven studies of thyroid cancer (six case/control, one cohort) and eight studies of meningioma (all case/control), showed that multiple (or repeated) exposures to dental X-rays were significantly associated with an increased risk of thyroid cancer (pooled RR = 1.87 [95% confidence interval, CI 1.11-3.15]) and meningioma (pooled RR = 1.53 [CI 1.26-1.85]). There was no association with glioma, and there were too few studies of other cancers of the head and neck region to conduct a meaningful meta-analysis. Conclusions: Based on a meta-analysis of retrospective case/control studies, these findings provide some support to the hypothesis that multiple (or repeated) exposures to dental X-rays may be associated with an increased risk of thyroid cancer and meningioma. These studies did not include individual organ doses and ages at exposure, and are subject to recall bias and other limitations. Furthermore, the thyroid exposure has decreased dramatically over time from the use of thyroid shields and improved technology/equipment. Prospective studies, based on dental X-ray records and patient follow-up, are needed to test the hypothesis further and clarify the possible cancer risk associated with dental radiography, as although the risk at the individual level, particularly with improved technology/equipment, is likely to be very low, the proportion of the population exposed is high. Considering that about one-third of the general population in developed countries is routinely exposed to one or more dental X-rays per year, these findings manifest the need to reduce diagnostic radiation exposure as much as possible.

Progressive evolution of thyroid adenoma to thyroid carcinoma

Nodules (adenomas), enlarged thyroid (goiter) and inflammation of the thyroid (thyroiditis) are the most important risk factors for thyroid cancer. Adenomas have the largest increase in risk. Objectives: to discuss two cases of adenomas goiter that became aggressive during follow-ups. Cases: Two patients, with an average age of 64 years, referred to Nuclear Medicine dr. M. Djamil Hospital in Padang for bone scintigraphy examination. Both patients had thyroid surgery and histopathology results were adenomas. However, after the removal surgery, the patients did not have proper follow-ups. Both patients developed pelvic pain. Bone scintigraphy showed an increase of radiopharmaceutical uptake at pelvic bones and computerized tomography (CT Scan) result showed destruction at the pelvic bone areas. Conclusions: These cases highlight the necessity for adenoma thyroid patients with a risk factor for thyroid cancer to have a complete follow-up program and sufficient length period.

IL1A & IL1B genetic polymorphisms are risk factors for thyroid cancer in a Chinese Han population

IntroductionThyroid carcinoma accounts for a large proportion of endocrine neoplasia, and the relationship between inflammation and thyroid cancer has been previously validated. IL-1α (Interleukin 1 alpha) and IL-1β (Interleukin 1 beta), encoded by IL1A and IL1B, respectively, are implicated in numerous inflammatory responses and in tumor progression. The objective of this research was to assess the association of genetic polymorphisms of IL1A and IL1B with the risk of thyroid cancer in a Chinese Han population. Materials and methodsGenotypes of the 12 candidate SNPs in IL1A and IL1B were identified among 208 thyroid cancer patients and 279 healthy controls using an Agena MassARRY method. Genetic model analysis was carried out to evaluate the significant links between the variants and thyroid cancer risk. HaploReg v4.1 and the GTEx database were used for SNP functional annotation and expression quantitative trait loci (eQTL) analysis, respectively. ResultsSignificant associations were detected between IL1A rs3783521 and an increased thyroid cancer risk in our study population (p < 0.05). IL1A rs3783546 and rs3783521 were associated with an increased cancer risk in men, and IL1B rs3136558 and rs1143623 were associated with an decreased cancer risk in women. Meanwhile, rs3783550, rs3783546, rs1609682, and rs3783521 in IL1A were identified as biomarkers of risk among individuals aged ≤48 years. Rs3136558 and rs1143623 in the IL1B gene showed strong correlations with a susceptibility to thyroid cancer among individuals aged >48 years. Additionally, bioinformatics and eQTLs analysis also provided supporting evidence for the effects of the SNPs on gene regulation. ConclusionsOur study is the first to report that IL1A and IL1B polymorphisms are risk factors for thyroid carcinoma in a Chinese Han population.