Thyroid nodule risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Prevalence of thyroid incidentalomas estimated from autopsy studies ranges from 30% to 60%. Studies comparing clinical palpation with thyroid imaging show a prevalence of 13% to 50%. Prospective studies of randomly selected patients have reported a prevalence of 19% to 67%. The risk for malignancy in asymptomatic nodules found in nonirradiated glands is 0.45% to 13% (mean +/- SD, 3.9% +/- 4.1%).

Risk Factors

Other factors associated with an increased risk of thyroid nodules and goiter include:

• Hard nodule
• Nodule that is stuck to nearby structures
• Family history of thyroid cancer
• Younger than 20 or older than 70
• History of radiation exposure to the head or neck
• Male gender
• Smoking 11863477
• Alcohol consumption 18031329
• Insulin-like growth factor 1 (IGF-1) levels

thyroid nodules in men and decreased serum TSH levels in women 17666480

• Uterine fibroids 17988198

Factors associated with a possible decreased risk include:

• Oral contraceptive use 12100072
• Use of statins (associated with a reduced risk of nodules on ultrasound)
  • reduced prevalence, number and volume of thyroid nodules 17666091

• A history of papillary thyroid cancer in at least one first-degree family member is associated with an increased risk of a nodule being malignant

  10030330

  1415299

  Papillary thyroid carcinoma

  Hepatitis C-related chronic hepatitis (odds ratio [OR] 12.2 in one report) 17542674

  Increased parity and late age at first pregnancy 10965973